Inspection on 14/12/06 for Willowdene Farm

This inspection was carried out on 14th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Willowdene Farm 27/02/06

Willowdene Farm 02/12/05

Willowdene Farm 21/12/04

Willowdene Farm 22/06/04

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

CARE HOME ADULTS 18-65 Willowdene Farm Chorley Bridgnorth Shropshire WV16 6PP Lead Inspector Deborah Sharman Key Unannounced Inspection 14th December 2006 09:30 Willowdene Farm DS0000020720.V316091.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 Willowdene Farm DS0000020720.V316091.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. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willowdene Farm Address Chorley Bridgnorth Shropshire WV16 6PP 01746 718658 01746 718039 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) Willowdene Farm Ltd Mrs Jennifer Mary Home Jenny and John Home Care Home 12 Category(ies) of Past or present drug dependence (12) registration, with number of places Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27 February 2006. Brief Description of the Service: Willowdene Farm is situated in the rural village of Chorley, Shropshire and is owned and managed by John and Jenny Home. The Farms purpose is to provide rehabilitation support over a nine-month period, to recovering drug addicts. This programme has enabled the home to commence their expansion plans and increase the student turnover, without diminishing the quality of therapy, support and care being provided. All referrals are made via care management and potential students are made fully aware of the commitment needed to complete the programme, prior to admittance. As a student, facilities are available for total rehabilitation, including the opportunity to safely learn new skills, gain qualifications and receive therapeutic support. A routine and structure is in place that encourages self worth, responsibility and trust. All services are provided in line with regularly reviewed care plans and risk assessments. Support is given to enable students to find accommodation and employment as part of the resettlement and discharge programme. A conscious decision was made earlier in the Farms history to accommodate male students only. The rehabilitation programme runs for 39 weeks. The weekly fee is currently £749.00. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection meaning no one associated with the home received prior notification and were therefore unable to prepare. One Inspector carried out the inspection over an eight-hour period. This was a key inspection meaning that all key standards as a minimum were assessed to judge the home’s performance. A range of methods was used to plan the inspection. Prior to inspection the provider was requested to send information to CSCI and this in conjunction with the home’s known history and written feedback provided by residents was used to plan the focus of the inspection. On the day of inspection the inspection process was supported by a range of staff and both Proprietor / Managers so the inspector was able to speak to a range of employees. In addition the Inspector met with a group of residents, interviewed one additional resident in detail about his experience of the service, toured the premises guided by a further resident and sampled the mid day meal. The inspector had access to a range of documentation including care documentation for one resident whose care was looked at in detail including the pre admission stage. The Inspector was able to interview this resident to verify the documentation. As this resident does not take medication, auditing medication records for a further resident contributed to the assessment of medication practice. Service users some of whom have experienced up to three other rehabilitation units stated that the service provided is excellent. The outcome of this inspection upholds their view. What the service does well: Almost all aspects of the service are provided to an excellent standard. There are clear admission processes as the success of this is considered to be central to the success of the rehabilitation programme. Applicants are well supported prior to admission to know what the programme entails and what their responsibilities will be. During the programme residents benefit from therapy, vocational activity and an approach that respects and meets their needs. This is provided in a safe, homely, family environment providing a foundation for personal current and future development. Residents have a high regard for the management approach of the home and value the contribution of each staff member. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 6 Here are some of the things residents said: ‘If you’ve got problems they have always got time to listen and it’s a safe environment. John and Jenny are really good people.’ ‘If you are thinking of coming here, just come. It’s a good place, a leg up to get a grip on things.’ ‘Willowdene Farm is giving me the skills to move on. Its helping me to find out what I’m good at’ ‘I had to do a lot of hard work to get here because it’s the only place I would have come. ‘Staff will ‘do anything to help you’ ‘Staff treat you – ‘too well, they are too kind’ ‘This place has changed my life for the better more than any one could ever know. I have my life back now’. Asked by the Inspector to rate the home on a scale of 1 to 10 one resident replied ‘10’. Asked what the home could improve the service user replied ‘ nothing’. Asked by the Inspector to rate the home as poor, adequate, good or excellent, a group of three residents all said ‘without a shadow of a doubt, excellent’. What has improved since the last inspection? What they could do better: Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 7 The service provided at Willowdene is unique and does not readily fit with many of the National Minimum Standards. A proportionate approach has therefore been taken in response to this. This is an excellent service and the home always acts in the best interests of service users. Some areas for improvement were agreed with the proprietor / Managers. These were in relation to some aspects of medication management and the recruitment of new staff. An excellent response committing to the improvement of recruitment and the provision of medication training has been received by CSCI from the proprietors prior to writing this report. The proprietor / Managers said that Adult Protection training had been provided for staff but this could not be evidenced. They had recognised the need to provide refresher training in this area and have committed to providing this for staff in 2007. In addition the Proprietor / Managers are now aware that they must report to CSCI any incident that affects the welfare of service users. Progress made will be assessed at the next inspection. 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. Willowdene Farm DS0000020720.V316091.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 Willowdene Farm DS0000020720.V316091.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): 2, 3, 4, 5 Quality in this outcome area is excellent. Applicants can be reassured that their needs will be assessed prior to admission and they will only be admitted if they meet the homes admission criteria and the home believes that it can meet their assessed need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Structured systems are in place for the assessments of a resident’s suitability for the rehabilitation programme on offer. Representatives of the home, travel to all areas of the UK to undertake evidenced assessments, collate information from other professionals and where possible ensure that residents have the opportunity to visit before admission. It is crucial to the therapy process that only residents who want to be there are admitted. Staff had a very clear understanding of the criteria for admission and applicants who don’t meet this criteria are turned down. All residents who provided feedback during and prior to the inspection said they received plenty of information to help them decide they wanted to become a resident at Willowdene Farm. A brochure, DVD and contract which are explained to the resident and signed prior to admission all support the Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 10 assessment and decision making process prior to admission. There was good evidence that procedures are adhered to in practice. Willowdene Farm DS0000020720.V316091.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, 9. Quality in this outcome area is excellent. A therapeutic plan is in place for all residents who are made aware on a daily basis of any changes. Risk management is an integral part of the home’s approach from prior to admission but residents are supported to take appropriate risks. Residents are subject to clear and agreed restrictions to aid the recovery process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoken to are very satisfied that their needs are known and understood. Their needs are reviewed and responded to. They understand their plan of care and the rationale behind the therapy, vocational activities and the rationale for the rules and restrictions that are in place. Daily schedules are posted on the wall daily to inform residents of the therapy, domestic and training schedules for that day. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 12 A resident described the support that staff are providing to facilitate his goal to improve his literacy. Using the Internet a staff member located a literacy programme he had described to her and purchased it for his use. He said staff are helping him to complete the exercises in it every night. He is delighted with the progress he is making and described to the Inspector how his improved skills are affecting his life in a very positive and tangible way. Risks are managed by identifying them prior to admission. Residents who are assessed as not fitting into or who risk disrupting the programme are not admitted. Risks to residents on the programme are minimised through the establishment of a culture of respect and a strict none tolerance programme. Breaches of contract, which by definition present risk, are dealt with by exclusion from the programme. A range of risk assessments is in place for the hazardous training activities undertaken and machinery used. Risk is also managed by providing residents with a range of training in health and safety. Residents through discussion indicated that they value this and during a tour of the environment with the Inspector a resident was mindful of the issues he had been taught. Willowdene Farm is a unique environment and the National Minimum Standards are not all relevant. For example there are restrictions of varying degrees to mail, telephone calls, access to the community and visitors depending on residents stage within the programme. However this is a clear part of the therapeutic process to meet resident need. All residents spoken to said they were fully aware before admission what restrictions would apply, that they fully appreciate their rationale and best interest purpose. One resident said that the rules were not hard rules to stick to. Willowdene Farm DS0000020720.V316091.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, 14, 15, 16, 17 Quality in this outcome area is excellent. Residents have opportunities for personal development by taking part in a range of vocational training and therapeutic programmes. Whilst there are some restrictions in place to support recovery, residents rights are respected and they are encouraged to take personal responsibility. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of their programme residents lead very full and active lives with plenty of organised, physical activity. They attend training sessions morning and afternoon in a range of vocational activities – forestry, tree felling, engineering, woodwork, numeracy, literacy and information technology. There are plans to develop opportunities further by acquiring farm animals for residents to work with as the Farm has recently purchased an additional 38 acres of adjacent land. Sessional workers whom the residents spoke very Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 14 highly of deliver some training. Residents are excited about the opportunities available to them and see their direct relevance to rehabilitation and the prospect of securing work upon completion of the programme. All residents complete health and safety training courses. Residents explained with pride how they had obtained recognised qualifications in Moving and Handling, Food Hygiene and First Aid within a three-day period. During leisure time there are plenty of facilities on the farm. Residents play football, walk in the woods, go fishing and when competent can work unsupervised in the woodwork workshop. They are also accompanied on trips into town to buy essential items. Restrictions are in force to aid recovery. These include restricted access to the community, phone calls, visitors, regular urine tests to ensure the well being of the individual and the group as a whole. Mail is not read by staff but is checked. Residents are asked to open it in the presence of staff. As discussed these are all agreed to by the residents who are free to leave the programme should they wish to. Access to family and children via agreed visits and telephone calls is approved where appropriate according to the stage of treatment. Contact with family is enabled although supervised in extenuating compassionate circumstances should a situation arise prior to the usual stage for contact. Willowdene Farm is associated with a charitable Trust in Guyana and is supporting communities there with sustainable work projects. Trips to Guyana are organised every two months with up and coming trips are planned for February and April. All residents have the opportunity to go to Guyana to contribute to the work there. The trip is entirely funded by Willowdene Farm. Service users contribution to preparing for the trip encourages personal responsibility and therefore reinforces the core of the therapeutic process. Willowdene Farm prides itself on the provision of good food. Discussion with staff demonstrated the recognition of the importance of this given the active lifestyles of the residents on the farm. Stocks of food are plentiful. Residents help themselves to whatever they want from breakfast time until 10pm preparing their own breakfast, tea, supper, drinks and snacks in between meals if required. A substantial main meal is cooked for them at lunchtime with the menu being adhered to. Residents can request an alternative in the morning and they confirmed that this is provided when requested and that the system works well. Residents told the Inspector that staff provide support with kitchen skills when necessary. The Inspector observed residents working in the kitchen. All were wearing disposable aprons to promote good hygiene practice. Willowdene Farm DS0000020720.V316091.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): 19, 20. Quality in this outcome area is good. Personal care support is not needed but service users general physical and emotional health needs are understood and are met exceptionally well. The home handles limited amounts of medication but some areas were identified as requiring improvement. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Willowdene Farm does not provide any personal care to residents. Health outcomes are very good. Staff understand the impact upon health of long term drug taking and plans show how health needs are assessed and met. One resident whose care was tracked is receiving ongoing dental treatment, has had an initial GP check up and following an optical assessment has been prescribed and issued with glasses for the first time. Willowdene Farm contributes £25 towards the purchase of glasses for residents. Changes in health are responded to well. One resident prior to inspection had had toothache. Willowdene Farm promptly arranged for him to see an out of hours dentist and paid the required fee for a private prescription. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 16 The purpose of Willowdene Farm is to support service users emotional health to aid recovery. Service users benefit from the provision of a fortnightly 3hour therapy session based upon Gestalt principles. The Farm has employed a new therapist since February and the residents indicated to the Inspector that they hold her in high regard. They said they find the therapy to be useful and effective. Medication Administration Records are maintained as the home takes responsibility for the administration of medicines to residents. Individual records are not kept and through discussion the proprietor agreed that this would be an improvement. There is usually an audit trail for medical direction as copies of prescriptions are kept which is good practice. However the emergency dentist issued antibiotics without a prescription and directions for the administration were not clarified. In this instance it was unclear how the doses had been decided. Medication Administration Records are handwritten and attention must be given to ensuring that directions are transcribed from prescriptions in full including the full name of the drug, the strength, the frequency, the amount received onto the premises and the times