Care Home: Cocklebury Farmhouse

Similar services:

• 2 Perhaver Park
• The Vicarage
• St George`s
• 5 Seafield Road
• Radfords
• Honeybourne House
• 32 Beaumont Way

What the care home does well Any potential new people to the service or their representatives have access to information about the service within the Statement of Purpose. People living at the home are also provided with an individual service user guide. This document is in an easy to read format and is supported by pictures. It informs the reader of what they can expect from the service, their individual room, information about staff members and how to raise a concern if they need to. Systems are in place to ensure that any new admissions to the service are fully assessed to ensure that the home is suitable for the person and that their needs can be fully met. Consideration is given to the existing group of people already living at the home and compatibility of the potential new person. Individual plans are person centred and kept under regular review. Plans are updated to reflect any changing needs. Files are well ordered and important information is easy to locate. The home identify if they are no longer able to meet an individuals` needs and appropriate action is taken, within a multi disciplinary team. People using the service have access to health care professionals as and when it is needed. People are supported to attend appointments. Evidence demonstrates that the people living at the home enjoy a wide and varied social life and are offered many life opportunities. Links with family and friends are encouraged and maintained. The people who use this service are treated with respect and their privacy is maintained. This is a service which is rarely complained about. A recent incident demonstrated that the home is fully signed up to the Swindon and Wiltshire safeguarding protocols. Staff members attend regular training and refresher courses when needed. People living at the home benefit from a pleasant environment, which is spacious, clean and well furnished. Structures within the home provide a high and consistent level of management and support. Quality assurance systems are in place to ensure that people using the service and their representatives are able to share their views. Policies and procedures are in place relating to the health, safety and welfare of the people living their and members of staff. This home continues to provide excellent outcomes for the people who live there. As a result of this inspection, no statutory requirements have been made.Within our surveys we asked, what does the home does well? Comments included; `It provides a structured environment that encourages service users in motivating themselves and gaining confidence to make their own decisions about their lives.` `Takes good care of vulnerable people and ensures that they achieve the best possible quality of life available.` `Cocklebury gives stability, routines and boundaries in a fun, friendly and family based environment with staff who have worked with individuals over many years and have built up good relationships and trust and friendships.` `The home treats all service users as complete individuals and makes every effort to ensure they can pursue their own interests as much as possible. They encourage family involvement and put themselves out to ensure home visits and contact is maintained. They give service users great holidays and parties.` What has improved since the last inspection? The service continues to maintain high standards and there were very few areas identified for improvement at the last inspection. No statutory requirements were made at the inspection in January 2006. Two good practice recommendations were set. One related to risk assessment review dates, which has been actioned. The other related to continuing to work on providing more detail about the techniques used for possible physical intervention. This recommendation has also been actioned. What the care home could do better: All documents should be signed and dated by the person who completed them to ensure a clear audit trail. The home may wish to consider developing a complaints log to enable them to easily identify any emerging trends or patterns. Within our surveys we asked, what could the home do better? We received the following comments; `I am happy the way things are.` `I would say the home does everything to a very high standard for the benefit and development of the service users.` Key inspection report Care homes for adults (18-65 years) Name: Address: Cocklebury Farmhouse Cocklebury Lane Off Darcy Close Chippenham Wiltshire SN15 3QW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Pauline Lintern     Date: 0 8 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Cocklebury Farmhouse Cocklebury Lane Off Darcy Close Chippenham Wiltshire SN15 3QW 01249658670 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): cocklebury@sky.com Mr Philip Taylor & Mrs Rhianydd Taylor Name of registered manager (if applicable) Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Cocklebury Farmhouse provides care and accommodation for ten adults with a learning disability. All current service users are male. They receive support with social and behavioural needs, in long-term placements. The service is one of a group of three in Chippenham known as the Cocklebury Farmhouse Homes . This is a private organisation. The ownermanagers founded the company in the late 1980s, and remain closely involved in its daily operation. This includes regularly working in each of the services. The property is close to the centre of Chippenham. The town offers various amenities, including shops, bars, restaurants, parks, a leisure centre with swimming pool, and a cinema. Rail and road links to Bath and Bristol are available. Service users regularly access a wide range of local amenities. This is a key feature of the programme at Cocklebury Farmhouse. The home is a detached property, set in its own Care Homes for Adults (18-65 years) Page 4 of 33 10 Over 65 0 Brief description of the care home grounds. The old farmhouse was restored during the 1980s. There is also a modern single storey extension. Service user accommodation is on two floors. There are six single bedrooms, and two which are shared. Three bedrooms have en-suite baths or showers. There are two further bathrooms for general use. Communal spaces are on the ground floor. There are two lounge areas, and a dining room. The home also has a sizeable garden, which has areas of both lawn and patio. