Inspection on 22/02/06 for The Old Farm House Residential Home

This inspection was carried out on 22nd February 2006.

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 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 Old Farm House Residential... 17/01/07

The Old Farm House Residential... 05/12/05

The Old Farm House Residential... 26/03/05

The Old Farm House Residential... 16/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Old Farm House Residential Home 48 Hollow Lane Canterbury Kent CT1 3SA Lead Inspector Jenny McGookin Unannounced Inspection 22nd February 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 Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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 Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Farm House Residential Home Address 48 Hollow Lane Canterbury Kent CT1 3SA 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) 01227 453685 Mr Paul Straker Mrs Vivien Fuller Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 Brief Description of the Service: The Old Farm House is privately owned and is registered to provide accommodation and personal care to 23 older people. It is located about a mile and a half from Canterbury town centre, with all the community resources and transport links that implies. What was originally a rural setting (hop fields), this is now a residential area, but the home retains views of the cathedral. There is ample car parking space. The home comprises an older detached building with a purpose built extension, set within an enclosed garden. The accommodation is on two floors, linked by a passenger lift and staircase. There are nineteen single rooms and two rooms with shared occupancy, although these are sometimes used as larger single rooms. Each bedroom has a private toilet, wash hand basin, and (with the exception of the shared rooms) a bath or shower. All rooms are connected to a call bell system, and each bedroom also has a T.V and telephone point. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which was used to check progress with matters raised from the last inspection (December 2005,) accepting their timeframes had still to run their course; and to reach a preliminary view on other aspects of the day-to day running of the home. This report should, therefore, be read in conjunction with the December report. The inspection process took just over eight hours, and involved meetings with two residents individually, and four residents over lunch; the proprietor, the deputy manager (the registered manager was on annual leave), and one member of the care staff. Interactions between staff and residents were observed throughout the day. The inspection also involved an examination of records and policy documents and the selection of two residents’ care planning files, to track their care. Two bedrooms were inspected for compliance with the National Minimum Standards on this occasion, along with some communal areas, in passing. What the service does well: What has improved since the last inspection? With the exception of the Registered Proprietor’s compliance with Regulation 26 inspection reports (see below), all matters raised for attention at the last inspection had been addressed ahead of the time frames set. This is judged a good use of the inspection and regulatory framework. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 6 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 Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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 Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 4, 5, 6 1. The registered person has produced and makes available to service users an up-to-date statement of purpose and provides a service users’ guide to the home for current and prospective residents. Consideration should be given to providing this information in other formats to meet special needs. 4. The registered person is able to demonstrate the home’s capacity to meet the assessed needs of individuals admitted to the home 5. Prospective residents, or their representatives, have the opportunity to visit the home before proceeding with the admission and there is a trial stay to further inform their choice. 6. This home does not provide intermediate care EVIDENCE: Public Information This home has a Statement of Purpose and Service User Guide, but these documents were not inspected on this occasion as four successive inspections have found full compliance with all the elements of this standard. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 9 No other languages are currently warranted, but given the fact two residents are visually impaired, the home should give consideration to making this information available in large print and audio tape – so that residents have all the information they need, in readily accessible formats, to make informed choices. Feedback on the day of this inspection confirmed that the decision to apply to this home was influenced more by its locality (i.e. close to where the resident or their friends or relatives lived) and by personal recommendation, or previous contact than by any public information produced by the home itself. The residents were satisfied with the choice of home made. Capacity to Meet Needs and Admission Process The home carries out a preadmission assessment, and there is a standard preadmission assessment format to ensure a consistent approach. Most residents are privately funded, but the inspector was advised that the home would also take any preadmission assessments carried out by funding authorities into account. The prospective resident or representative is invited to visit the home, and residents spoken to on this occasion confirmed this process as described. Each resident is offered a trial stay before their admission is confirmed by contract. See section on “Environment” for a description of equipment and adaptations, and section on “Health and Personal Care” for a description of services provided. This home does not provide intermediate care. Should the home provide rehabilitation and/or convalescence, all the elements of National Minimum Standard 6 will apply The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 7. The assessment and care planning processes cover a range of health and personal care needs, as well as some social care needs – though this requires further development 8. The home is served by a range of healthcare professionals, to promote good health and has generally good facilities for privacy. 