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Inspection on 01/02/08 for The Old Farmhouse - The Briars

Also see our care home review for The Old Farmhouse - The Briars for more information

This inspection was carried out on 1st February 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Admissions to the home would be carefully planned and take into account the needs of existing residents and staff skills and experience. All people at the home have a contract with the home detailing the terms and conditions of residency. People have well written and maintained care plans. Individual `My Day` programmes (a record a daily activities) are regularly reviewed and there are a wide range of daily activities. Risk assessments are carried out as necessary and regularly reviewed. This enables staff to support people in a wide range of options. People are provided with individualised support in order to live active lives within the local community. Healthy eating is promoted and people are encouraged wherever possible to be involved in planning, shopping for and cooking their meals. The home has an accessible complaints policy and staff facilitate access to advocacy services if needed. The home`s medication management is safe. Staff recruitment practices are good with all relevant documentation obtained before staff start work at the home. Staff receive regular formal supervision of their practice and management support and advice is always available if needed. Health and safety procedures and checks are in place to protect residents, visitors and staff.

What has improved since the last inspection?

At the last key inspection of the service in October 2006 two requirements and five recommendations were made. It was required that medication administration practices be reviewed and that the home`s written complaint`s policy be amended. Both these requirements have been met. Of the five recommendations four have been implemented. These relate to staff training, policies in the home and medicines. One recommendation about the home`s staff application form has not yet been implemented.

What the care home could do better:

This has been a positive inspection with the home demonstrating that it is managed well with skilled staff providing individually tailored care packages for the people who live at the service. Four good practice recommendations are made to the home, these can be found in detail at the end of this report. We recommend obtaining the most recent professional guidance on safe administration of medicines to inform best practice. We recommend that the manager consider how the environment could be enhanced to add homeliness to what is an austere building. We recommend that the staff application formbe amended to reflect that posts at the home are exempt from the Rehabilitation of Offenders Act. Finally, we recommend that the manager have access to an in-house mandatory staff training matrix to assist the staff annual training plan.

