Inspection on 23/01/06 for The Manor Farm House

This inspection was carried out on 23rd January 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Manor Farm House 09/11/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Manor Farm House Church Street Radstock Bath Bath & N E Somerset BA3 3QG Lead Inspector Carole White Announced Inspection 23rd January 2006 10:00 X10015.doc Version 1.40 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 Manor Farm House DS0000065524.V271204.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 Older People. 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 Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Manor Farm House Address Church Street Radstock Bath Bath & N E Somerset BA3 3QG 020 8909 2986 020 8909 2986 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) ARTI Services Ltd Mr William Sorby Docherty Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 20 persons aged 65 years of over requiring personal care 15th & 16th August 2005 Date of last inspection Brief Description of the Service: Manor Farm House is a privately owned care home in Radstock, which is an exmarket town some eight miles from Bath and the Somerset village of Frome. The property itself is an attractive 18th century converted farmhouse. Radstock offers a range of shops and facilities, including a bank, post office, library, college, churches of different denominations, a local museum, hairdressers, a dental surgery and a good bus service, all of which are just a few minutes walk away from the home. The home offers two communal lounges, a conservatory overlooking the rear garden, a dining room and a spacious hall. All of these communal facilities are located on the ground floor. There are fifteen bedrooms, ten single and five shared rooms. There are no en suite facilities, but all rooms are equipped with was hand basins. The home has an attractive enclosed rear garden, small front garden, and car parking to the side of the home. There is also a free public car park directly opposite the home. The home changed ownership at the end of September 2005. The previous owners also managed the home, therefore a new manager has been appointed who was a senior worker at the home. This person has now been registered with the Commission for Social Care Inspection as manager. The outgoing owners are four months into a six-month consultancy period and will continue to work with the new owners until the end of March 2006. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place in one day in the presence of the Responsible Individual Mrs Raja and the newly registered manager Mrs Amanda Allen. On the day of the inspection the home had 18 residents. Two of the shared rooms only have single occupancy at the moment. Comment cards were given to residents and relatives/visitors prior to the inspection. 15 were returned from residents and 6 from relatives/visitors. The inspector spoke to 4 care workers, the cook and 12 of the residents seeking their views of the home. A tour of the building was conducted and records examined. What the service does well: The home offers a comfortable homely environment with a friendly and welcoming atmosphere. Residents spoken to and comment cards received confirmed that they were happy living in the home, enjoyed the meals and the staff treated them well. Their comments included: “very good care and nice place to live”, “activities very good, food good”, “lovely home”, “I feel safe living here”, “ I get on very well with the staff”. There was clear evidence from observing staff that they treat the residents with respect, and have built good relationships with them. A key worker system is operated. The home has an activities co-ordinator working 6-8 hours per week, and a variety of daily activities are provided in the home. Trips outside of the home are also arranged including visits to museums, pub lunches, the local park and theatres visits. The manager will often accompany residents to appointments, such as opticians, and assist residents to shop for new clothes. The home is fully staffed and retention rates are high. The morale of the staff team is good and the staff and residents respond well to the new manager. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 6 The home does not use agency staff as the staff team works together to cover for sickness and holidays. Meals are varied and although the menu is set without a choice, residents are informed in advance of the menus and other choices are offered if required and any personal preferences are accommodated. Residents’ needs are assessed before moving into the home and care plans are developed with the residents and their families. Residents are able to personalise their rooms and bring in their own furniture. What has improved since the last inspection? What they could do better: The home’s protection of vulnerable adults policy and procedure has been amended since the last inspection, but still suggests that staff would undertake an investigation. Staff still need to be made aware that the local authority would lead any investigation of potential abuse cases. The policy also needs to state that Social Services and the Commission for Social Care Inspection need to be informed of any cases. Residents or their representatives should sign the care plans. It is recommended that as reviews are carried out residents are asked to sign to say that they agree with the care plan drawn up. Residents care plans would benefit from greater detail about what actions the care staff should take, so that the residents’ needs and preferences can be fully met. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 7 With the resident’s consent a referral should be made to social services to explore what other options could be available for the resident who has low level needs. 