9. The home has a procedure for the management of medication, but the manager needs to ensure this complies with accredited guidance on best practice. 10. Residents confirmed that staff treat them well, and that their privacy is respected. 11. There is a policy in place to ensure that staff know what action to take in the event of a resident dying. However, regulatory duties need to be included. EVIDENCE: The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 11 The home keeps daily reports on each resident. At the last inspection, the manager was advised to keep each resident’s records separate, and this has been complied with. The use of colour coding to separate out different kinds of observations is judged a useful auditing tool. Care Planning Records confirm care plans are underpinned by some generic or standard risk assessments (though the inspector judged these could be further extended) and are being reviewed monthly – in each case counter signed by the staff reviewing them. However, records of reviews often showed no change overall, and there was scant evidence of active follow-up of some social care needs (interests, activities). Less clear, moreover, was the extent to which residents or their relatives were involved in formal reviews, thereon, for want of records. Only those reviews led by care managers do this. Neither resident spoken to individually on this occasion showed any recognition of an active care planning review process. But one did generally recall being asked questions about their care needs from time to time. Health care The home accesses a range of healthcare professionals, but the inspector understands residents would need to pay for chiropody, physiotherapy or any special or private treatment or medication themselves. Medication. The home has its own policy on medication, but this is dated May 1999; refers to outdated legislation and is not as comprehensive as it should be. It should, therefore, be updated or replaced altogether. The inspector was assured that the home also has access to a copy of the latest Royal Pharmaceutical Society Guidance and should use this to check practice compliance with its provisions. The home uses the Boots Monitored Dosage System over a 4-week cycle, though new residents usually bring in their own medication to begin with until they switch over to the MDS system. The inspector judged the arrangements for securing the medication trolley robust. One resident self medicates and keeps her medication in her room. However, the arrangement is not judged adequately secured and better provision should be made. Privacy and Dignity Residents confirmed that the daily routines are as flexible as healthcare needs and staffing levels will allow. Residents confirmed that they can choose when to get up and go to bed. Feedback from the residents also confirmed that their privacy was respected and that staff generally treated them well, though they The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 12 are said to be sometimes too busy to attend to their needs as quickly as some residents would like. With two exceptions, all the bedrooms in this home are single occupancy, which means personal care and treatments can be given in privacy. Death and Dying The home has a policy for the action to take when death occurs. It needs to include the need to notify the CSCI of all deaths (Regulation 37); the retention of records for three years from the date of the last entry, and medication for seven days after death in case of a Coroner’s Enquiry. It would also benefit by information on counselling and support services available. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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, 13, 14, 15 12. The residents appear to have adjusted very well to their lifestyle in this home. This home offers a very limited range of activities inside and outside the home, and some residents would like the home to organise more. 13. There are open visiting arrangements, and the home is well placed for access to local shopping outlets and other community based activities. 14. There is choice and control over most aspects of daily routines. Personal care is offered in a way, which generally protects residents’ privacy and dignity. 15. The meals in this home are generally very satisfactory, offering both choice and variety and catering for personal preferences. EVIDENCE: Residents were not able to give many examples of any particular interests and hobbies being actively promoted by the home. Some residents said they wished the home would organise more activities or outings. The introduction of an Activities Co-ordinator would, therefore, be of benefit. However, feedback indicated that activities included Bingo sessions, music, exercise sessions and seasonal events. The home has its own library room, The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 14 which is replenished by the library (including large print versions of books), and two residents have the Talking Books service. The residents watch mainstream TV channels and quite a few have TVs in their bedrooms. The home has a communal DVD player and gets DVDs from the library. The residents also enjoy reading newspapers. The inspector was interested to hear about an arrangement the home has with a local funeral company which provides it with a minibus and driver at no charge to the residents (the home just makes a donation) for outings. The minibus has the funeral directors name on it, but residents don’t seem to worry about this. They will go out on trips to the sea-side, park up for an ice cream; go to a garden centre and have a cup of tea; visit a local stables to see the horses. Or simply ride around and