Care Home: Decoy Farm

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What the care home does well This was the first inspection of this, new service. Imagined and set up as a totally new type of community based care scheme, where residents not only lived, but also worked and ran the farm with staff support; it created an environment that was safe for residents, but that expected them to contribute and run the place how they wanted. This promotion of their abilities was used in therapeutic plans, offering them the opportunity for a progressive, responsible and full integration into the community. Nurses, mainly coming from an NHS background with huge clinical knowledge and skills and support staff that did not have a clinical background set the administrative aspects, including care plans. These documents were very well written, in detail, with all relevant information and signed and dated. The main achievement of the scheme was seen and heard when a resident showed us the home and the farm and talked with enthusiasm and pride in the already achieved stage of their work and integration.Decoy FarmDS0000072813.V376041.R01.S.docVersion 5.2 What has improved since the last inspection? This was the first inspection since the home was opened. What the care home could do better: The home and the residents had their own plan for progress and there was no need for the regulation authority to require or recommend anything. Key inspection report CARE HOME ADULTS 18-65 Decoy Farm Browston Lane Browston Gt Yarmouth Norfolk NR31 9DP Lead Inspector Dragan Cvejic Key Unannounced Inspection 17th June 2009 08:30 Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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 home adults 18-65 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. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Decoy Farm Address Browston Lane Browston Gt Yarmouth Norfolk NR31 9DP 01502 573054 01502 502392 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) Country Retirement and Nursing Homes Limited Wendy Jack Care Home 5 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (5) of places Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Mental Disorder, excluding learning disability or dementia - code MD The maximum number of service users who can be accommodated is 5 2. Date of last inspection Brief Description of the Service: This new service opened within a farm created very nice conditions for its residents. The farm house provides a home for 4 residents. The barn, next to it, is going to be converted into another residential part, which will expand the size of the scheme. The other buildings are used for different purposes for residents. A woodwork workshop, a place for a new canteen, a home for small animals with a patio used for rabbits, with hatches and a wooden fence area around it, and a conservatory currently used as a quiet lounge. A garden with three different parts: one was a leisure area with an inflatable swimming pool and a football play area, the other, much larger part, was used as an organic vegetable farmyard and the third currently provided a home for chicken, geese and a planned area for a home for donkeys. The staff allocated to the scheme primarily looked after the residents and worked together with them tending to the animals and a vegetable patch. The entire farm constituted the residents home. The fees are agreed with referring bodies and presented in the home’s documents. Decoy Farm DS0000072813.V376041.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 stars. This means the people who use this service experience good quality outcomes. Since its opening the home was given time to develop for the first six months. We visited the home on 17/06/09. A resident showed us the home, the lounge, where two other residents rested, the farm and the animals, talked about further development plans and explained how the farm functions: who does what work, explained how the committee consisting of residents and staff plans to use income generated from the farm and who pays what for current running. The manager and a senior nurse explained the care principles and administrative aspects of care, such as care plans and other documents. Senior nurse talked about management style and staff feelings and atmosphere in the home. She also explained in detail therapeutic methods and work done with residents. We checked two residents and two staff files. We checked medication and records for two residents. What the service does well: This was the first inspection of this, new service. Imagined and set up as a totally new type of community based care scheme, where residents not only lived, but also worked and ran the farm with staff support; it created an environment that was safe for residents, but that expected them to contribute and run the place how they wanted. This promotion of their abilities was used in therapeutic plans, offering them the opportunity for a progressive, responsible and full integration into the community. Nurses, mainly coming from an NHS background with huge clinical knowledge and skills and support staff that did not have a clinical background set the administrative aspects, including care plans. These documents were very well written, in detail, with all relevant information and signed and dated. The main achievement of the scheme was seen and heard when a resident showed us the home and the farm and talked with enthusiasm and pride in the already achieved stage of their work and integration. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 6 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. Decoy Farm DS0000072813.V376041.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 Decoy Farm DS0000072813.V376041.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although currently referred to the scheme from the hospital and clinically run settings, residents were provided with the information and trial that allowed them to decide if they wanted to stay on the farm as their main residence. EVIDENCE: Information about the farm provided appropriate details in their statement of purpose and service users guide, which helped residents understand the setting and get a clear picture of expectations and opportunities. In their AQAA, a self assessment, the manager explained details about the admission: “We have a colour brochure for Decoy Farm, Service user’s guide and Statement of purpose, which were sent out to all the residents and their families prior to them moving in. Some of the families were involved very early in the planning and building of Decoy Farm as a new service. We provide a full assessment prior to the admission of any residents. We carried out transitional processes for the residents and worked with their health care professionals, other members of the multi-disciplinary team as well as families so as to ensure Decoy Farm was the most suitable placement for them. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 9 All residents admitted so far have been detained in hospital under the Mental Health Act (1983) prior to admission. The Home’s Manager attended CPA and Section 117 meetings as well as Mental Health Review Tribunals in the period leading up to discharge for all residents. This pre-admission period was essential in order to achieve the best possible outcome for each resident i.e. a smooth transition and robust plan of care involving all relevant professionals.” The resident who showed us the farm stated that staff were excellent and “completely met the needs of all residents.” The files checked also proved that a multidisciplinary team was involved in assessments of how the needs were met. Mixing clinically experienced and non experienced staff created further potential for reviewing both clinical and non-clinical needs, including social, intellectual and spiritual needs. Independent advocates were recently engaged for each individual. An introductory period was organised for a month, testing if all assessed needs could be met and if residents were keen to stay to live and work on the farm. A three monthly review after the opening included families and external professionals in the assessment of the settling in period. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 People using the 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 first inspection showed that residents were running the farm according to plan and in negotiation with staff who supported them, rather than doing things for them. Appropriate documentation created with residents’ involvement already confirmed very good outcomes for residents. EVIDENCE: “We run the farm”, stated a resident who showed us the farm. The files checked contained appropriate and detailed care plans. Risk assessments contained both risks and action to prevent risk for each individual. Documents were reviewed monthly for 3 residents and one weekly, as this was appropriate for a resident who was going through frequent changes whilst settling in. In 4 weeks time this resident progressed from being in the house all the time to coming out to the nice garden and from being very solitary to becoming more social with others. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 11 Nurses working within staff team kept their records within the file and it was easy to monitor progress for each individual. Absolutely new aims for each individual were developed with them and they enjoyed this “turnover” of their lives. Previously completely institutionalised, they started with fast and safe integration in the community. The home had contact with a local pet shop, where some of the farm-bred animals were sold, some of the vegetables were also going for sale to a local shop and residents were completely involved in this process. Key workers supervised residents who cared for animals on the farm. It was lovely to observe how chickens already recognised the resident who looked after them and ran after him when he showed us them and collected fresh eggs from the nesting hatch. A resident who showed us the farm stated that all decisions were made in consultation between staff and residents. Two residents held the keys of their bedrooms. There were still some limits that applied to residents due to the forensic background, but plans were made for how to ease all restrictions. One resident did not like curtains and obscured glass was used for his bedroom window, making him happy and preserving his privacy. Not only residents meetings, but all their ideas were considered, discussed and where appropriate implemented. Residents were doing their shopping with staff support; easy initial tasks in the kitchen were slowly introduced to each individual, as well as keeping the home clean and tidy. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 12 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): This is what people staying in this care home experience: 11,12,13,14,16,17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The whole concept of the Farm was to engage residents in their slow, but progressive integration into the local community and they enjoyed this challenge from which achievements were already visible. EVIDENCE: A total change of lifestyle was a major task for each resident. Three of them had already made very significant progress towards integration into the community, mixing with others and partaking in therapeutic activities. Leisure activities were also promoted and residents enjoyed swimming, horse riding and sport. In their AQAA the manager reported: “One of the residents is really keen on carpentry so we will develop that side of the service. We offer a therapeutic service that allows the residents to have meaning to their day. All Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 13 activities offered are flexible to allow for people being able to do as little or as much as they can.” One of the residents was trained to check eggs for salmonella. The other, keen on carpentry was allowed to use wood cutting machinery, one tool at a time, as there was one electric plug fitted in the workshop, making it much safer for the resident. The AQAA also explained meal times and residents’ contribution: “Residents are encouraged to participate in menu planning and shopping for the home. They are also encouraged to assist in preparing meals and baking as part of their daily routines. Meal times are flexible and we try to do spontaneous events like meals out and take away dinners. One gentleman has specific dietary requirements that must be adhered to for health purposes. However his needs are taken into consideration without impacting on the diet of the other residents by careful planning. They are also supported to take part in completing domestic tasks.” “Each of the residents has a care plan that addresses their spiritual needs and this is discussed with the residents and families. Two of the residents like to attend local church services on occasions; one gentleman is offered the Lord’s prayer at night before he goes to sleep. Gender, age and individual needs and abilities are taken into consideration when supporting individuals in all aspects of care”, the AQAA reported and the resident spoken to confirmed that this was happening and was proud of their achievements. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Healthcare of residents was well organised and ensured that they could make the appropriate decision regarding their general health. Safe and robust medication procedure also ensured good protection of residents. EVIDENCE: Very personalised care ensured better progress for each resident. The manager conducted initial assessment taking into account how to match all people admitted. The staff team was constructed according to the assessed needs. All these measures and a flexible approach helped residents make slow but steady progress. One of the residents was not verbal when admitted, however, was talking by the time we conducted the site visit. Another was not used to leaving an indoor space while in hospital, but had now started using the garden comfortably. There were no restrictions regarding their life on the farm, but due to their background, all residents needed to be accompanied when leaving the farm, either for shopping, or leisure activities in the local community. All Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 15 these elements were well written and recorded in residents’ files and especially in risk assessments. Multidisciplinary team continued to have a significant involvement in the care process. Designated key workers also helped residents relax and gain trust in staff. Residents’ healthcare needs were very well monitored and acted upon when necessary. One of the residents was in hospital for a minor operation. He was constantly refusing to consent to this necessary operation whilst in hospital, his previous setting, but here, at the farm, with appropriate staff support and encouragement from other people, he consented to the operation. Having nurses as a part of the team on the farm also ensured the good health of residents. Medication was checked for 2 residents and one complete audit showed that all records matched, demonstrating good and safe medication practices. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear and concise complaints procedure, open to all, ensured that residents were confident that their interests and voices would be listen to and acted upon. EVIDENCE: There were no complaints and all comments received from relatives were positive. One relative stated: “I cannot begin to tell you how much this move to the farm meant both to my son and to me.” There were no allegations or referrals to the Adult Protection Team. All staff were trained on Deprivation of Liberty, ensuring that residents could exercise their rights fully. Advocates were already contacted to support residents independently. The AQAA reported: “Staff have attended a course about Adult Safe-Guarding. Staff have also received robust training for the safe management of challenging behaviour and of accurate record keeping.” Decoy Farm DS0000072813.V376041.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate and individualised accommodation inside, and development of outdoor facilities according to residents’ wishes and abilities ensured that they experienced for them a completely new and homely environment. EVIDENCE: One of the residents showed us the farm and spoke of plans for further development. He stated that residents were deciding on most aspects of their accommodation and about the farm in general. In their AQAA, the manager reported: “We feel the rooms reflect the age and personality of the individuals living here at Decoy Farm. All bedrooms have been changed since the residents moved in and now show the individuals personalities. One resident loves painting and has expressed wish to have the superman logo painted on his wall. He will be supported to do this. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 18 All residents have access to the kitchen although may require supervision as identified in a Risk Assessment. All residents were able to choose their bedroom prior to admission and all have an ensuite bathroom with the exception of one gentleman who has a bathroom directly next to his room. All residents have locks on their doors and are offered their own door key unless a Risk Assessment identifies otherwise. There is a range of living areas to enable the residents to have private space, quiet areas or to socialise with others. We have procedures in place to ensure that Decoy Farm remains clean and tidy. All external doors are secured with an electronic system which only staff have the ability to open. This is to maintain the safety of the residents. All residents, if requesting to do so, are supported to access the grounds of Decoy Farm and are not prevented access to the outdoors unless a care plan and risk assessment are in place and clearly states how this should be managed. At no time is their liberty deprived unless to maintain the safety of themselves or that of others. Decoy Farm has an Infection Control Link Nurse. Nurses from a variety of settings in the community meet regularly to share ideas and concerns and to update on best practice.” Decoy Farm DS0000072813.V376041.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good structure and an excellent mixture of staff ensured that residents were not only given appropriate care, but also enabled them to develop trust and confidence. EVIDENCE: All staff spoken to were clear of their roles and expectations. Staff files checked also showed job descriptions that matched to the staff’s statements. Very good relationships between staff and residents helped residents develop trust. A specially organised “committee” consisting of both residents and staff was established to make decisions of how the farm is run and to plan for further development. A mixture of nursing and non-nursing staff with care roles ensured that all aspects of residents’ lives were addressed, including healthcare, social, spiritual and all other aspects of community life. Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 20 Nurses kept their registration active. This ensured their up-to-date training and skills and knowledge. Non-nursing staff attended relevant training and ensured very good care practices at the farm. Staff were able to fully meet the needs of residents in a relaxed, but well structured working atmosphere. Staff files checked contained evidence of staff checks being conducted prior to their start date, ensuring the protection of residents. Training records also showed regularity of the sessions of the carefully chosen topics related directly to the residents’ conditions. Supervision was planned, organised and executed so that all staff felt well supported. A cascaded system ensured that supervision was carried out as planned, as more staff were supervising junior carers and it was easier to arrange for these sessions to take place as planned. Decoy Farm DS0000072813.V376041.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate management of the farm ensured satisfaction, protection and progress for all residents living on the farm. EVIDENCE: The manager was an experienced nurse, who had in the past worked in a hospital setting with patients who were now residents at the farm. Her skills and knowledge of residents helped create an effective and progressive atmosphere where residents could express all their ability and learn new skills necessary for community living. Quality assurance was organised at the organisational level and the manager was preparing her first analysis of the quality of the service that would include Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 22 surveys from residents, relatives, external professionals, a review of working practices and procedures and review of the tasks and plans that determined development programme. Safe working practices were in place. The manager reported in their AQAA: “We work closely with other managers in the 3 other Kingsley Learning Disability Services. This has provided mentorship, peer supervision and helped with planning and moving Decoy Farm forward as a new service. We use self appraisal as a way of reflecting on our own practice and to look for ways to improve our service.” Decoy Farm DS0000072813.V376041.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 3 2 3 3 3 4 3 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 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 24 Decoy Farm DS0000072813.V376041.R01.S.doc 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 Decoy Farm DS0000072813.V376041.R01.S.doc Version 5.2 Page 25 Care Quality Commission Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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