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 Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5 Current and potential residents have access to the relevant information to make an informed choice about the home and trial visits to the home are facilitated. An assessment of the residents’ needs is carried out prior to moving into the home. The home demonstrates that it has the ability to meet the needs of the residents. EVIDENCE: The Statement of Purpose and Service user Guide have been updated to reflect the change of ownership and new manager, and provide information that is expected in the legislation and in this standard. There was evidence from the six residents files examined that assessments are carried out prior to moving into the home. The manager or owner visits each new resident to assess their needs and the person is able to visit the home for the day to see if they like it. New residents move into the home on a trial period of one month. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 10 There was clear evidence from speaking to residents and comments received prior to the inspection that residents are satisfied that the home can meet their needs. At the last inspection it was recommended that the resident who goes out everyday to visit their partner and drives their own car should have their situation reviewed with Social Services. The home has asked the resident if they are happy to stay there, which they are, but Social Services were not contacted. At this inspection it was still apparent from speaking to the resident and staff that other options should be on offer, to enable this person to make an informed choice about where to live. The resident seems unaware that other options may be available. It is recommended that with the resident’s consent a referral should be made to social services to explore what other options could be available. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 Residents care plans are well documented, but would benefit from greater detail about what actions the care staff should take, so that the residents’ needs and preferences can be fully met. The care planning process involves the residents, but residents or their representatives should sign the care plans. Residents feel that they are treated with respect and their right to privacy is upheld. EVIDENCE: Eight residents’ files were examined and there was evidence that residents’ preferences are considered and their needs met. The care plans give an “overall aim of the care plan” and any actions that should be taken to achieve that aim. The manager advised the inspector that care plans are developed with the residents and the home has just started monthly reviews. It is recommended that residents or their representatives sign the care plan as confirmation that they are in agreement with its content as reviews are carried out. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 12 It is also recommended that further detail be added to care plans in order to develop how care duties should be carried out by staff. For example instead of saying, “assist with bathing” give details of how that individual likes to have a bath and exactly how much assistance they need. Individual contact books are used to maintain daily records for each resident. In the front of each book is a personal profile of the resident and a photograph. Entries are made each day be staff and these records were comprehensive and informative. There was also evidence of requests for changes to daily routine being recorded. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 Residents are offered a range of activities both within and outside of the home that enables them to have choice and flexibility in their lifestyle. Daily routines in the home are flexible and allow residents to have choice and control over their lives. The home offers a balanced choice of meals in a relaxed and pleasant environment. EVIDENCE: The home has an activities co-ordinator working 6-8 hours per week, and a variety of daily activities are provided in the home including craft sessions, bingo, sing-a-longs, memory boards and card games. Trips outside of the home are also arranged including visits to museums, pub lunches, the local park and theatre visits. The new manager has held a residents meeting, and these will continue about every 2 months. As a result of the meeting all residents now have books, jigsaws and cards to use when other activities are not taking place. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 14 A hairdresser and chiropodist visit the home regularly and communion takes place each week. Residents confirmed that they are able to exercise choice about the times that they get up and go to bed. All residents spoken with said that their relatives were free to visit the home whenever they wanted to. An eight-week menu plan is used to keep the meals varied and although the menu is set without a choice, residents are able to ask for an alternative. The inspector had lunch with the residents and witnessed two residents have a different meal cooked for them at their request. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 There is a clear complaints policy and information is given to residents and their families detailing how to complain. Residents are protected by good communications and good record keeping. However, the home’s protection of vulnerable adults policy and procedure needs to be amended in order to clarify the actions to be taken when staff report suspected or actual abuse. EVIDENCE: There have been no complaints received by the home or the commission since the last inspection. Most residents spoken to and those who completed comment cards confirmed that they knew whom to contact if they had any concerns. All except two new staff have received Adult Abuse training through B&NES Social Services. New staff are booked for an alerters course in March and the owner and the manager are booked on an investigators course in March. The home’s protection of vulnerable adults policy and procedure has been amended since the last inspection, but still suggests that staff would undertake an investigation. The procedures should give clear instructions to Staff about who they would report any suspicions of abuse to, and staff also need to be made aware that the local authority would lead any investigation of potential abuse cases. The policy also needs to state that Social Services and the Commission for Social Care Inspection need to be informed of any cases. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 & 26 Residents live in a safe, well-maintained environment with access to comfortable communal facilities. Toilet, washing and bathing facilities are sufficient to meet the residents’ needs. Residents are able to bring their own possessions and furniture to personalise their rooms. The home is maintained in a clean and hygienic state. EVIDENCE: The inspector conducted a tour of the premises. The home has a homely and pleasant feel about it with residents rooms personalised with their own possessions. There are sufficient washing and bathroom facilities to meet the residents’ needs. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 17 The two lounge areas are comfortable and clearly used by the residents. The dining room is small but the large adjoining conservatory is also used for eating. The conservatory is a light and pleasant room both to sit and eat in. The home was clean and tidy on the day of the inspection. The bathrooms, toilets, commodes in residents’ rooms and the kitchen were all hygienically clean. There is a nice garden with seating to the rear of the premises and one resident was seen to use the garden during the course of the inspection. The home is well maintained; the previous owner still carries out any repairs required. The new owner informed the inspector that she would be employing a person to carry out maintenance work before the previous owner leaves. Any plans that the new owner may have to make any changes to the premises were not discussed in detail. If any changes are panned then the commission should be kept informed. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 29 Residents’ needs are met by the numbers and skill mix of the staff. The home’s recruitment procedures protect and keep the residents safe. EVIDENCE: Evidence from speaking to staff, the manager and residents shows that the home has sufficient staff to met the residents’ needs. The inspector reviewed the rota for the next two weeks. The home is fully staffed and retention rates are high, with a team of long standing members of staff. The home does not use agency staff as the staff team works together to cover for sickness and holidays. 42 of staff have either achieved or are working towards NVQ level 2. Plans are in place to enrol more staff this year. Progress of this will be a focus of the next inspection. The recruitment and selection procedure is sound and the manager is updating the application form to include a larger section for previous employment history. Personal files are also being updated by the manager. The manager is arranging for staff to attend specialist training courses and at the next inspection the progress of this will be examined. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 The home is well managed and the manager communicates a clear sense of direction and leadership, ensuring that the home in run in the best interests of the residents. The health, safety & welfare of the residents and staff are promoted and protected. Residents’ financial interests are safeguarded. EVIDENCE: The home changed ownership at the end of September 2005. The previous owners also managed the home, therefore a new manager has been appointed who was a senior worker at the home. The out going owners are four months into a six-month consultancy period and will continue to work with the new owners until the end of March 2006. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 20 Mrs Allen as the new manager has undertaken a registration process and has now been approved by the Commission for Social Care Inspection. Mrs Allen is working towards her NVQ level 4 and Registered Manager Award. The previous owners are still spending time in the home but it was clear that the new owner and manager are running the home and developing their own style and relationships with the residents and staff. The owner spends about three days a week in the home and she has developed a good working relationship with the manager. The residents and staff responded well to the new owner when she went around the home. Residents spoken to say that they liked her. There is clear evidence from spending time in the home and speaking to the staff and residents that the home is well run under the new management and ownership. There was no indication that this change was causing any concern to either residents or staff. The manager has build good working relationships with the staff and residents and it is clear that both respect her. Staff spoken to all said that they enjoyed working in the home and there is a good team spirit. The owner manages and records the personal allowances of the residents. These records were examined and found to be in order. Staff supervision has started and this standard will be a focus for the next inspection. A fire safety risk assessment on the premises has been carried out since the last inspection and fire drills and fire safety training for staff is up to date. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP18 Regulation 13.6 Requirement The home’s protection of vulnerable adults policy and procedure must be amended to state that Social Services will lead any investigation and all cases should be reported to both Social Services and the Commission for Social Care Inspection. (previous timescale of 30.10.05 only partial met) Timescale for action 30/04/06 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 2 3 Refer to Standard OP3 OP7 OP7 Good Practice Recommendations Make referral to Social Services so that further options can be discussed with the resident who has low level needs. Residents or their representatives should sign their care plans. Residents care plans should be in sufficient detail to provide clear guidance to staff on the action to be taken to meet their health needs. The Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Manor Farm House DS0000065524.V271204.R01.S.doc Version 5.0 Page 24 - 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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