stop every now and then to take a look. Contact with friends and relatives The home has open visiting arrangements, and feedback from residents confirmed that their visitors were always made welcome whenever they visited. The visitors’ book confirmed that the residents do get a lot of visitors (on average 8-9 each day) who take them out. Visitors can also stay for meals. All bedrooms have telephone points and some residents have had phones installed in their bedrooms (which would be at their own expense). Residents can use the office cordless phone – there is no charge. Catering The meals in this home tend to be traditional English, and there is a choice of options in each case. A lunchtime meal was sampled on the day of this inspection and was judged well prepared and presented, and residents confirmed their satisfaction with the arrangements. The setting was judged congenial. The residents were observed being assisted by staff in a respectful and unhurried way, and although there was no adapted cutlery in use, residents have some adaptations available to them such as beakers (with and without spouts), straws and plate guards. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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, 17, 18 16. There is a complaints procedure readily available, though this will require amendment to fully comply with this standard, and residents feel that any complaints they had would be listened to and acted on. The home relies on staff, or the residents’ families and friends to raise issues and represent the interests of the less able residents. There are no independent advocacy services. 17, 18. Residents generally feel well cared for and safe, and have information on independent advocacy services. EVIDENCE: The home’s complaints procedure is on open display in the entrance lobby, and describes the process and timeframes involved, in general compliance with the provisions of Regulation 22. However, it gives the CSCI as an option only if the complainant feels the complaint has not been dealt with properly or wishes to take the matter further. This is not a correct interpretation of the National Minimum Standard or Regulation 22 and the registered person will need to correct all copies. The home also has a policy on abuse and whistle-blowing and this includes the need to notify the Commission of events (Regulation 37) as they occur. And residents generally confirmed that they would know who to talk to if they had a complaint and felt safe. The home displays information on independent advocacy services but would otherwise rely on staff, or the residents’ families and friends to raise issues and represent the interests of the less able residents. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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, 22, 23, 24, 25, 26 19. The location and layout of this home is suitable for its stated purpose; it is accessible, safe and well maintained; and it meets the residents’ needs in a comfortable and homely way. 20. The home provides sufficient communal space and facilities. Residents have a choice of communal areas, and furnishings tend to be domestic in character. There are homely touches throughout. 22. There is a range of equipment and adaptations to support residents and staff in safety in their daily routines and to maximise residents’ independence, though the home would benefit by periodic assessments by an OT to ensure it maintains its capacity to do so. 23, 24. Most residents have access to the privacy of their own bedrooms and all bedrooms have en-suite facilities The individual are well in excess of the National Minimum spatial Standard. Each room inspected was furnished and fitted in full compliance with this standard; and was maintained and decorated to a satisfactory standard. Each bedroom inspected was personalised. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 17 25, 26. All areas of the home inspected were judged well lit, heated and maintained to a satisfactory standard of cleanliness and safety. There were no unpleasant odours. EVIDENCE: The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 18 The site of this home is judged generally suitable for access to Canterbury City centre and all the local community facilities and transport links that implies. All areas of the home seen were judged well lit, heated and ventilated and maintained in the best interest of the residents who live there and staff who work there. There are nineteen single rooms and two rooms with shared occupancy, although these are sometimes used as larger single rooms. The smallest single bedroom is 15.87 square metres and the smallest double room is 22.50 square metres i.e. well in excess of the National Minimum spatial standard. Two bedrooms were assessed against the National Minimum Standards on this occasion and had all the furniture and fitments required. Both were judged well maintained and in satisfactory decorative order. Each room had been personalised with the residents’ possessions and some pieces of their own furniture, and there were homely touches throughout. Although one resident said she did not want to use the lock on her bedroom doors, this is standard provision, as required. However, the provision of portable cash tins is not judged a secure enough arrangement. All rooms are connected to a call bell system, and each bedroom also has a T.V and telephone point. The home provides a choice of communal space for each resident – all of which are located on the ground floor of the original building. There is a main lounge area, a second lounge, a conservatory, a dining room and a library, which is kept replenished by Canterbury library. All furnishings within the communal areas are domestic in character and of good quality, suitable for the residents. All areas seen were adequately maintained, and subject to a cycle of redecoration. All corridors have handrails on each side, and there is a shaft lift and staircase to access both floors, so that residents can move about as independently as possible. All areas are linked with a call bell system. Specialist equipment includes raised toilet seats, grab rails and lifting equipment, including two hoists (though one of these belongs to a resident). Access to the front door is ramped and access to the rear garden is good. Two residents have their own wheelchairs and the home has two for communal use. There are many zimmer frames in use. Two residents have Talking Books. See section on catering for adapted crockery. The home would benefit by periodic assessments by an OT to ensure it maintains its capacity to meet the needs of residents as they age or become more dependent. The new wing has five en-suite showers, and there is a main shower room. Other rooms have all got en-suite bathrooms, although only two residents are said to use them. Two double rooms have WCs and hand basins. The communal bath is a standard one with a hoist. An adapted bath is recommended. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 These standards were partially inspected on this occasion, notably in respect of compliance with staffing levels as described on the day of this inspection. 27. Staffing numbers complied with the staffing arrangements as described 29. The home has an Equal Opportunities policy in respect of its recruitment and staffing arrangements, but this needs to be extended to cover service provision and the rights and responsibilities of all parties concerned. EVIDENCE: The inspector understands the following staffing arrangements apply: • AM (i.e. 8am to 2pm) – The manager or deputy manager plus two carers on duty. The manager usually stays till 2.30 / 3.oopm. • PM (i.e. 2-8pm) – two carers (one would be in charge i.e. NVQ qualified). • At night there are two waking night staff. Over the weekends there is the same level of staffing: Saturday AM – 3 care staff, Saturday PM – 2 care staff Sundays – always 2 staff. It has not been easy to get 3. There is always someone in charge over the weekend, with an on-call arrangement as a back up. On the day of this inspection, there was compliance with the staffing arrangement as described, though there was said to be an overall shortfall of one member of staff. Since the last inspection, there have been no concerns raised with the Commission about the home’s capacity to maintain these The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 20 staffing levels and the home operates a bonus system for staff who cover shifts or come in on short notice. But one or two residents have raised the ready availability of staff as a concern, which may warrant closer scrutiny at the next announced inspection. At the time of this inspection, the home was fully occupied, and there were several prospective residents on its waiting list. The home has a policy its commitment to Equal Opportunities in respect of staffing issues but see section on “Management and Administration” for its recommended extension to other key areas of the day-to-day operation, to ensure its ownership by all parties concerned. The home has a policy on the recruitment of Staff (dated 08 03 00) but it is a very summary document. It needs extending to include the number of references required in each case, and the homes policy on the checks and balances required to allow staff to work while awaiting CRB clearance. The home has its own Staff Handbook, but staff don’t have copies of the GSCC Code of Practice. This is required practice. Training records were in need of updating and were not, therefore, subject to inspection on this occasion. The last inspection found compliance with the National Minimum Standard for NVQ accreditation. See section on Management and Administration for findings in respect of the proprietor’s regulatory duty to carry out formal documented inspection visits at least once a month, and staff supervision – where major shortfalls were found. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 36, 37, 38 31. The registered manager has demonstrated her competence to run this home and meet its stated purpose. However, she has yet to complete all the elements of her NVQ Level 4 accreditation. There is also a shortfall in respect of the Registered Proprietor’s duty to carry out Regulation 26 visits (matter raised at the last inspection) which combine to obtain a score of 2 for this standard. It is accepted that he is in regular contact with the home. 32. The home’s policy on Equal Opportunities needs to be extended, to ensure a more inclusive approach. Meetings with residents as a group and quality assurance initiatives ensure the home is run in the best interests of the residents. 35. There appear to be a suitable policy for safeguarding the residents’ dayto-day financial interests, but any such arrangements require periodic audits to ensure compliance with its provisions and probity. 36, 37. Staff have ready access to line management and policies on a day-today basis, though some policies will require attention. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 22 38. Property maintenance records were up to date. EVIDENCE: Management Arrangements and Lines of Accountability Mrs Vivien Fuller has been the registered manager since March 2005 and the Commission’s registration process has established that she has a range of relevant qualifications and experience. However, she has yet to complete all the elements of her NVQ Level 4 accreditation, which means that a score of 3 is not yet obtainable. There are clear lines of accountability within the home and staff and residents have reported that in-house line management is generally accessible. There was no evidence, however, of the proprietor’s compliance with his duty to carry out formal documented inspection visits of his own at least once a month (Regulation 26). This is judged a major shortfall, which must be addressed. The inspector did not see all the home’s property maintenance certificates, but those which were seen were up to date. The last Fire Officer’s assessment, for example, was in February 2002, where the home’s fire safety measures were judged suitable and sufficient. Diversity and Inclusion With one exception, all the residents are white British. Two are male – the rest