of administration. Residents are provided with homely remedies upon request. This is without medical authorisation and discussion showed that at times the Manager is making clinical decisions. Medical authorisation for homely remedies provided during the initial GP health check would support both the safety of the service user and provide safe guidance for staff. Where a service user needs medication this for evident reasons is stored and administered by staff. Minimal amounts are stored and administered. All staff administer medication but medication training is not provided. The proprietors confirmed in writing to CSCI within hours of this inspection their commitment to providing medication training. The Commission for Social Care Inspection’s Pharmacy Inspector has provided advice in respect of the issues outlined. Willowdene Farm Proprietor / Managers provided the Inspector with a copy of their medication policy. CSCI’s Pharmacy Inspector has been consulted in respect of its sufficiency and he will subsequently provide the home with advice. Willowdene Farm DS0000020720.V316091.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, 23 Quality in this outcome area is excellent. Service users feel safe and feel that their views are listened to and know how to complain should they need to do so. There is however an established culture of responding to grumbles before complaints or incidents arise. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Policies and procedures have not changed since the last inspection and so were not assessed. All residents were satisfied that they know how to complain should they want to. However weekly residents meetings evidence the allocation of time to ‘grumbles’ so that issues can be dealt with before they become complaints or incidents. The home has not received any complaints for over two and a half years and none have been made to the Commission for Social Care Inspection. The previous complaint was not made about the quality of the service but was made by a visitor about the conduct of a resident. This complaint was investigated, upheld and the resident concerned was required to leave the programme. This evidences how seriously complaints are taken when received and that appropriate action is taken in response. All service users spoken to said that they feel exceptionally safe at Willowdene Farm. The therapeutic approach employed directs a respectful and diffusing approach to the management of issues which may trigger anxiety or Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 18 aggression. All service users spoke very highly of how staff approach and respond to issues before they get out of hand and there is an inherent culture of respect, tolerance and anti violence or competitiveness to aid individual development and social cohesion. This is because the basis of the therapy is the fundamental establishment of a safe environment which inspection shows is maintained. All staff are issued with copies of the Whistle blowing policy. The Inspector was told that all staff including a new staff member had undertaken Adult Protection training. Evidence could not be located but the Registered Proprietor / Manager said he was aware of the need for refresher training and it was agreed that this would be arranged for all staff and volunteers. The proprietors have confirmed this intention in writing to the Commission for Social Care Inspection prior to writing this report. The management of service users monies was not inspected on this occasion although service users said they were satisfied with arrangements. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 19 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, 30. Quality in this outcome area is excellent. Residents live in a homely and safe environment that is comfortable, welcoming and meets their needs and lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A resident offered to show the Inspector around. His pride and ‘ownership’ of the farm, its mission, its work and its facilities was very evident. Another resident said that it was fantastic as it was the first real home he had had. Residents spoken to were very satisfied with their bedrooms some of which are shared and all communal facilities, which meet service user need. Residents said that they like the home’s ‘lived in feel’ as it helps them to relax without ‘standing on ceremony’ or having to take boots off. All residents accommodated are mobile. Discussion with the proprietor / Manager indicated an awareness that as a result of prolonged drug use the Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 20 home may be asked to provide a service for a service user who is an amputee. The proprietor stated that some ground floor accommodation is available and adjustments could be considered subject to their registration. Laundry facilities are available which residents use when they want to. Pre inspection comments from residents indicated that the environment is ‘usually’ clean. Exploration of this with service users at inspection showed that they are responsible for domestic chores on a rostered basis and are satisfied with the cleanliness. During the inspectors tour of the premises all facilities were found to be acceptably clean and fresh. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 21 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, 34, 35 Quality in this outcome area is generally excellent. A dedicated, competent and qualified staff team within a family environment supports residents. Decisions about the recruitment of staff are made in the interests of service users but recruitment systems require some improvement to protect their interests as far as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a good staff training programme in place. A new staff member has undertaken several relevant courses including induction since employment five months previously. All service users spoken to spoke exceptionally highly of all staff and described them as more than competent. Service users in a group meeting with the Inspector said that the proprietor / Managers are ‘good people’ and appreciated that they benefit from their dedication. One service user said ‘it’s a way of life for them’. Service users stated that they are satisfied with staffing levels as ‘there is always someone available to talk to day or night’. One service user gave the example that there is enough staff available to ensure that he is supported Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 22 nightly with his literacy programme over and above the usual activity timetable. He was delighted with the progress he is making and described how it is changing his life. There were some significant omissions in recruitment checks undertaken for a new staff member and volunteer, both of whom are well known to the proprietors. However the omissions were acknowledged and immediate action was taken and was confirmed in writing to CSCI to ensure future improvement. There was good evidence of the provision of supervision for staff. A therapist confirmed that she receives clinical and personal support external to the home regularly and also from the homes management. She said she feels well supported. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 23 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, 38, 39, 42. Quality in this outcome area is excellent. Residents’ benefit from a well run home and from the ethos, leadership and management approach of the home. Service user welfare and safety underpins the practice and their best interests guides the homes focus. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Proprietor / Managers are very experienced and are appropriately qualified. Residents spoke of the professionalism and dedication. They are clear about the aims of the service provided and the values that underpin and sustain it. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 24 The home has quality assurance systems in place. It was positive to see that written feedback had been sought from a resident about the service and his perception of his progress at the first review stage. The feedback was exceptionally positive and required no further action or follow up. Review meetings are very well managed. They are held regularly are well recorded and feed into the quality assurance system. Staff team meetings with a resident welfare and safety focus were well evidenced and are held very regularly. There are many risk assessments in place for the range of hazardous activities and environments provided by the farm and the vocational training undertaken by residents. Whilst on a tour of the premises with a resident, the Inspector was mindful of the residents attention to health and safety issues and knowledge he had gained from his induction training was very apparent in discussion. All service and maintenance documentation requested was made available and was seen to be up to date. Electrical wiring tests which are usually undertaken five yearly are carried out annually in recognition of the increased risks associated with the tasks undertaken. Fire safety systems were not inspected as the Fire Service carried out a satisfactory fire service inspection in July 2006 with no requirements or recommendations for improvement. The Proprietor / Managers had not been aware of the need to report incidents affecting the welfare of residents to CSCI and undertook to do so in future. In discussion with a group of three residents, the Inspector asked them to judge the service as either poor, adequate, good or excellent. The resounding response was ‘without a shadow of a doubt – excellent’. Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 25 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 X 2 4 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 4 34 2 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 4 2 X 4 4 3 X X 3 X Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 26 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 YA20 Regulation 13(2) Requirement The Managers must ensure that: • Clear prescribing directions are obtained at all times for the administration of medication. Prescribing directions are fully and accurately transcribed into the plan of care and Medication Administration Record. Timescale for action 31/12/06 • 2 YA20 13(2) Requirement arising from inspection December 2006. The Managers must ensure that: • All staff that administer medication are provided with appropriate medication training and that systems are put in place to assess on going competency. The Medication Policy is reviewed. There is a homely remedies protocol for 31/03/07 • • Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 27 individual service users that is based upon medical authorisation. Requirement arising from inspection December 2006. 3 YA34 19 13(4) The Managers must ensure that all information and documents required by regulation in respect of a person working at the care home are obtained prior to commencement in employment – paid or voluntary. Requirement arising from inspection December 2006. The Registered Persons must ensure that all accidents, injuries, incidents affecting the welfare of service users as defined by Regulation 37 are recorded and reported in writing to CSCI without delay. Requirement arising from inspection December 2006. 31/12/06 4 YA42 37 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. Refer to Standard Good Practice Recommendations Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Willowdene Farm DS0000020720.V316091.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!