CARE HOME ADULTS 18-65
The Old Farmhouse/The Briars The Old Farmhouse Avishayes Lane Chard Somerset TA20 1RU Lead Inspector
Ms Sue Hale Unannounced Inspection 30 October 2006 09:40
th The Old Farmhouse/The Briars DS0000030383.V297960.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.V297960.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.V297960.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) Somerset County Council (LD Services) Miss Laura Diane Anderton Care Home 9 Category(ies) of Learning disability (0) registration, with number of places The Old Farmhouse/The Briars DS0000030383.V297960.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. 19th December 2005 Date of last inspection Brief Description of the Service: The Old Farmhouse caters mainly for residents on the Autistic Spectrum. All residents 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 Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of one day in October 2006. The Inspector looked at selected resident and staff files and other documents related to the running of the home. The Inspector undertook a tour of the home and spoke with some of the people working there. Surveys were sent out to some care staff, some residents and medical, health and social care professionals who have contact with the home. Six surveys were received from residents who had been assisted with this by staff or relatives. Three comment cards were received from staff and none from health and social care professionals at the time of writing this report. The current fees are £249.40 per week. 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 residents have a contract with the home detailing the terms and conditions of residency. All residents have well written and maintained care plans. Individual ‘My Day’ programmes (a record a daily activities for residents) are regularly reviewed and progress has been made in developing and a wider range of daily activities. Risk assessments are carried out as necessary and regularly reviewed. This enables staff to support residents in a wide range of options. With increasing stability in the staff team, staff are now in a better position to maintain regular activities. This is imperative for this group of autistic residents whose fundamental need is for structure and routine. It is evident that residents are well liked and respected by staff and are supported to live active lives within the local community. A relative commented that their relative was ‘loved and so well cared for’. Healthy eating is promoted and residents are encouraged wherever possible to be involved in planning, shopping for and cooking their meals. The home is clean and staff work hard to make it as homely as possible whilst managing the needs of individuals. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 6 Residents receive good personal support and staff endeavour to meet their physical and emotional needs. The home has an accessible complaints policy that is available for residents and staff facilitate access to advocacy services if needed. The home’s medication file is very informative with lots of useful guidance for staff and medication practices have improved since the last inspection. Staff recruitment practices are generally 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. A relative commented that the ‘staff are helpful and considerate towards residents needs’. Staff were very positive about the range of training on offer and support from the manager of the home to attend. Health and safety procedures and checks are in place to protect residents and staff. What has improved since the last inspection? What they could do better:
The statement of purpose and service user guide should be reviewed and changed if necessary to ensure that it its up to date. Residents care and support plans should all be reviewed and updated to reflect current needs and situations once the new care planning documentation is introduced. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 7 Two staff signatures should be obtained on all MAR sheet entries in line with the homes policy. If this is not possible the reason why should be recorded. All handwritten entries on the MAR sheet should have two signatures to record that appropriate checks have been made as to the accuracy of the prescription and details of how it should be administered. The complaints policy must include the name and details of the CSCI and should make clear that complainants are able to contact the commission at any stage of a complaint. The manager should take advice to see if the way information about individual residents is recorded on staff meeting minutes breaches the Data Protection Act 1998. Consideration should be considered to how the standard of the interior of the home could be improved within the constraints of the needs of the residents. The staff application form must make clear that the Rehabilitation of Offenders Act does not apply to posts within the home due to the nature of the work with vulnerable people. Mandatory training updates should be in place in sufficient time that certificates do not run out and staff are working with no up to date qualifications. Significant efforts should be made to increase the number of qualified staff employed at the home. The manager has the skills, qualifications and experience to effectively manage the home. Internal quality audits take place but the views of residents’ relatives and other professionals involved in the home have not been sought recently. 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 Farmhouse/The Briars DS0000030383.V297960.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.V297960.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 The quality of this outcome group is good. The home produces information for prospective residents and their relatives/representatives. Thorough assessments are carried out before new residents are admitted to the home. All residents have 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. All residents have a terms and conditions of their residency at the home that is clear and includes all the information required in the national minimum standards. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 10 The home produces information about the home in the statement of purpose and service user guide, they were both drawn up in 2002 and should be updated to reflect the current staffing structure in the home and any changes since that time. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 11 The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The quality of this outcome group is good. All residents have well written and maintained care plans. Individual ‘My Day’ programmes (a record a daily activities for residents) are regularly reviewed and progress has been made in developing and a wider range of daily activities. Risk assessment are carried out as necessary and regularly reviewed. This enables staff to support residents in a wide range of options. EVIDENCE: The inspector discussed care and support issues, staffing levels and it was clear from checking records that incidences of violence had reduced as the staff team has stabilised. Throughout the day residents 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. Some care plans had not been reviewed and updated for some time, the manager acknowledged this and stated that staffing difficulties had