are female. All the staff are currently female. All the daytime staff are White British. At night there are two Zimbabwe staff. One female resident is said to have made racist comments in the past, and this had upset staff. She was spoken to, and there have been no further incidents. The inspector would recommend, however, that the home’s policy on Equal Opportunities is extended beyond staffing issues, to include service provision and the rights and responsibilities of all parties concerned, and summarised for wider circulation so that there can be no misunderstandings about its commitment to the principles of Equal Opportunities. Records confirm information from residents, that there are regular meetings with the residents as a group to discuss the running of the home, and the inspector understands there are quality assurance initiatives (including questionnaires) in place to evaluate the home’s performance against its stated aims and objectives. Policies and Procedures Staff have access to a range of policies and procedures, and fifteen were selected for closer scrutiny on this occasion. Many did not show their original issue date; some showed an issue date of 1999 and will, therefore, require updating; others will require extending or checking against accredited models or regulatory requirements. Examples are detailed throughout this report. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 23 Policies need to checked for compliance with best practice models and regulatory requirements, and there should be systems in place to ensure staff practice is compliant Residents’ Day to Day finances The Home has an undated policy on the management of residents’ finances, which usefully makes provision for the proper storage and accounting of monies. There are however, no periodic auditing arrangements to check compliance with its provisions. This is recommended. Each resident has a cash tin in their bedroom, but these require securing against firm surfaces, as a precaution against their theft. Service Development There is a summary statement of the home’s development plan for the current financial year but this is concerned with property development / refurbishment. This inspection did not on this occasion include any inspection of the home’s business planning or service development planning arrangements. The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 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 2 X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 X X 2 2 2 3 The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 25 Are there any outstanding requirements from the last inspection? Yes -one 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 OP9 Regulation 12(4)(c) Requirement Medication arrangements. The following matters are raised for attention: • The home’s own policy on medication, dated May 1999; refers to outdated legislation and is not as comprehensive as it should be. It should, therefore, be updated or replaced altogether. • Where residents self medicate, storage arrangements need to be secure in their bedrooms Complaints Policy. This needs to be amended to give the CSCI as an option at any stage if that is the complainant’s preference. The registered person will need to correct all copies. Portable cash tins need to be properly secured against theft The home needs to show that staff are employed in accordance with the code of conduct and practice set by the GSCC and need to be given copies of the code. The registered proprietor must DS0000023301.V282657.R01.S.doc Timescale for action 31/03/06 2 OP16 22 31/03/06 3 4 OP24 OP29 23(2)(m) 18 30/04/06 30/04/06 5 OP31 26 31/03/06 Page 26 The Old Farm House Residential Home Version 5.1 comply with his duty to carry out formal documented unannounced inspection visits of his own at least once a month (Regulation 26). 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 OP1 Good Practice Recommendations Given the fact two residents are visually impaired, the home should give consideration to making this information available in large print and audio tape – so that residents have all the information they need, in readily accessible formats, to make informed choices. Care Plans. The following matters are raised for attention: • There should be better evidence of active follow-up of some social care needs (interests, activities). • Records should show the extent to which residents or their relatives are involved in formal reviews. Policy on action to take in the event of death. The following matters are raised for attention: • It should include the need to notify the CSCI of all deaths (Regulation 37); • It should include the retention of records for three years from the date of the last entry; • It should include the retention of and medication for seven days after death in case of a Coroner’s Enquiry. • It would also benefit by information on counselling and support services available. An adapted bath is recommended. The home would benefit by periodic assessments by an OT to ensure it maintains its capacity to meet the needs of residents as they age or become more dependent. One or two residents have raised the ready availability of staff as a concern, which may warrant closer scrutiny. The inspector would recommend 3that the home’s policy on Equal Opportunities is extended beyond staffing issues, to include service provision and the rights and responsibilities of all parties concerned, and summarised for wider circulation so that there can be no DS0000023301.V282657.R01.S.doc Version 5.1 Page 27 2 OP7 3 OP11 4 5 6 7 OP21 OP22 OP27 OP32 The Old Farm House Residential Home 8 OP36 misunderstandings about its commitment to the principles of Equal Opportunities. Policies need to checked for compliance with best practice models and regulatory requirements, and there should be systems in place to ensure staff practice is compliant The Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Old Farm House Residential Home DS0000023301.V282657.R01.S.doc Version 5.1 Page 29 - 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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