CARE HOME ADULTS 18-65 The Old Farmhouse - The Briars The Old Farmhouse Avishayes Lane Chard Somerset TA20 1RU Lead Inspector Judith McGregor-Harper Unannounced Inspection 1 February 2008 09:30 st The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Farmhouse - The Briars Address The Old Farmhouse Avishayes Lane Chard Somerset TA20 1RU 01460 66058 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) LDAnderton@somerset.gov.uk Somerset County Council (LD Services) Miss Laura Diane Anderton Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may have concurrent sensory impairment There are a maximum of 5 service users in The Old Farmhouse and 3 service users at The Briars. This condition will be evaluated at each inspection. 30th October 2006 Date of last inspection Brief Description of the Service: The Old Farmhouse caters mainly for people on the Autistic Spectrum. All people can display behaviours, which are challenging to manage. The total numbers of residents is currently restricted to eight. This is a condition of the homes registration, and reflects long- term difficulties related to staffing levels. The home is made up of The Old Farmhouse, a newer bungalow, (The Briars), and a self-contained annex (known as the annex). The Old Farmhouse has six single, en-suite bedrooms, a kitchen, dining and living areas, communal WC and garden areas. A sun room/lounge provides additional living space. The Briars bungalow has four bedrooms, with washing facilities, communal bathroom and WC, kitchen/dining room and a living room. One of two living rooms in the Briars has been altered to provide separate accommodation to one service user. It consists of an en-suite bedroom, patio area and sun room/lounge. The houses are linked by office and cloakroom space. Outside, there are enclosed patio and green areas, car parking space, a partly converted barn and remains of outbuildings. There is potential for clearing the extra fields of old farming machinery and developing the area as a horticultural and recreational resource. The home is sited at the edge of Chard, off a farm track, but close to a housing estate and to Chard’s reservoir and nature trails. It is also near local shops and facilities. The current fees are £255.80 per week. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means that people who use this service experience good quality outcomes. This inspection took place over one day in February 2008. One inspector carried out the inspection. The inspection was unannounced. Eight people were living at the home on the day of the inspection. People living at the service are aged between 26 – 54 years. Both women and men live at the home. There have been no new admissions to the service since 2004. We (the Commission) were able to see and observe staff interactions with people and talk to people about how they view living at the home. We spoke with duty staff. We received feedback about the service in surveys from five staff and three relatives. No surveys were completed from people living at the service. This could be because surveys were mistakenly not sent to the home in easy to read formats. We sent out surveys to health professionals linked to the service and received nine replies. The manager Miss. Anderton was on duty and available during the inspection process. We would like to thank the duty staff for their time and hospitality shown to the inspector. This aim of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. Records examined during the inspection were three care and support plans, written risk assessments, staff recruitment and supervision records, staffing rosters, staff training records, complaints/compliments, medication administration records and maintenance records. After the inspection, at our request, the home provided and forwarded copies of staff rosters, revised Statement of Purpose, generic Service User’s Guide, admission procedure and business plan aims with annual objectives for the service. As required, on request, the home completed and submitted an Annual Quality Assurance Assessment (AQAA). What the service does well: Admissions to the home would be carefully planned and take into account the needs of existing residents and staff skills and experience. All people at the home have a contract with the home detailing the terms and conditions of residency. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 6 People have well written and maintained care plans. Individual ‘My Day’ programmes (a record a daily activities) are regularly reviewed and there are a wide range of daily activities. Risk assessments are carried out as necessary and regularly reviewed. This enables staff to support people in a wide range of options. People are provided with individualised support in order to live active lives within the local community. Healthy eating is promoted and people are encouraged wherever possible to be involved in planning, shopping for and cooking their meals. The home has an accessible complaints policy and staff facilitate access to advocacy services if needed. The home’s medication management is safe. Staff recruitment practices are good with all relevant documentation obtained before staff start work at the home. Staff receive regular formal supervision of their practice and management support and advice is always available if needed. Health and safety procedures and checks are in place to protect residents, visitors and staff. What has improved since the last inspection? What they could do better: This has been a positive inspection with the home demonstrating that it is managed well with skilled staff providing individually tailored care packages for the people who live at the service. Four good practice recommendations are made to the home, these can be found in detail at the end of this report. We recommend obtaining the most recent professional guidance on safe administration of medicines to inform best practice. We recommend that the manager consider how the environment could be enhanced to add homeliness to what is an austere building. We recommend that the staff application form The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 7 be amended to reflect that posts at the home are exempt from the Rehabilitation of Offenders Act. Finally, we recommend that the manager have access to an in-house mandatory staff training matrix to assist the staff annual training plan. 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 Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home produces information about the home and provides opportunities to discuss the facilities and care at the home. Thorough assessments are carried out before people are admitted to the home to ensure that the home can meet a person’s needs. Everyone living at the home has a contract with the home detailing the terms and conditions of residency. EVIDENCE: There have not been any admissions to the home since the last inspection. This standard was evidenced by good practice that was demonstrated at the time of the last inspection. Due to the complexity of individual residents needs pre admission assessments are thorough and well planned to take into account existing residents needs, staffing levels, and staff skills and experience. The manager forwarded to the Commission a copy of the specific assessment document developed for the service. It is very detailed and takes into account physical, emotional, social and mental health needs. Contracts were inspected for three people at random. Documents were clear and included all the information required in the national minimum standards. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 10 The home produces information about the home in the statement of purpose and service user guide. The statement of purpose has been reviewed. The service user guide is generic for social services learning disability services. We discussed with the manager the appropriateness of future development of a service user guide that is accessible and meaningful to people who live at the home. