Care Home: 2 Farnham Road

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What the care home does well There are good systems to assess the needs of service users before they move into the home. The home has good care planning and risk assessment systems, which help service users to make decisions about their lives. Service users are supported to take part in a wide range of activities, which they enjoy. The home encourages and supports service users to meet with family and friends. Service users are supported to choose the menus for the week. Medication is stored safely and staff are trained in administering medication. Service users have access to the complaints procedure and staff know what action to take if allegations of abuse are made. The home is well maintained and comfortably furnished to provide a homely environment. Staff are well trained, which helps them meet the needs of service users. The home is well run by an experienced manager and there are good systems to keep service users and staff safe. What has improved since the last inspection? All service users now have a person centred plan in place, which have been created by service users with staff, identifying individual goals and aspirations. Service users have continued to be involved in how the home is run. A sensory garden has been created and service users have been supported in the redecoration of bedrooms. A training course called, `Our Approach` has been rolled out to staff which staff identify as a good course to enable them to work better with service users. What the care home could do better: This report does not identify any areas which the home must improve, but the AQAA states areas which they hope to improve in the next twelve months. CARE HOME ADULTS 18-65 2 Farnham Road Fleet Hampshire GU51 3JD Lead Inspector Beverley Rand Unannounced Inspection 7 February 2008 10:55 th 2 Farnham Road DS0000011541.V355618.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 2 Farnham Road DS0000011541.V355618.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. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 Farnham Road Address Fleet Hampshire GU51 3JD 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) 01252 623248 www.new-support.org.uk New Support Options Ltd Mrs Monja Gregory Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only one named person may be accommodated in the category LD (E). Learning disability over 65 years of age. 28th November 2006 Date of last inspection Brief Description of the Service: 2 Farnham Road is registered to provide care and accommodation to five people who have learning disabilities. Each service user has a single bedroom and shares the use of two bathrooms. Service users share the use of a lounge and the kitchen / dining room. There is an enclosed garden to the rear and side of the home that service users are able to access. The home is located in a residential area, approximately half a mile from Fleet town centre. Current information regarding the fees was not available, but all service users are funded by the local authority. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Before the inspection we looked at the last inspection report and read the Annual Quality Assurance Assessment, (AQAA) which the manager completed and sent to us on time. The AQAA was detailed and gave us good information. On the day of the inspection, the manager was unavailable, but we were able to speak with three staff. The service users were either unable or chose not to talk with us specifically about the service provided, but were part of the inspection process. We saw how staff spoke with service users and offered them support, as well as looking at records such as daily records and menus. What the service does well: What has improved since the last inspection? All service users now have a person centred plan in place, which have been created by service users with staff, identifying individual goals and aspirations. Service users have continued to be involved in how the home is run. A sensory garden has been created and service users have been supported in the redecoration of bedrooms. A training course called, ‘Our Approach’ has been 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 6 rolled out to staff which staff identify as a good course to enable them to work better with service users. 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 summary of this inspection report can be made available in other formats on request. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 7 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 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 8 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to assess the needs of service users before they move into the home. EVIDENCE: There have not been any new service users since the last inspection. During the last inspection we looked at three pre-admission assessments and found they covered the individual needs of the service users, including communication, personal care and cultural needs. During the assessment process, potential service users were encouraged to visit the home to meet with other service users and staff and could move in on a three month trial. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good care planning and risk assessment systems, which supports service users to make decisions about their lives and take managed risks. EVIDENCE: The AQAA stated that people who use the service are supported to have an active role in developing and achieving their person centred plan. Regular meetings are held for the people they support to enable them to be involved in making choices and decisions about the service. One service user continues to be a member of the organisation’s Regional Advisory Forum and ‘everybody counts’ group. Each person they support has a communication ‘passport’ and tools to be able to communicate in the method of their choice. Each person has a named link worker to support them in the way in which they wish to be supported. People are enabled to take risks as part of an independent lifestyle and the home regularly liaises with care managers to review whether activities 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 10 continue to meet the needs and choices of the people they support. During the visit we looked at the support plans for two service users and found them to be detailed, showing evidence of activities, risk assessments, personal preferences and healthcare needs. Daily records were set out well, meaning that it was easy to identify incidents, accidents, activities, medication issues, food eaten and to monitor the effectiveness of the support plan. We found evidence to show that information given in the AQAA was accurate. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support for service users to take part in suitable activities, to maintain relationships with family and friends and to have a balanced diet of food they enjoy. EVIDENCE: Service users are supported to take part in a range of educational and leisure activities, including bowling, attending a local day service, attending an art project, aromatherapy, pub visits and social clubs. During the day we saw service users going out, individually, with support from staff. Staff told us that service users choose how to spend their time and that staff will suggest new activities or places to go in the community. Staff also told us that friends of service users are welcome to visit the home and have a meal with them. There is art and craftwork created by service users displayed around the home and a person visits the home weekly to undertake art sessions with them, providing the necessary equipment. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 12 The menu is shown in picture format and staff said service users were involved in choosing the menus and shopping for food. During the visit we saw staff creating a new menu and trying to engage service users but they said they did not want to help. Staff persevered in trying other ways to engage them. A varied menu is offered being mindful of individual dietary needs. We saw that a service user who did not want what was on the menu for lunch chose something else. