Inspection on 11/08/05 for The Old Haybarn

This inspection was carried out on 11th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Haybarn 30/08/07

The Old Haybarn 06/03/06

The Old Haybarn 08/12/04

The Old Haybarn 01/07/04

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Insight - Eastchurch

Southfields

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Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Old Haybarn London Road Crowborough East Sussex TN6 1TQ Lead Inspector Elaine Green Unannounced 11th August 2005 10:00 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 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 Stationary 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 Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Old Haybarn Address The Old Haybarn London Road Crowborough East Sussex TN6 1TQ 01892 654057 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Baronsmede Family Homes Ltd Mrs D J Tormey Care Home 7 Category(ies) of Learning Disability (LD), 7 registration, with number of places The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That The Old Haybarn is registered to accommodate up to seven adults with learning difficulties between the ages of 18 and 45 years on admission Date of last inspection 8 December 2004 Brief Description of the Service: The Old Haybarn is registered for a maximum of seven adults with a learning dissability, with an additional condition of registraion that service users should de aged between 18 and 45 years on admission. This home was first registered in October 2003. The home is situated in a pleasant semi-rural setting on the outskirts of Crowborough, and close to the local shops, banks, public houses, cafes, takeaways and restraunts. The Old Haybarn provides a high standard of accomodation for seven service users. All seven bedrooms have en-suite facilities with a wash basin, toilet and either a shower or bath. On the ground floor there are three bedrooms, a bathroom, a sitting room, dining room, kitchen, laundry and an office/sleep in room. On the first floor there are four bedroomns. The home us well decorated, furnished and maintained. The home is set in three acres of grounds. A day centre which service users attend is on the same site and is facilitated by the same staff team. This day centre is run by the homes provider and is also attended by service users from the providers two other homes close by. The home aims to provide services to people with learning dissabilities, which would provide opportunities for them to evelop a greater degree of independence. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 11th August 2005 between 9am and 1.30pm. The Inspector had a tour of the home and day care facility, had discussions with the manager of the home, 5 service users and the co-ordinator of the day care activities. Records were examined including, 3 care plans, 4 recruitment files, 4 staff training records and 3 service users’ files which detailed all their likes dislikes and contained records of all the activities they are involved in. What the service does well: What has improved since the last inspection? 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 Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 7 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 standard(s) 2,3,4. The information provided to prospective service users is sufficient for them to make a decision re the homes ability to meet their needs. EVIDENCE: Prospective service users needs are assessed prior to admission. The manager undertakes detailed assessments as to prospective service users abilities and needs. The care plans examined were based on thorough and detailed assessments. They had been reviewed on a regular basis to ensure that they continued to meet the service users’ needs. Prospective service users individual aspirations and needs are assessed as part of the pre admission assessment. This forms a basis on which the service users’ individual plan and care plan are based. It covers all aspects of a service users life including their likes, dislikes, preferred activities, family/social contact, specific physical or emotional health care needs, spiritual needs, educational needs, skills and general interests as well as behavioural issues and risk assessments. The manager assured the Inspector that they would not admit anyone into the home unless they felt absolutely sure that the home could meet their needs and that they work very closely with prospective service users family or representatives during the assessment process to ensure that the placement is appropriate. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 8 There is a detailed admissions procedure in place ensuring that prospective service users are given the opportunity to visit the home prior to making a decision about moving in to the home. Service users can move in for a trial period. Admission to the home is planned with the service user to ensure they understand what is going to happen and that their wishes are taken into consideration. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 6,7,8,9. Care plans are relevant and up to date. Service users Individual Plans’ are realistic and reflect service users’ current goals. Service users are supported to lead an autonomous lifestyle. EVIDENCE: Three care plans were examined. The support notes are comprehensive and provide staff with the guidance they require to support service users in their daily living and chosen activities. The care plans had been reviewed on a regular basis, typically twice yearly and had involved the service user and their family. The manager stated that some of the service users have a Personal Centred Plan (PCP). Each care plan specified the service users’ friendships, likes dislikes, diet, family involvement, activity timetable, risk assessments, correspondence, behavioural guidelines, and guidance as to how to minimise any risks to the service user. The day care facility and the activities offered play an integral part of the care planning process and the day centre facilitates many of the goals set at reviews. Courses include, personal presentation, choosing clothes, shopping, personal grooming, daily skills and personal safety both of which are taught in the home to give context and meaning. