Care Home: Fairview Farm

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What the care home does well The manager and staff provide an atmosphere where the people feel it is their own home and where they always have a say in how the home is run and what they do with their time. The staff provide a balanced, healthy diet with plenty of choice to help all the residents "to stay healthy". The manager and staff actively promote independence, choice and privacy by listening to residents, relatives and representatives, by encouraging people to speak for themselves, by using independent advocates and by having an accessible suggestions book. They also have regular residents` meetings, questionnaire surveys and quality assurance systems to ensure people have a full say in the running of the home. What has improved since the last inspection? The Grantham and District Mencap Society have produced a website for service users to access and put photographs on. The company purchased a digital camera for communal use, when the residents said they wanted to take more photographs. Storage for confidential information in the main office has improved. Built-in cupboards with a lockable facility have been fitted and personal files and confidential material are now kept locked at all times. Staff have attended internal and external safeguarding adults training which will not only enhance the care provided to the service users but also envisage how it will impact on their own lives should their circumstances change. The manager purchased a green house to enable service users to have another hobby. She also sought two kittens for the people at the home to nurture. What the care home could do better: No requirements or recommendations were set at this inspection. The home is meeting and in some areas, exceeding, the National Minimum Standards. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Fairview Farm Gloucester Road Grantham Lincs NG31 8RJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vanessa Gent     Date: 0 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Fairview Farm Gloucester Road Grantham Lincs NG31 8RJ 01476565660 Telephone number: Fax number: Email address: Provider web address: lynn.pashley@granthammencap.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Lynn Pashley Type of registration: Number of places registered: Grantham & District Mencap Limited care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Fairview Farm is registered to provide personal care only to service users of both sexes in the following categories :- Learning Disability under the age of 65 years (LD) 19 Learning Disability over the age of 65 years LD(E) 3 The maximum number of service users to be accommodated at Fairview Farm is 22 Date of last inspection Brief description of the care home Fairview Farm was originally a converted farmhouse. This has been extended over a period of several years to provide personal care for up to twenty-two people of both sexes who have a learning disability, and two places for people over 65 years of age, within this category. It is situated in a residential area in Grantham, set in approximately 1.5 acres of land overlooking countryside. Within walking distance of the home, there are shops and a pub. The town of Grantham is approximately two miles away, accessible by bus. Accommodation is provided within five separate selfcontained units in two main buildings and is partially based around group living Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 3 19 Brief description of the care home models. Each building has all the facilities to make them more like a residential house. In total, there are seventeen single bedrooms and three double bedrooms; none of these have an ensuite facility. It is the companys philosophy for people to choose how they spend their time, where possible, and to make as many decisions regarding their day-to-day lives as appropriate for each individual. Information about the fees, the statement of purpose and service user guide, and a copy of the last inspection report, are available from the manager. Care Homes for Adults (18-65 years) Page 5 of 27 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: An unannounced visit to the home was made as part of a key inspection. It started at 11.00 and lasted seven hours. The manager had completed a questionnaire called the Annual Quality Assurance Assessment (AQAA) giving important information about the service and this was used to contribute to the inspection process. Information from this as well as that which the Commission for Social Care Inspection (CSCI) holds about the service was used to plan the visit and produce this report. The main method of inspection used is called case-tracking. This involves selecting a proportion of residents, and tracking the care they receive through the checking of Care Homes for Adults (18-65 years) Page 6 of 27 records, discussion with them, the care staff and observation of care practices. The Commission is improving the way that we engage with people who use services, so we gain a real understanding of their views and experiences of social care services. During this inspection, an Expert by Experience joined us on our visit to the home as part of the inspection to help us get a better picture of what it is like to live in this service. The term Experts by Experience describes people whose knowledge about social care services comes directly from using services themselves. The Expert met and talked with the residents we case-tracked over a four hour period. They also spoke with other residents and some staff. The things people said to them, and their observations, are included in the body of this report. Other people at the home also shared their views with us about the care they received and the facilities provided. The site visit focused on whether key standards and requirements from previous inspections had been met and how the residents feel about the service provided. Three residents health, safety and welfare assessments and care plans were checked to ensure they are allowed dignity, autonomy and choice and their needs are met. We made a partial tour of the home and looked at other records. We spoke with most of the staff on duty and many of the twenty-one residents, including those being casetracked. The manager was present throughout this inspection. What the care home does well: 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information to decide if they want to live at Fairview Farm. The measures in place for assessing the needs of prospective residents and checking that the right procedures are followed ensures that their needs and wishes can be met. Evidence: People who are interested in living at Fairview Farm are always encouraged to visit and meet the residents before making a decision to move in. The manager has