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support to meet the personal care and health needs of service users. The system for storing and administering medication is good and protects service users. EVIDENCE: Details of the personal support and health care needs are set out in their care plans. Staff spoken with demonstrated a good understanding of the needs of service users. Records are kept about service users’ visits to health services, including GP, dentist, chiropodist, psychiatrist, speech and language therapist and occupational therapist. The records kept included details of any advice given by the practitioner. Specialist health care professionals train and support staff to meet needs such as continence, mental health and diet. Medication is stored in a locked cabinet in the office and records are maintained of medication brought into the home, administered and returned to the pharmacist. Medication is regularly checked to ensure that the balance recorded matches the stocks held and that all administration records have 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 14 been fully completed. However, we found two items of medication which were no longer being prescribed and had not been returned to the pharmacy in a separate store cupboard. Staff were not aware of any reason for this but said they would look into this further. All staff administering medication have undertaken assessed training, which is updated every six months and we saw records for this. A medication error was reported to us earlier in the year and this was dealt with appropriately. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that service users have access to the complaints procedure and the home has good adult protection systems, which help to keep service users safe. EVIDENCE: The AQAA says that all service users have a copy of the complaints procedure in a format which suits them. We saw a pictorial procedure displayed in the kitchen/dining area. The home has not received any complaints and neither have we. Records showed that staff had received training in the protection of vulnerable adults and staff told us they knew to report any suspected abuse to the manager. However, they were unclear about how allegations would then be handled, saying they thought more senior staff within the organisation would always investigate. They were not aware of the role of the local authority Adult Services in investigating abuse and could not find a procedure relevant to the service itself. As stated in the AQAA, the home does have the Hampshire County Council’s procedure, but this is too lengthy for staff to use as a point of reference in the event of needing to be guided by the policy. The manager should consider how to address the above matters. The home has reported a safeguarding matter to Adult Services and following the investigations has agreed appropriate remedial action. We were advised as to what further action the home was going to take to ensure such an incident did not happen again. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 16 Some service users manage their own money, but the home does look after money on behalf of others. Receipts are kept for all transactions and we found two which showed two drinks were purchased by the service user. Staff agreed that one of these drinks would have been for the staff member. Staff spoken with said they did not usually eat out with service users but if they did, it would be refunded through petty cash. However, it was felt that a drink was different. They said they would always choose the cheapest drink possible, and would sometimes buy a drink for a service user in return. Staff were not aware of any policies and procedures around this. We are concerned that service users may not have the ability to give informed consent and that staff do not have clear guidance to ensure service users’ financial interests are maintained. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a safe, homely environment for service users. EVIDENCE: A tour of the communal areas of the home was made during the visit. The home is well maintained and decorated throughout. Furnishings are domestic and of good quality. The home has an enclosed rear and side garden that service users are able to access. We saw two service users bedrooms and they told us that they had chosen the colour scheme. There are adaptations in place where needed, such as raised toilet seats and an assisted bath. The home has a separate laundry room, which means laundry is not taken through food preparation of storage areas. There are hand-washing facilities in the kitchen, laundry room, bathrooms and toilets. Staff explained the procedures they followed when dealing with soiled laundry to reduce the risk of cross infection. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 18 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 19 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 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to protect service users and meet their needs through the staff training programme and recruitment procedures. EVIDENCE: We spoke to staff about the training programme and they confirmed they had been on training courses. A five day induction course entitled, ‘Our Approach’ has been provided for staff. One of the staff members referred to this and said it was an, ‘excellent course which puts you in the position of a service user and makes you appreciate things’. They also said two of them had attended a podiatry course, which was not part of the training programme but their attendance was supported by the organisation. Records confirmed that staff had attended a variety of training such as fire safety, food hygiene, first aid, moving and handling and health and safety. The AQAA shows that three of the ten permanent staff and one of the four agency/bank staff have achieved a National Vocational Qualification in care, level 2 or above. This is lower than the 50 suggested by the National Minimum Standards. We were unable to discuss this with the manager, but the AQAA has identified this as an area for improvement in the next twelve months. Staff confirmed that they received regular supervision sessions. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 20 As the manager was not available on the day of the inspection, we were not able to see the recruitment records of new staff. However, this standard was met at the last inspection and the AQAA states that recruitment checks are in place before new staff start work. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager and there are good systems to promote the health, safety and welfare of service users and staff. The home is run in the best interests of the service users. EVIDENCE: The manager was unavailable on the day of the inspection. However, we know that she has completed an NVQ level 4 in Care and the Registered Manager’s Award. The home holds regular meetings with service users during which household issues are discussed and we saw minutes of some of these meetings, which also showed that the evenings finished with cheese and wine, tea and cake and music. People have been supported in implementing a Person Centred Plan if they have wished to do so and have received support in regularly reviewing 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 22 and updating them. We saw from service users’ files that they have completed a quality audit form called the, ‘Ten Big Questions’ which are completed regularly. The organisation has set up a Regional Advisory Forum which is attended by people they support and their parents to enable their views to be heard at a higher level. We looked at fire records and saw that the equipment was tested regularly and staff had received training in fire safety. The AQAA states that regular health and safety checks are carried out throughout the home. We found that the potentially hazardous cleaning fluids were kept in a lockable cupboard but when we walked around the home, we saw that the cupboard was unlocked with the keys in the door. Staff said the cupboard was usually locked, and locked it straight away. Some of the open food jars were labelled, but some items were not labelled and not wrapped well. We found pate, cheese and cream cheese were exposed in the fridge. We made staff aware of this and they dealt with it. 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 23 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 3 3 X 4 X 5 X 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 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 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 3 X 4 X 3 X X 3 X 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 24 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 2 Farnham Road DS0000011541.V355618.R01.S.doc Version 5.2 Page 26 - 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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