Inspection on 09/11/06 for The Manor Farm House

This inspection was carried out on 9th November 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 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 Manor Farm House 23/01/06

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 Unannounced Inspection 9th November 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.V319209.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 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.V319209.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor Farm House Address Church Street Radstock Bath Bath & N E Somerset BA3 3QG 01761 436127 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 Ms Amanda Jayne Allen 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.V319209.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 20 persons aged 65 years of over requiring personal care 23rd January 2006 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 one communal lounge, a conservatory/lounge 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, although currently one shared room has single occupancy. 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 range of fees for the home are £380-£410 per week. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection for the home carried out in one day. A tour of the premises was conducted and records were examined. The inspector spoke with 6 members of staff including the manager and assistant manage, who both assisted the inspector with the inspection. 8 residents were spoken with during the course of the inspection, together with 2 relatives/friends who were visiting the home. On the day of the inspection the home had 19 residents. Surveys forms were sent to the home prior to the inspection and given to residents. 13 surveys forms were returned from residents and 7 comment cards from relatives/visitors and 3 comment cards from Doctors. What the service does well: What has improved since the last inspection? The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 6 There are no outstanding requirements from the last inspection. The manager and her team have worked hard since the last inspection to update residents’ care plans to include more detail about residents’ wishes and preferences. Care plans now have details of the actions that staff need to take to ensure that residents’ needs are met. The care plans are also being reviewed monthly and residents are involved in that process and signing where they are able to do so as agreement to that care plan. The home’s Protection of Vulnerable Adults policy has been amended to show that any potential abuse cases should be referred to Social Services and CSCI informed of this. 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 summary of this inspection report can be made available in other formats on request. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 7 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.V319209.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 & 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each resident has a written contract that sets out some of the terms and conditions that apply to living in the home, although this information would be improved by the contract being updated. Residents’ needs are assessed before moving into the home for those that are social services funded. A care needs assessment for privately funded must be documented. Residents and their families know that the home has the ability to meet their needs. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 9 EVIDENCE: Four of the six files examined showed evidence of a care needs assessment that had been carried out by social services. Two of the files examined were for residents who are privately funded. These two files did not have any clear evidence of a care needs assessment. Although it is clear from discussions with the manager that comprehensive information is gathered at the referral stage for all new residents, in order to ascertain if the home can meet the residents needs. It is especially important that a care needs assessment is documented for residents who are self funding as no other form of assessment is available. It is therefore required that a care needs assessments be carried out and recorded for all privately funded residents. All of the files examined had a copy of a contract signed by the resident, although this document has not been updated for some time. It is recommended that the contract be amended to cover the points in Standard 2. In particular to include the room number, what services the fees cover and what services are charges as extra. Also to cover the rights and obligations of the residents and the home and who is liable if there is a breach of contract. Evidence from speaking with residents and their relatives and surveys received confirms that residents feel that the home can meet their needs. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs are recorded in a care plan that is developed with the residents. Resident’s health care needs are fully met. Residents feel that they are treated with respect and their privacy is upheld. Medication management and recording systems and practice protect service users. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 11 EVIDENCE: The manager and her team have worked hard since the last inspection to update residents’ care plans to include more detail about residents’ wishes and preferences. Care plans now have details of the actions that staff need to take to ensure that residents’ needs are met. The documentation was well presented and easy for staff and residents to understand and follow. The care plans are also being reviewed monthly and residents are involved in that process and signing where they are able to do so as agreement to that care plan. All six files examined had a comprehensive care plan, with clear records of monthly reviews and up to date risk assessments. One resident had a fall recently and there was clear evidence of an updated care plan and a revised risk assessment identifying new risks as a result of his decreased mobility. Although a separate log on each file showed that the care plans are reviewed monthly, the care plans did not show a date. Therefore it was difficult to know exactly when any changes had been made to the care plan. It is recommended that care plans are dated in the future to give clarity as to when changes have occurred. In conjunction with the local hospital the home has developed ‘advanced care plans’. This consists of one sheet that gives basis information about the person and their conditions, the home that they live in and their wishes with regard to resuscitation. In the event of someone being admitted to hospital this form will go with him or her to give the hospital information about the person and contact details. These forms are only completed with the agreement of the resident, and all those viewed were signed by the resident to confirm their agreement with the information. Individual contact books are used to maintain daily records for each resident. Each book has a personal profile of the resident and a photograph at the front of the book. Entries made by staff were seen to be comprehensive and informative and written in an appropriate manner. Evidence of district nurse and G.P involvement showed that health care needs are fully met. One resident spoken with confirmed that since he had had a fall the home been helpful in arranging doctor’s appointments for him. The medication round was observed by the inspector. Medication is administered through a dosage system and a senior care worker administers the medication to the residents. Medication is stored appropriately and records examined were found to be correct. As required medication is also put into The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 12 each resident’s dosage box and recorded as a refusal if not required at that particular time. Evidence from speaking to residents and from the comment cards shows that service users feel that they are treated with respect and their right to privacy is upheld. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a range of activities within the home that enables them to have choice and flexibility in their lifestyle. Residents are able to receive visitors at their convenience. The home offers a balanced choice of meals in a relaxed and pleasant environment. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 14 EVIDENCE: The home has a part-time activities co-ordinator who comes in each day to organise a range of activities. These include bingo, sing-a-longs, card games, exercise to music and craft sessions. In addition to this the home regularly takes residents out on trips to local shops, pub lunches and the theatre. A hairdresser and chiropodist visit the home regularly and communion takes place each week. Residents meetings take place monthly to discuss forth-coming events and ideas for outings and activities. Recently the home organised a party with a bonfire and entertainment, which families attended. Many residents spoke about this event at the inspection, which clearly had been very enjoyable for them. On the day of the inspection one resident asked if someone could walk with her to the local shops. This was arranged straight away and is was clear from the interaction between the resident and staff that this is a regular occurrence that is facilitated spontaneously as and when the resident feels she wants to go out. Two relatives visited the home during the inspection and both confirmed that they are always made welcome and are free to visit whenever they like. The home has a relaxed, friendly and homely environment and all residents spoken with and surveyed confirmed that they are happy living there. The interaction observed between residents and staff is good and staff are kind and attentive to their needs and wishes. Daily routines are flexible and staff accommodate individual lifestyle choices, whilst enabling residents to remain as independent as possible. An eight-week menu plan is used to keep the meals varied and although the menu is set, residents can ask for an alternative. Evidence was seen in the kitchen of a list of any special dietary requirements or requests that residents may have. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple, clear complaints procedure and residents know how to access it. The home promotes the protection of residents from abuse through the training and awareness of staff. EVIDENCE: There has been one complaint received by the home since the last inspection and none by CSCI. Full details of the complaint, the action taken and the outcome were clearly recorded. All of the residents spoken with and surveyed confirmed that they knew how to complain. Since the last inspection the home’s Protection of Vulnerable Adults policy has been amended to show that any potential abuse cases should be referred to Social Services and CSCI informed of this. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 16 Staff have attended Protection of Vulnerable Adults courses through B&NES Social Services. The manager and owner of the home have attended an investigators course. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. The home is maintained in a clean and hygienic state. Bedrooms are comfortable and residents can personalise them with their own possessions. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 18 EVIDENCE: The inspector conducted a tour of the premises and overall the home was clean, hygienic and odour free. Residents spoken with and surveyed also confirmed that the home is maintained in a clean and hygienic state. Some rooms are small but the home encourages residents to make the most of the available space and residents had personalised their rooms with pictures and ornaments. Each bedroom has a washbasin and there are sufficient bathroom and toilet facilities to meet the residents’ needs. Since the last inspection the conservatory is no longer used as the dining room and one of the lounges is now used to eat in. This change was made because some residents would stay in the conservatory all day and it was felt that a completely separate dining room would be more beneficial to residents. Residents spoken with confirmed that this was a better arrangement. The conservatory is used for the activities and residents will play cards and do puzzles independently. The smaller lounge has a television in whilst the conservatory does not have a television, which gives residents a choice as to the type of environment they wish to sit in. The home also has attractive garden with seating that is viewed from the conservatory. The home employs a maintenance person who comes in every day. On the day of the inspection the back of the bath seat in one of the bathrooms was broken. The manager advised that a new one had been ordered and it arrived whist the inspector was there and was fitted that day. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by the numbers and skill mix of the staff. Residents are protected by the home’s robust recruitment policies and practices. The home ensures that staff are trained and competent to carry out their jobs in order to meet the residents’ needs. The numbers of staff that are NVQ qualified and working towards qualification ensures that residents are in safe hands. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home has sufficient staff on each shift to meet the residents’ needs. 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 staff work together to cover for holidays and sickness. Staff spoken with at the inspection clearly enjoy working in the home and they work well together as a team. The dedication and commitment of the staff team creates a happy relaxed atmosphere that clearly benefits the residents. Since the last inspection the home has increased the numbers of staff who have either completed or are working towards NVQ level 2. The home now has 50 of staff that have NVQ level 2 and there is an on-going programme in place to recruit the remaining members of staff. Six staff files were examined and all found to have the relevant documentation. The training files were also examined for the same six members of staff and statutory training was up to date. Since the last inspection staff training in fire safety has been updated and measures are in place to systematically maintain the required frequency of training. In addition staff have received training in kitchen hygiene, safe handling of medicines and first aid. Since the last inspection the application form has been updated and is clearer and easier to follow and also includes a larger section for details of the applicants previous employment history. All residents and relatives spoken with and surveys confirmed that the staff are competent to do their jobs. The care workers spoken with at the inspection all confirmed that they felt that they had been well trained to carry out their work and are encouraged to develop their skills with on-going training. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Staff are informally supervised, but would benefit from a structured approach to formal supervision. The health, safety & welfare of the residents and staff are promoted and protected. Residents’ financial interests are safeguarded. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 22 EVIDENCE: Evidence from residents and relatives spoken with and surveyed confirmed that they have confidence in the way in which the home is run. Just prior to the inspection the home had appointed an assistant manager to help the manager with the running of the home and the supervision of staff. Ms Allen works closely with the proprietor and demonstrates that she has a clear vision of the quality service that she feels the home can achieve. There is clear evidence that staff have regular meetings and have informal supervision and are supported in their work by the open culture of the management of the home. The manager has not yet set up a systematic programme for regular formal one-to-one supervision. Although, now that the home has an assistant manager the manager feels confident that a programme for supervisions can be implemented very soon. Staff spoken with confirmed that communication between them and the manager is good and they would always feel comfortable raising any concerns. Residents meetings are held monthly and the outcomes from these are clearly recorded. Appropriate risk assessments are in place to ensure the safety of residents and staff, these are reviewed monthly. Records relating to the testing of the home’s fire alarm system and equipment were up to date, and staff are up to date with fire drill training. Since the last inspection the home has carried out a survey of the residents views of living in the home. Residents and their relatives/friends were asked 15 different questions about their care plans, the cleanliness of the home and how it is maintained and if they are happy living in the home. All of the questions from both the residents and their relatives/friends were answered as good or excellent. The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 23 The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 24 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 X 2 2 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 3 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 The Manor Farm House DS0000065524.V319209.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1)(a) Requirement A comprehensive care needs assessment must be carried out and recorded for all privately funded residents. Timescale for action 31/01/07 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 OP2 OP7 OP36 Good Practice Recommendations The contract should be amended to include all of the points in Standard 2. Care plans should be dated to give clarity as to when changes occur. A systematic programme should be introduced to achieve one-to-one supervisions for staff of at least 6 times a year. 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