The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 13 led to this delay. New care planning documentation is shortly to be introduced and all residents’ files will be reviewed and updated. Residents’ 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, the manager has attended specialist training on Autism and is planning to pass on this knowledge to the staff team via a series of training days. Residents 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. Residents 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 Residents 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. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 14 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15,16 & 17 The quality of this outcome group is good. With increasing stability in the staff team, staff are now in a better position to maintain regular activities. This is imperative for this group of autistic residents whose fundamental need is for structure and routine. It is evident that residents are well liked and respected by staff and are supported to live active lives within the local community. Healthy eating is promoted and residents are encouraged wherever possible to be involved in planning, shopping for and cooking their meals. EVIDENCE: The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 15 All residents have a daily programme of activities recoded on their personal file in a variety of accessible formats including pictures and symbols where appropriate. The home has links with Yeovil College. Residents can access college and a trainer works in the home during term time. During holidays staff continue this work. Residents also have access to aromatherapy, hydrotherapy sessions, and hairdressing. An outside building has been utilised as an arts and crafts room that has proved very popular with residents. This was used recently to make artwork to take to a Halloween party at the day centre. At the time of this inspection, there were eight residents at the home. Some residents have accessed the local swimming pool, when the home has combined with other services to hire the pool. The home has a minibus that staff can drive. Residents walk to and from the local shops accompanied by staff. With the modernisation of day services in April 2004, some residents have continued to have reduced access to the facilities at The Laurels Resource Centre. The home’s staff is responsible for all planned activities. Residents continue to access local shops, PO, pubs, cinema, leisure centres, cafes and restaurants. There is a nature reserve close to the home, used by local people and where some residents’ users like to walk with support from staff. Staff assists residents 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. 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. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 The quality of this outcome group is adequate. Residents receive good personal support and staff endeavour to meet their physical and emotional needs. The home’s medication file is very informative with lots of useful guidance for staff. Whilst there had been some improvements since the last inspection, not all staff are following the homes guidance. EVIDENCE: Residents are all 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 resident, 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 residents 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 has worked particular well in relation to dental care.
The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 17 There was evidence that staff try and ensure that residents receive support in the way that they choose and that gender specific care is taken into account whenever possible. The Boots MDR 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. Service users’ bedrooms have lockable space in them. The community pharmacist continues to audit this area twice a year. Staff signature list was kept and advice for staff on recording expiry and opening dates on creams and ointments. Areas in need of attention are, two staff signatures on all hand transcribed medication and following the house policy of obtaining two staff signature when administering medication. The manager stated that this was sometimes due to staffing difficulties, but acknowledged that the rationale for this should be recorded. These were both identified in the previous inspection report. . The home has obtained two controlled drugs books should these be necessary and are recording the quantities of medication received into the home on the MAR sheets. The home’s medication file is very informative with lots of useful guidance for staff and it is at hand, together with other health and safety books in the staff room/office. The consultant psychiatrist has been involved with reviewing, and reducing the medication that residents have had prescribed, in connection with mood and behaviour and this has worked well for individuals. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The quality of the outcome group is good. There is a clear complaints procedure written in special format for residents. The changes to day services have meant that more residents are at home for longer periods during the day. To ensure harmonious living and minimise the number of incidents, it is essential to maintain both well-structured days and good staffing levels. Progress has been made in this respect. EVIDENCE: There has been one complaint/ allegation made by a resident since the last inspection. The manager dealt with this appropriately, although the paperwork relating to this was not available for inspection, as it has been sent to the homes organisational head office as part of the investigation procedure. The home has a corporate complaints and compliments policy, it needs minor amendment and must include the name and telephone number of the CSCI and should make 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. Residents 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. Summaries show that incidences of