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 10 Individual learning plans from local colleges link directly to the service users individual plans set at reviews, and their care plans. Each service user has a detailed plan for the week including all activities. Service users are consulted on, and participate in, all aspects of life in the home. Service users are involved in doing laundry, laying the table, loading the dishwasher, choosing the menu, cleaning, food preparation, making of drinks and snacks planning events, outings and they are also involved in updating the web sit for the home and the day care facility. Regular residents meetings are held and service users participate annually in a customer satisfaction survey. Minutes of residents meetings, letters and other information are available in symbolic language for those who use it. Service users have access to Inspection reports. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 11,12,13,14,15,16. Service users are supported to develop personally and socially. Service users’ lead socially active lifestyles and access local facilities and amenities. EVIDENCE: Service users have the opportunity for personal development. Service users are encouraged and supported to attend appropriate courses at the homes’ own day care centre and those run by other local colleges. Courses include those which meet emotional and spiritual needs of the service users as well as those that are purely academic or skills based e.g. assertiveness. The manager stated that not all objectives are task based and could include e.g. not interrupting people when they are speaking or following simple instructions. Social activities are organised by the home, which include inviting people from their other homes, and form homes in the local community. The home provides a social club in the day care centre every Friday that the majority of the service users attend. The club provides a range of activities to suit different needs of the service users. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 12 The home and day care facility involve the service users in a whole range of activities and trips such as BBQ’s, open days, art sessions, drama - “Stars In Their Eyes” show and Christmas show performed by the service users to which their family and friends were invited, bowling at the local leisure complex, sport with a day centre and other homes in the Horsham area with whom they have forged links, trips to the Eastbourne air show, Brighton sand sculptures, horse riding, going out for meals, going to the pub, etc. The service users are fully involved with the planning of these events and activities and will ring up to book the bowling lanes and then update their own web site afterwards so that friends and families can click onto the links on the site to see what they have been doing. Service users have their own e-mail addresses and are encouraged communicate with their family and friends over the Internet. Service users are also encouraged to keep in touch with family and friends through writing of letters and sending greetings cards and each service users’ personal file contains a list of who they like to send cards to and when. Service users stated that their friends and family visit them in the home and that they go and visit them. They also spoke about going to the local shops and pubs. The service users gave very positive feedback to the Inspector re they social aspects of living at the Old Haybarn. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 18,19, Service users are supported appropriately. Service users physical and emotional health needs are met. EVIDENCE: The interaction between staff and eservice users observed by the Inspector was balanced, appropriate. Staff were noted to be treating the service users with respect and to engage with them in a dignified and friendly manner. Service users are encouraged to be as independent as possible and staff support them to complete tasks themselves rather than doing it for them. The atmosphere between service users and staff appeared relaxed and the Inspector was pleased to note how well the staff communicated with those service users who had communication difficulties. Staff were observed on several occasions during the inspection to ask service users if they wanted any help or not and asking the service users what they wanted the staff to do for them. Records examined showed that service users regularly receive check ups from health care professionals and that thorough assessments are sought when needed. Detailed information is made available to staff in relation to meeting service users health care needs. Visits to, and by, health care professionals are fully documented. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22,23 Service users views form an integral part of the homes planning process. The homes policies and procedures ensure that service users are adequately protected from abuse. EVIDENCE: The home has a detailed complaints policy and procedure in place. The service users asked stated that they would tell their key worker or the manager if there was something wrong. None of the service users spoken to had any complaints to make to the Inspector. The manager stated that there had been no complaints since the last inspection. Service users take part in an annual customer satisfaction survey and attend regular resident meetings the minutes of which are available in symbolic language for those who require it. The manager and day centre co-ordinator stated that service users views are taken into consideration when planning events, trips out and other activities in the home. They are also consulted as part of the recruitment process. The home has an Adult Protection procedure in place which provides all staff with a comprehensive induction and training programmes that covers all aspects of what constitutes abuse and how to make an alert. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24,25,26,27,28,30. Service users live in a clean, comfortable and well-maintained home. EVIDENCE: The home meets all the required standards re space available for service users in their own rooms and communally. All bedrooms are single and en-suite offering a toilet hand basin and either a bath or shower. The bedrooms are all personalised, decorated and furnished to a high standard. Service users are able to bring their own furniture to the home should they wish. There is a large lounge area that has a comfortable and homely feel. It is decorated and furnished to a high standard and has a large modern T.V and DVD player. The dining room is separate and can accommodate all the service users at once. This too is furnished and decorated in a homely way and to a high standard. The home has a large garden to the rear of the property and is accessible to all service users. All areas of the home were found to be clean and tidy on the day of the inspection. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36. The homes’ staff team are effective and there is continuity in the care and support provided to service users. The homes’ recruitment process is inadequate. EVIDENCE: The staff team are competent, well trained and appropriately supervised. Recruitment files examined hold documents confirming that all staff receive job descriptions that clearly define the extent of their roles and responsibilities in the home. All new staff follow a detailed induction programme that is signed by the individual and their line manager as they complete each section. All staff are expected to attend training in first aid, moving and handling, basic food hygiene and fire safety. A full training programme for each member of staff is held on file. This identifies what training has been undertaken and when, it also identifies training required, courses to be attended, the provider and the dates that training will be undertaken. This plan is reviewed annually. All staff receive a full copy of all the home’s policies and procedures. They have their own folder in which they must sign to show that they have read and understood the organisation policies, procedures, the principles of care, and the workers role. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 17 The manager stated that all new staff, whether experienced or not, are supervised in all aspects of their role until such time as the manager is confident that they are competent to carry out their responsibilities. All staff receive regular supervision from the manager of the home. These records were examined, found to be satisfactory and are held in the recruitment files. Of the three recruitment files examined, one contained all the relevant information and checks. The other two had everything but a current CRB check. The CRB’s held had been carried out for the individuals’ previous employment and did not specify that they were for working at the Barons Mede Homes organisation. The need for current CRB checks to be obtained and state that the individuals work for the Barons Mede Homes organisation, was stressed to the manager and an immediate requirement was made to this affect. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40,41. The home is well run. Service users views are listened to. The homes policies and procedures are comprehensive and relevant to the service provided. EVIDENCE: The staff team from the Old Haybarn accompany the service users to the day care facility provided by Barons Mede, this is on the same site as the home. The staff teams from the Barons Mede homes’ in the Crowborough area, staff the day centre. This ensures continuity of care and that, individual plans set at reviews and documented in care plans, are implemented through activities run by the day centre. All staff receive regular documented supervision and have an annual appraisal where training is identified and a programme for the following year drawn up. All staff receive a job description and are inducted in all aspects of their roles and responsibilities by a senior member of staff. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 19 Service users views are sought on arrange of issues through a customer satisfaction survey, residents meetings, reviews and one to one sessions with their key workers. The manager stated that changes would be made re the running of the home should there be an indication that the service users were not happy with the way the home was being run. All staff as previously stated receive a full copy of the homes’ policies and procedures. These were found to be adequate, appropriate, relevant and reviewed regularly. All the homes records that were inspected were found to be appropriate, adequate, accurate and complete. The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 4 3 4 4 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Old Haybarn Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 4 3 3 x x H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 21 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. 1. Standard YA34 Regulation 19(1,a,b) Requirement The manager must ensure that all staff hold a current CRB check specifying that they are employed to work for the Barons Mede organistaion, prior to them being deployed in the home. Timescale for action 12.08.2005 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 Good Practice Recommendations The Old Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Haybarn H59-H10 S44188 The Old Haybarn V237593 110805 Stage 4.doc Version 1.40 Page 23 - 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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