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have well written and maintained care plans that inform clear and consistent guidelines for staff supporting people. Care practices are flexible to respond to the daily choices of people living at the home. Risk assessment are carried out as necessary and regularly reviewed. This enables staff to support people in a wide range of options. EVIDENCE: We discussed care and support issues with the manager. Throughout the day people were observed relaxed and willing to interact and make friendly contact with each other and staff. Care plans and observation on the day demonstrate that the right of each resident to make decisions is encouraged as part of their life skills and personal development. All care plans sampled had been reviewed and updated. New The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 12 simpler to access care planning documentation is due to be introduced from February 2008. The care and support plans used presently are very detailed but are a file of information rather than a summary of care needs. Peoples’ rights are sometimes limited following an assessment of risk, i.e. they cannot access outdoors safely alone, and electronic pads are fitted to exit doors for their protection. Staff continue to be sensitive to their needs and are ready to respond appropriately. Risk assessments are completed for many aspects of individual’s lives. In recognition of the need for specialist training for staff working with this client group there has been a staff training drive in the last 12 months on Autism. People go to the local shops and access the local facilities in Chard. While they need assistance with managing their cash, they all have individual savings accounts. A local authority administrator checks transactions relating to personal finances approximately once a month. This monthly audit on behalf of the local authority was taking place on the day of the unannounced visit. People living at the service need one-to-one encouragement and support for most activities of their daily life. Staff demonstrated a good personal knowledge of each resident’s likes, dislikes and needs. Independent advocacy services have been utilised for three people to support decision making processes. People are encouraged to get involved in tasks related to daily living as much as they are able. This includes tidying their room, shopping, cooking and banking. They are assisted to choose what to do and what to eat, aided by a range of visual resources and communication techniques. One comment in a survey response from a relative stated that the staff “treat the whole person, as an individual.” The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are regularly structured and planned activities, a fundamental need for people with autism. People are supported to live active lives within the local community. Healthy eating is promoted and people are encouraged wherever possible to be involved in planning, shopping for and cooking their meals. EVIDENCE: The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 14 Everyone living at the home has a daily programme of activities recorded on their personal file in a variety of accessible formats including pictures and symbols where appropriate. The home has links with Yeovil College. People access college and a trainer works in the home during term time. During holidays staff continue this work. People also have opportunities to experience aromatherapy, hydrotherapy sessions, and hairdressing. An outside building has been utilised as an arts and crafts room that was being used enthusiastically on the day of the inspection. A polytunnel has been erected in the large grounds to promote horticultural projects. Some people regularly use the local swimming pool. The home has a minibus that staff can drive. People can walk to and from the local shops accompanied by staff. During the inspection people were coming and going from the home to planned leisure pursuits in the local area. People access local shops, Post Office, pubs, cinema, leisure centres, cafes and restaurants. There is a nature reserve close to the home, used by local people and where some people like to walk with support from staff. Staff help to maintain and develop family and other social links. Evidence of this was seen on individuals’ files where family birthdays and special occasions were noted and contact with family recorded. Home visits to families are structured where possible. Survey responses from relatives indicated positive responses with support provided at the home and contact given with them as relatives. Records were kept on individuals’ files of their likes and dislikes in relation to food and staff supported them to eat a healthy diet. Residents were encouraged as far as they are able to be involved in planning, shopping and preparing food and drinks. People were cooking with staff support during the inspection visit. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive attentive and professional health care support and staff endeavour to meet their physical and emotional needs. Medication management is safe but the home would benefit from obtaining the medicines best practice guidelines. EVIDENCE: All people are registered with the local G.P. practice. The home accesses NHS community staff such as the district nurse and continence advisor as necessary. There is involvement from the speech and language therapist, with regular reports seen on individuals’ files. The team assesses the best option for each person, according to disability needs, whether to attend a particular clinic or to ask specialists to visit residents at home, in each area of health care. Attention is paid to introduce people to treatments and health checks that may distress them on a gradual basis until they are relaxed and able to cooperate. There was evidence that this on going in relation to dental care. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 16 We received survey responses from eight local GPs who have patients at the home. We received a survey response from one social worker that works on behalf of a person in the home. All responses were positive regarding the care delivered at the home. Comment received included the following; “Excellent caring personal service.” “Very caring home who put residents needs first.” “I think it is an excellent service.” There was evidence that staff try and ensure that people receive support in the way that they choose and that gender specific care is taken into account whenever possible. For medicines the Boots pharmacy Monitored Dose Record system is in use and staff have been instructed on how to use the system. Medication is kept in the home’s medicine cupboards, one in each house. People’s bedrooms also have lockable space in them. Nobody in the home currently self-medicates. We examined medicines records, medicines storage and written guidelines for medicines administration. There is an organised systematic protocol in the home for handling and recording medicines. There are clear guidelines for the administration of ‘as required’ prescription medicines. The home’s medication file is very informative with useful guidance for staff and it is at hand, together with other health and safety books in the staff room/office. The current document to inform staff of best practice in medicines management is the 2001 Royal Pharmaceutical Society’s guidance for care homes. This document was revised and reprinted in 2007. It is recommended that the home obtain this most recent revision. The consultant psychiatrist has been involved with reviewing, and reducing the medication that people have prescribed, in connection with mood and behaviour and this has worked well for individuals. Very clear and explicit behaviour management protocols and restrictive practice guidelines were seen recorded for individuals. Staff were observed providing individual support during the inspection in a calm, friendly and professional manner. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear complaints procedure written in accessible format for people living at the service. There have been recent staff training updates in protecting people from abuse. This is informed by revised policies and protocols in protecting vulnerable adults. EVIDENCE: There has been one concern made by a relative since the last inspection. This was investigated by the home and was found to be a medication error by the dispensing pharmacy. The home has a corporate complaints and compliments policy that since the last inspection has been updated and amended to include the name and telephone number of the CSCI, making clear that complainants are able to contact CSCI at any stage of a complaint. The network manager audits the home during monthly visits, and more often when necessary. People have access to advocacy services. The home has a corporate policy for the protection of vulnerable adults. The home uses forms to report accidents and incidents. The manager had a summary of incidents for each month. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and staff work hard to make it as homely as possible, although the environment appears austere. EVIDENCE: The home is effectively separated into three units on one site. It is this separation that underpins harmonious living. Current arrangements (a condition of registration) to reduce the number of people living there to eight have been of benefit to the residents. It would seem desirable for this arrangement to continue. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 19 The layout of the home is described in the section ‘brief description’ at the beginning of this report. Everyone has his or her own room. Six rooms have en-suite shower or bath facilities. There are sufficient toilet, bathroom facilities and adaptations provided. Due to the sometimes challenging behaviours and needs of individuals who live at the home the environment is subject to heavy wear and tear damage. Whilst the staff work hard at making the environment homely the interior of the home is fairly basic. For example there is lino to a long stretch of corridor and little adornment of walls, affecting the overall warmth of the building. One person is accommodated in a separate bed-sit with its own living space, which works well for that individual. People have access to enclosed patio and grassed garden areas. Several people were seen to be enjoying using the gardens on the day of the inspection. Access to unused farm buildings and fields is restricted. The manager is hoping to further improve work done to provide outside facilities. The polytunnel has been covered since the last inspection and work has started to commence gardening projects. The premises were clean and hygienic. On the day of inspection, the home was free from unpleasant odours throughout. Protective clothing was in use as appropriate. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment practices were robust and staff did not start work at the home until all necessary checks were completed. However, the staff application form needs amendment to ensure that vulnerable people are protected. There are good training opportunities for staff and sufficient numbers of duty staff to meet people’s needs. EVIDENCE: The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 21 The local authority’s training department has the dedicated training budget and is now developing a training database. Staff confirmed that they had undertaken mandatory training courses as part of their induction. It would be useful for the home manager to have access to the current mandatory staff training matrix to assist her with her in-house annual staff training plan. The staff team has recently undertaken a days training in equality and diversity issues within the service and affecting people who use the service. Staff have in-house and central induction programme linked to NVQ. Half of the staff at the home either have achieved a minimum care qualification at NVQ level 2, or are currently working toward this award. Staff spoken to said that they received good support from the manager and senior staff and from each other. The five staff surveys received reported positive feedback regarding training, support and supervision at the home. Two staff reported that they had not received moving and handling training. At the inspection the manager was able to produce documents to demonstrate that two staff require such training and that they had been booked on a moving and handling course to commence within the next 4 weeks. The files of four new members of staff were checked. Recruitment procedures are undertaken by the organisations personnnel department and staff do not start work at the home until all necessary checks and documentation is in place. New staff spoken to were very enthusiastic about their role at the home. The application form tells applicants that they do not need to declare ‘spent ‘convictions. The form should be revised to make clear that all convictions must be declared, and that the Rehabilitation of Offenders Act does not apply to staff posts at the home due to the nature of the work with vulnerable people. Staff files contained records of staff supervision, staff spoken to said they they had access to regular supervision and that the manager and other senior staff were always available for advice and support if needed. The manager supplied copies of four weeks’ current staffing rosters. The rosters indicated that sufficient staffing is allocated to meet the assessed needs of people in the home. Some people in the home receive 1:1 staffing support. The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the skills, qualifications and experience to effectively manage the home. Internal quality audits take place but would be more meaningful by including the views of relatives and health professionals. Health and safety procedures and checks are in place to protect residents and staff. EVIDENCE: The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 23 The registered manager, Ms Laura Anderton is skilled and experienced. She has managed the home for 7 years and in the last year had worked on her professional development in gaining expertise in Autistic spectrum disorders. The network manager does quality audits every month, in line with the annual service plan. This involves residents, staff, systems and building issues. Previous targets in these areas are reviewed and new targets set in the monthly report that follows these visits. There is an annual development plan agreed with the service manager and service provider, used as the bench mark for monthly quality reviews. The home completed and submitted an Annual Quality Assusrance Assessment as required. This document was based on the home’s own annual development plan. Staff use various communication techniques to involve people and to meet their needs and preferences. The speech and language therapist is engaged when necessary to guide and advise. An audit tool to seek the views of residents (or their representatives), relatives and professionals is also available but has not been used since the last inspection. The home has health and safety policies and procedures set by the organisation. Fire records examined demonstrated regular safety checks are carried out and that staff receive fire training three monthly. First aid boxes were checked and were in need of tidier organisation. This was attended to during the inspection. The Old Farmhouse - The Briars DS0000030383.V354950.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA20 Good Practice Recommendations To inform good practice it is recommended that the home obtain the 2007 copy of the Royal Pharmaceutical Society guidelines for administration of medicines in care homes. Taking into consideration good practice guidelines in managing autistic spectrum conditions, the manager should consider how the environment could be made more homely. The staff application form should make clear that the Rehabilitation of Offenders Act does not apply to jobs within the home due to the nature of the work with vulnerable people. It is recommended that the manager devise an in-house mandatory training matrix to assist the home’s annual training plan. 2. YA24 3. YA34 4. YA35 The Old Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Farmhouse - The Briars DS0000030383.V354950.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!