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection took place on January 10th 2006. The home was rated as Excellent. The unannounced inspection took place on April 8th 2010 between the hours of 9:30 am and 4:30 pm. The registered manager/providers were available throughout the day to assist us. The remaining senior team were also present throughout the day. We were able to meet with all of the people who live at Cocklebury Farmhouse at some point during the day. We took the opportunity to meet with two members of staff in private to discuss their views on the service provision. We asked the home to complete an Annual Quality Assurance Assessment., known as the AQAA. This was their own assessment of how they were performing. It also gave us information about what has happened during the last year and about their plans for the future. Care Homes for Adults (18-65 years) Page 6 of 33 As part of the inspection process, we sent surveys to the home for people to complete, if they wanted to. We also sent surveys; to be distributed by the home to staff members, care managers, GPs and other health care professionals. Three health care professionals, seven staff members, and six people using the service responded. The feedback received, is reported upon within this report. We reviewed the information that we had received about the home since the last inspection. We looked around the home and read a number of records, including care plans, risk assessments, health and safety procedures and training records. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the experiences of people using the service. Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: Any potential new people to the service or their representatives have access to information about the service within the Statement of Purpose. People living at the home are also provided with an individual service user guide. This document is in an easy to read format and is supported by pictures. It informs the reader of what they can expect from the service, their individual room, information about staff members and how to raise a concern if they need to. Systems are in place to ensure that any new admissions to the service are fully assessed to ensure that the home is suitable for the person and that their needs can be fully met. Consideration is given to the existing group of people already living at the home and compatibility of the potential new person. Individual plans are person centred and kept under regular review. Plans are updated to reflect any changing needs. Files are well ordered and important information is easy to locate. The home identify if they are no longer able to meet an individuals needs and appropriate action is taken, within a multi disciplinary team. People using the service have access to health care professionals as and when it is needed. People are supported to attend appointments. Evidence demonstrates that the people living at the home enjoy a wide and varied social life and are offered many life opportunities. Links with family and friends are encouraged and maintained. The people who use this service are treated with respect and their privacy is maintained. This is a service which is rarely complained about. A recent incident demonstrated that the home is fully signed up to the Swindon and Wiltshire safeguarding protocols. Staff members attend regular training and refresher courses when needed. People living at the home benefit from a pleasant environment, which is spacious, clean and well furnished. Structures within the home provide a high and consistent level of management and support. Quality assurance systems are in place to ensure that people using the service and their representatives are able to share their views. Policies and procedures are in place relating to the health, safety and welfare of the people living their and members of staff. This home continues to provide excellent outcomes for the people who live there. As a result of this inspection, no statutory requirements have been made. Care Homes for Adults (18-65 years) Page 8 of 33 Within our surveys we asked, what does the home does well? Comments included; It provides a structured environment that encourages service users in motivating themselves and gaining confidence to make their own decisions about their lives. Takes good care of vulnerable people and ensures that they achieve the best possible quality of life available. Cocklebury gives stability, routines and boundaries in a fun, friendly and family based environment with staff who have worked with individuals over many years and have built up good relationships and trust and friendships. The home treats all service users as complete individuals and makes every effort to ensure they can pursue their own interests as much as possible. They encourage family involvement and put themselves out to ensure home visits and contact is maintained. They give service users great holidays and parties. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. There is a clear admission process in place yet information given to people to help them make a decision about using the service needs to be kept up to date and in an easy to read format. People benefit from having a detailed assessment of their care and support needs before they move in. Evidence: The service has information available within the home for any prospective new person to access. There is the more detailed Statement of Purpose and an individual service user guide for each person living at the home. The guide provides information, supported by pictures on the service provision. It provides information on the ethos, management and staff support within the home. It tells the person about their individual room and the opportunities available to them. A copy of the complaints procedure is within each document. Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: As there have been no changes to the admission processes, we used the AQAA and the last inspection to judge that a clear, well managed system would be in place if required. Two health care professionals responded always in their survey when we asked whether the care services assessment arrangements ensured that accurate information is gathered. Another health care professional stated usually. The manager explained that one person using the service had recently moved back into the home from another home within the organisation, as it was agreed within a multi- disciplinary team that the move would be of benefit to the person. We saw chronological records detailing meetings/discussions and visits to the home prior to admission. The person was able to join others on activities and for meals before the decision to move was agreed. Staff told us X was excited to come back and has slotted back in their own routines, they feel relaxed here. The manager reported that great care is taken to ensure compatibility with the existing group of people living at the home. During our visit we observed that everyone using the service appeared happy in their environment and comfortable with their peers. Since our last visit to the service one person has moved to another service, which was more suitable to meet their changing needs. Evidence demonstrates that the move was in the persons best interests and was carried out appropriately. Within our surveys one person told us It is difficult for me to give an accurate account as my visits to Cocklebury Farm are yearly and brief. However, my experience has been that residents are happy and receive the best possible care within the financial restraints. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. Service users needs and goals are reflected in their individual care plans. Service users are supported to exercise choice and control in all aspects of their daily lives. There are effective systems to manage risks so that service users can benefit from social and leisure opportunities which they enjoy. Evidence: As part of the inspection process we looked at the care records of two people living at the home. We saw that files were well ordered and information was easily accessible. Plans were person centred and individual, detailing all aspects of the persons life. This Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: included information about me, communication, personal care, communication, occupation and leisure, personality and relationships, any identified restrictions and medication and health. In addition to this the records state the amount of staff support/interaction that is needed to meet the persons needs. Evidence shows that plans are kept under review. The manager reported that review meetings are held every six months. One is an internal review and the other one with the care manager attending. The manager confirmed that most of the people receiving a service choose to attend their own review; however some people do not stay for the duration of the meeting. We saw one file where the persons needs had changed and this had been fully reflected within their plan of care. Staff members we spoke to told us that the senior staff members take responsibility for making changes, reviewing and updating care plans and risk assessments. We asked how this information is cascaded to the care staff. Staff confirmed that communication within the home is good and that changes are discussed during handovers and staff meetings. All staff sign to confirm that they have read and understood care documents. Staff members told us that having such a well structured management team accessible daily ensures that information is communicated between the team. We observed people making decisions about the way they live their lives. Through discussion we saw that people made choices about the food they ate and activities and holidays they wish to participate in. This is a service which is clearly structured around the wishes and needs of the people living there. We saw minutes from service user group meetings, where people have the opportunity to discuss the service provision and make suggestions for improvement if they wish to do so. The group discussions take place monthly. Within the AQAA under the heading what we do well it states; All service users are encouraged to make their own choices and to manage any risks these choices may entail. The service user group are involved as much as possible in the areas of the running of the home that they have an interest in. These include food menus and activities. We also asked how the service has improved over the last twelve months The service users documents about their life are improved and updated regularly on reviews. Aspects of choice concerning the Mental Capacity Act are considered and where necessary included as part of the Service User Plan. Best interest decision forms have been completed for any necessary areas. We sampled best interest checklists and suggested that they are dated to ensure that Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: there is a record of when they need to be reviewed. The assistant manager told us that he has attended training on the Mental Capacity Act 2005 and the Deprivation of Liberties Safeguards (DOLS). Strategies are in place to support people to take responsible risks. We saw one risk assessment which related to aggression and violence. The assessment was particularly detailed providing information on distraction techniques and advising staff on how to manage a potential situation whilst gaining Xs respect. Members of staff sign to confirm that they have read and understood each assessment. Care Homes for Adults (18-65 years) Page 15 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. People are provided with a range of activities and opportunities, offering them full engagement with their local community. Service users are supported to maintain personal and family relationships. Daily lives for service users have an appropriate balance between necessary routine, and individual choice. There was a high emphasis on fresh food produce. Evidence: It is evident from observation and discussion with people using the service, staff Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: members and views canvassed within our surveys that this is an outcome area where the home excel. People have an opportunity to attend colleges and partake in activities/hobbies of their choice. The home has a positive approach to getting the people they support out and about in the local and wider community. When we arrived at the home on the day of the inspection we noted that music was playing loudly and people were actively preparing for their day. People appeared motivated and keen to start their day. The manager explained that the ethos of the home was to ensure people had opportunities to keep busy. He added that people were encouraged to join in activities and people rarely declined opportunities offered to them. Within our surveys we received the following comments relating to what the service does well within this outcome area; Support the service users health, what they require, take the service users out to horse riding, bowling, college, swimming, beach