The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 19 violence between residents and by residents towards staff have steadily reduced alongside the stabilisation of the staff team. The inspector remains concerned about the welfare of service users and staff now that the modernisation of day services is in operation, and more service users are at home for longer periods during the day. The filling of the three staff vacancies, staff training and the continued stabilisation of the staff team are crucial to providing a safe environment for residents and staff. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 20 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The quality of this outcome group is adequate. The home is clean and staff work hard to make it as homely as possible whilst managing the needs of individuals. 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 residents to eight have been of benefit to the residents. It would seem desirable for this arrangement to continue. EVIDENCE: The layout of the home is described in the section ‘brief description’ at the beginning of this report. All residents have their own room. Six of these 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. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 21 One resident is accommodated in a separate bed-sit with its own living space, which works well for that individual. Some rewiring has been completed since the last inspection that means that some rooms need redecoration or paintwork needs retouching. Due to the needs of the residents any renovation work has to be done in a planned and managed way to reduce the impact it could potentially have on individuals’ behaviour and well being. Residents have access to enclosed patio and grassed garden areas. A resident was seen to be enjoying using the garden on the day of the inspection. Access to unused farm buildings and fields is restricted The manager is hoping to access some additional funds to further improve facilities outside to provide increased variety and of opportunities for residents. Funding has been found to cover the polytunnel and it is planned to carry out this work in the near future. The new gardener and maintenance man has improved the appearance of the outside areas and made certain areas more accessible. The premises were clean and hygienic. A relatively new carpet cleaner keeps the carpets clean, although they show clear signs of staining due to wear and tear. 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.V297960.R01.S.doc Version 5.2 Page 22 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 & 36 The quality of this outcome group is adequate. It is positive to see that there has been progress on Autism specific training for the manager and the plans to cascade this down to the staff team. It is hoped that this training will help with staff retention. The numbers of qualified staff are relatively low considering the complex needs of the residents. 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. Staff receive regular supervision of their practice. EVIDENCE: The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 23 The local authority’s training department has the dedicated training budget and is now developing a training database. New staff confirmed that they had undertaken mandatory training courses as part of their induction. However, it was evident that existing staff find it difficult to access mandatory training updates and that certificates frequently run out before additional training is available. Staff have in-house and central induction programme now linked to NVQ.New staff spoken to have enjoyed the induction training and found it very useful. The home has 24 care staff, eight of which are qualified to NVQ level 2 or above. Staff reported that it has been a difficult year as a lot of experienced staff have left and the staff are all relatively new to the home. Staff spoken to said that they received good support from the manager and senior staff and from each other. Two staff surveyed said that there was not always a senior member of staff available to consult with if necessary and that they were not always clear what duties they must not undertake. The manager recognised the stress and tension involved in the work at the home for staff and acknowledged that staff may need ‘time out’ including a brief period outside the home. Staff spoken to confirmed that this was accepted within the home and that they found it useful. The files of three 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.All new staff spoken to were very enthusiastic about their new 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. There are regular meetings held for staff and minutes kept and circulated, the minutes seen by the inspector included specific detials about individaul residents who live at the home. The manager should ensure that information recorded on such minutes does not breach the Data Protection Act 1998. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 The quality of this outcome group is adequate. The manager has the skills, qualifications and experience to effectively manage the home. Updating of mandatory training topics is not always available. Internal quality audits take place but the views of residents’ relatives and other professionals involved in the home have not been sought recently. Health and safety procedures and checks are in place to protect residents and staff. EVIDENCE: The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 25 The registered manager, Ms Laura Anderton is skilled and experienced. Ms Anderton has been involved with a working group looking at developement of a policy to support residents with an autism spectrum disorder and a draft policy has been submitted to the provider. 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. Staff use various communication techniques to involve residents 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.As referred to previously in this report staff find it difficult to access updates in mandatory training and frequently certificates run out before staff training updates are arranged. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 26 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 2 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 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 2 X The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 27 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13(2) Requirement To ensure that the management of medication meets Somersets own guidance and the advice of the community pharmacist. (This refers to the homes policy that states that two signatures must be obtained for all medicinces administered and all hand transcribed entries on the MAR sheet must be signed by two people). The complaints policy must include the details of the Commission for Social Care Inspection. Timescale for action 30/11/06 2 YA22 22(7)(a) 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA20 YA22 Good Practice Recommendations Two members of staff should sign all hand transcribed entries on MAR sheets. The complaints policy should make it clear that
DS0000030383.V297960.R01.S.doc Version 5.2 Page 28 The Old Farmhouse/The Briars 3 4 YA32 YA34 5 YA42 complainants are able to contact the CSCI at any stage of a complaint. Significant efforts should be made to increase the number of qualified staff employed at the home. 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 strongly recommended that mandatory training updates are set up in good time and certificates are not allowed to run out. The Old Farmhouse/The Briars DS0000030383.V297960.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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