trips, fun parks and trips to town to purchase items for themselves They have a full social life, with a variety of activities, including pub trips, weekly bowling, swimming, horse riding and service users needs are met at all times. I love all the activities that are available like swimming, bowling and horse riding. The home provides good fresh quality food, also helps the service users to make their own decisions when possible. It provides good daily routines and activities. In the summer and during the year, the service users have a 2 week holiday to St Ives Holiday Park and separate holidays for smaller groups during the year. Some people attend Lackham College where they attend courses on woodwork and horticulture. Some people had brought home plant cuttings, which they were nurturing. People attend the PHAB club. One person told us that they were going to Torquay with the PHAB club at the weekend. They discussed their trip during lunch with staff and their peers. Staff members told us that some people had chosen to go to St Ives this summer, where they will stay in holiday chalets. Other people had chosen to stay at home and take day trips. One person told us that they hadnt made up their mind where to go yet. Some people at the home have bicycles and they regularly ride along the cycle path to Calne. People living at the other organisations homes also join them. Staff reported that the homes do interact with each other regularly and join each other for various activities and events. This enables people to meet up with friends and acquaintances Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: other than their own peers. Throughout the home there are photographs of the people who live there at various events and day trips. One person who likes Elvis Presley showed us a photograph of themselves in an Elvis outfit. Another photograph shows service users by a limousine, which was hired for a birthday trip. The manager reported that the limousine trips are a great favourite. He told us about a recent trip to a local Indian restaurant to celebrate his birthday. The manager treated all of the people in the home to a meal. Staff reported that it was great fun and everyone enjoyed it. People regularly go swimming, horse riding and bowling. On the day of our visit some people had left to go to the Olympiad pool in Chippenham. The manager commented that they make sure they go early during school holidays so that they have access to the flumes before the pool becomes crowded. On their return people were telling everyone about their experiences and how much fun they had. The home has its own vehicle, which seats nine people. Two staff always accompany service users when they go out in a full bus. Some people at the home are able to access the community independently. One person has a girlfriend who lives locally and he visits her regularly. One person told us that they are keen on horse racing and liked to place a bet now and then. We discussed their tips for the Grand National. They added that they enjoyed football and sometimes watched the results at a staff members home. Another person using the service told us about their experiences as a goalie; there were cups and shields which they had won displayed in their bedroom. They told us that they were a season ticket holder for Chippenham football club. A staff member confirmed that the person often went to football practices held in a local school. On a Wednesday night the two managers carry out sleeping in duties in two of the houses. They use this as an opportunity to take service users from both homes to the pub for a social evening. Service users are supported to attend concerts, the theatre and to watch tribute bands. One staff member told us that she had accompanied one service user to London to see Cliff Richard in concert. This was followed by an overnight stay in a hotel. As mentioned previously, peoples choices are respected by staff although people are encouraged not to lie in but to get up and become involved in the days activities. Most people appeared keen to not be left out. The manager told us that everyone has Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: a healthy sleeping pattern as they are so busy during the day. Evidence demonstrates that people are encouraged and supported to maintain links with families and friends. One relative told us within our survey I am filling this form in on behalf of my son X as he cannot read or write. He has a home visit every week and is always well dressed and clean. He is happy and returns with staff after his visit quite happily. We visit Cocklebury and we know it is kept well and the staff are wonderful. People living at the home benefit from the large communal space, available to them. The manager explained that generally people do not choose to spend time in their rooms, preferring to be with staff and other people using the service. On the day of our visit we saw that people sat in various areas of the home, some watching TV, some colouring, listening to music or just joining in conversations with staff and managers. We noted that staff and managers interacted positively with the people they support and they were never excluded from any discussion. We saw staff respecting peoples wishes and seeking their views. Meal times are a social event, when everyone sits together for their meal. The emphasis is on providing home made meals using fresh local vegetables and meat from a local farm shop. The home has a cook working Monday to Friday. At the weekends care staff takes over the responsibility of meal preparation. On the day of our visit the main meal was homemade cottage pie and vegetables. Fresh fruit is served as a dessert. Service users made drinks for everyone following the meal. During the course of the meal we noted that everyone interacted well with each other. Care staff and managers joined in the banter. It was evident that meal times are a very important event within the home. One person using the service told us there are good cooks here. We went for a Chinese meal last week and I had spare ribs, duck pancake and beef in onion and ginger. Care Homes for Adults (18-65 years) Page 19 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. People are supported with areas of personal care if required. People have access to healthcare professionals if required. People are protected by the homes policies and procedures for dealing with medicines. Evidence: Within the AQAA under the heading what we do well it states, Individual needs and preferences in terms of personal care and healthcare support is defined clearly in the Service User Plan. All service users have their own Health Action Plan detailing the healthcare support they receive and who helps them to access this professional support. Service users on prescribed medication are fully protected by the homes procedures and risk assessments. Physical exercise is promoted by the home to encourage healthy lifestyles. The health needs are very well catered for. All service users have annual routine health checks and whenever there is a suspected medical problem, appointments are made with the appropriate professional and a member of staff assigned to support them in this. Weight charts are updated weekly. Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: Within care plans we saw that some people require some support and prompting with their personal care. For example one plan reminds staff that X needs assistance with running the bath. Records demonstrate that people have access to healthcare professionals when required. Within the AQAA it states One service user currently has a broken arm. This is being treated by the fracture clinic at Bath RUH. The same member of staff has been attending all the appointments with the service user to ensure continuity. We have been following all the advice from the hospital and have been keeping the service users mother informed of all developments. Policies and procedures are in place for the safe handling of medicines. We sampled the medication administration record and noted that it had been completed properly with no unexplained gaps. Guidelines on the use of as required medication are included within the persons care plan. Only senior staff administer medication. They receive relevant training from the pharmacist that supplies medicines to the home. Training has also been given to other carers, to promote their understanding of the topic. Care Homes for Adults (18-65 years) Page 21 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. People living at the home are safeguarded by the homes policies and procedures for complaints and protection. Evidence: Overall this is a service where residents are safe and listened to and a service rarely complained about. Within our surveys we asked if people knew how to make a complaint or raise a concern. All responded positively. One health care professional commented that the service usually responded appropriately when they have raised concerns. All other responses confirmed that they always responded appropriately. The home does not have a complaints log, which is kept within the home although documents are kept of any complaints received. We suggested that a complaints log be developed and kept at the home for easy access. This will ensure that any trends or emerging patterns are easily identified. Within the AQAA it states that the service has improved over the last twelve months complaints procedures have been updated to include extra information. Arrangements for protecting people from abuse are suitably in place, with staff being Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: aware of the procedures to be followed. Staff members reported that they have read the No Secrets guidance. Staff impress as being protective of the people they support and wanting to provide a safe service. The home recently had an adult protection issue, which was dealt with appropriately, effectively and efficiently involving outside professionals and following safeguarding procedures. Following the incident all staff members received refresher training in safeguarding people. The manager explained that during a team meeting they also discussed the impact of a safeguarding investigation and how staff may be supported throughout the process. Within the AQAA it states Physical intervention is required on occasion due to the nature of the service user group. This is performed as a last resort and the intervention used is the least restrictive possible. There is detailed information in the Service User Plans and as risk assessments and this utilises best practice principles. The managers consulted with relevant parties in deciding which techniques should be applied to a particular person and the risk assessments and procedures in place are extensive. Staff members attend training on the use of physical intervention, which is followed up with refresher courses. Service user plans contain details on distraction and physical techniques to be applied to individuals if appropriate. Care Homes for Adults (18-65 years) Page 23 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. People live in a comfortable, clean and safe environment. Evidence: The home is located in a quiet residential area, within its own pleasant grounds. Local amenities are easily accessible. As part of the inspection process we toured the premises and found the home to be decorated and furnished to a high standard. All areas were cleaned to a good standard and well maintained. The provider told us that they employ a maintenance man when necessary to carry out tasks. He reported that the staff will often volunteer to undertake decorating tasks with the people who live there assisting them if they wish to do so. The home is spacious and homely. People living there benefit from having ample space, where they can either choose to be alone or join others in communal areas. The home has a pleasant garden with lawns and a patio area. Staff reported that Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: sometimes they hire a bouncy castle for the garden in the summer months. They added that the people living at the home enjoy taking advantage of the garden, especially when the paddling pool is in use. The home employs a cleaner, who works weekdays. Care staff carry out these duties at other times. The home has a separate laundry, which houses two washing machines and two driers. All toxic materials are stored in the office. Care Homes for Adults (18-65 years) Page 25 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. People are supported by an effective staff team, who appropriately trained, competent and qualified to meet their needs. There has been no new staff since the previous inspection when the standard about recruitment was met. Evidence: Throughout the day two care staff are on duty. In addition to this there are two managers and one deputy manager and one assistant manager, who provide extra support as and when it is needed. One member of staff undertakes sleeping in duties. There is also an on call system in place. The managers reported that they cant remember the last time we were needed during the night. The home has never used agency staff. If cover is needed for annual leave or sickness, staff from elsewhere in the organisation cover these shifts. The assistant manager reported that the staff at Cocklebury are very motivated and are happy to give up their own time for the people they support. Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: The management structure is well established and appears to work very well. One member of staff we spoke to told us communication between us and the managers is excellent as they are always around to discuss issues. Another staff member told us I am happy, we provide a good level of care and each manager knows each service user well. Seven members of permanent staff have achieved a National Vocational Qualification level 2 or above. Within the AQAA it states each of the management team have earned the NVQ HSC Level 4 and Registered Managers Award. All staff have the minimum of HSC NVQ level 2 and many now have level 3. Within the AQAA under the heading what we do well it states Cocklebury Farmhouse has a long term and dedicated staff team. Continuity of staff is pivotal to the successes of Cocklebury Farmhouse. It is essential that the staff have a good working relationship with the service users and a good knowledge base of the service users characters, likes, dislikes, wants and needs. All staff are provided with clear and concise job descriptions, their own copy of the policies, procedures and risk assessments (except those specific to service users) as well as the GSCC Codes of conduct. Staff are also given their own policies and procedures file which includes the No Secrets document for safeguarding vulnerable adults. All staff follow an intense period of induction which includes a pack to work through and a period of a few weeks where they are shadowed to ensure they know exactly what they should be doing. The induction process is intensive and specific to the home and service users. Due to there being no newly recruited staff since the last inspection the key standard which relates to the recruitment process could not be fully addressed. However within the AQAA it states All staff are recruited through a recruitment process including adverts, application forms, interviews and subsequent management discussions about the candidates. Before staff commence employment, two written references are obtained along with a returned POVA and CRB checks. These along with records of supervision sessions, are found in the personal staff files, locked in a filing cabinet in the office. The assistant manager explained that any new candidates are invited to the home before the interview process so that service users can meet them and have the opportunity to show them around the building. The manager reported that service users views on the potential new staff are canvassed. Employees who are new to the organisation begin at another home. If they are then deemed suitable, they may move to Cocklebury Farmhouse. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: Induction is carried out in line with the Common Induction Standards. Two members of staff explained their induction period which included, reading policies and procedures, shadowing more experienced members of staff, fire training and a vehicle induction. Staff receive mandatory training in subjects such as manual handling, fire awareness, basic food hygiene, health and safety and safeguarding. The care staff we spoke to told us that they had also attended training in epilepsy, oral hygiene, breakaway techniques and autism. We asked one member of staff if they feel that they are appropriately trained to meet the needs of the people they support. They commented I definitely feel trained enough to meet peoples needs. Within our surveys we received the comment Cocklebury farmhouse by virtue of excellent organisation and excellent staff provide great help and back up to their clients, enabling clients to have a far better quality of life than would be possible in any other environment. Care Homes for Adults (18-65 years) Page 28 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to the service. People using this service benefit from a well run home, with clear leadership Systems are in place to monitor quality assurance. Health and safety policies and procedures are in place. Evidence: The home has been registered since 1988. As mentioned previously in the report there is an established senior management team, who have regular direct contact with the people they support and members of staff. It was evident from our visit that the people living at the home have good relationships with all of the management team and are used to having regular access to them. We saw senior managers spending time with individuals, sharing a joke and reassuring them when necessary. People are clearly benefiting from a well run home. Quality assurance is taken very seriously and conscientiously. Service user satisfaction Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: questionnaires are in a pictorial format. Questionnaires are sent out to service users, friends and families every two years. As a result of the surveys, actions and outcomes are documented and fed back to the appropriate people. People living at the service have regular group discussions to share ideas and views on the service provision. Due to the ethos of the home people are able to discuss issues, worries or ideas at anytime of the day. People we spoke to told us that they were happy living at Cocklebury Farmhouse and this was evident from our visit. The most recent discussion group took place on 23/03/2010 when fire evacuation, complaint procedures, lunch swaps and a valentines party were amongst the topics. The home has a development plan in place, which includes issues relating to each of its services. We saw that regular health and safety checks take place and records are kept. The fire risk assessment has just been reviewed to include recent changes; this was dated 6/4/10. The fire officer had recently carried out an inspection of the premises. Environmental risk assessments are in place for all areas of the home. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 31 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 7 22 All best interest checklists should be signed and dated. Consideration should be given to developing a complaints log. Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 33 of 33 - 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!