produced a pre-admission pack and we saw that and an audit tool that is in place to ensure that they can meet the needs of anyone who moves into the home. The manager said, in the self assessment form she returned to us, service users have chosen to live here - not through emergency placements. Some have lived here since opening - a long time. The Expert by experience, when they talked with the first resident, observed that the person is happy living in the home. All people who want to live at the home have a comprehensive assessment of their Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: needs and wishes before being accepted or accepting that they want to move in. The people we spoke with confirmed that they and their representatives had been asked and involved fully in the process. Care Homes for Adults (18-65 years) Page 11 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning, healthcare and risk assessments in place help to keep residents safe and healthy. People are supported to live the life they choose, to take reasonable risks and participate fully in the daily life of the home. Evidence: There are comprehensive person-centred care plans in place for everyone living at the home. All the information needed for staff to know how to care safely and to meet their needs were clearly written and easy to understand and follow. The Expert by Experience found that, the staff were seen to be friendly to all Service Users and know their needs. The Expert by Experience discussed with people how they are happy to help around the home. The residents said it is their home and they are proud of the part they play Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: when they help with house tasks. The people were encouraged to make decisions about their daily life and to take risks, within their capabilities. Care Homes for Adults (18-65 years) Page 13 of 27 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. People are supported to maintain their independence in their chosen activities and lifestyles, and to eat healthily. Evidence: People told us about all of the things they are able to do, such as going to church, going to a local day centre, meeting up with friends, and going shopping. They also go to clubs sometimes and go with friends to eat out. There is home-owned transport for residents to use to take them to their many community-based activities. The care plans contained information that showed how people can choose to do what they want, with the help of staff as and when needed. The people told us that their families and friends are free and encouraged to visit them Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: often and that the manager and staff make visitors very welcome. Visitors get closely involved with the activities of the home and help in many different ways. People told us, I eat well to stay healthy and well and I eat nice food to stay healthy. At the mealtime we joined in, the staff showed that they understood the wishes of residents with restricted communication skills and catered for them as they wished. Care Homes for Adults (18-65 years) Page 15 of 27 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. People are satisfied that their health and personal care needs are met in the way they want, that they are respected and are happy living at the home. Evidence: The staff help the residents when they need to go to doctor or the dentist, using the homes own transport to take them there as necessary. People told the Expert by Experience that both male and female staff attend to them and they are happy with that. They said and we observed that the manager and staff are friendly, respectful to them and treat them with dignity. When asked Is there any thing you need, people replied, I dont need anything; Im alright; Im happy in the home; I like living here. I wouldnt want to live anywhere else. None of the residents see to their own medicines. They said they prefer the staff to see to that. The medication practices that we saw the staff follow helped to keep the Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: residents safe. The staff kept clear records to show when and to whom the medicines had been given. All staff who give medicines out have had the appropriate training from the pharmacy which supplies the homes monthly medications. Care Homes for Adults (18-65 years) Page 17 of 27 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. There is an effective system in place for the manager to respond appropriately to complaints made. People living at the home are kept safe by well-trained and conscientious staff and their views are listened to. Evidence: Neither we nor the manager have received any formal complaints since the last inspection. The manager and staff told us they are happy for constructive criticism as that helps them to improve. Several people told us that staff tell them their rights. I have a key worker who I can go to if I need anything. Sometimes we have house meetings to put grumbles and ideas across. Sometimes we complain to staff and we get feedback on our complaint but theres nothing serious. Some people told us, I feel safe in the home, I can walk around anywhere in the home, Im treated well by staff and the manager. Staff told us they are trained right from their induction to respect the residents and keep them safe. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: They said they all work to keep everyone safe and well. Care Homes for Adults (18-65 years) Page 19 of 27 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. People enjoy a clean, comfortable and homely environment, which is well maintained. Measures are in place to maintain the homes hygienic and safe surroundings. Evidence: The Expert by Experience felt that Fairview Farm was clean and tidy with a nice homely feel and that it was a very nice place to live. The service users are happy to be helpful around their home. Peoples rooms were decorated in their choice of colour and contained the knickknacks that made them feel more at home. A maintenance man attends daily to undertake repairs and regular maintenance tasks. He keeps clear records for the testing and maintenance of electrical equipment, shower-heads, carbon monoxide monitors, fire alarms and water temperatures. Staff showed they understand infection control practice. They helped the residents keep clean and healthy practices as they helped around the home. Care Homes for Adults (18-65 years) Page 20 of 27 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. The residents are looked after by safely recruited, skilled, knowledgeable and caring staff, who work in sufficient numbers to fully meet their needs. Evidence: New staff without previous experience of working with vulnerable people told us that the manager made sure they were well-supported by senior and more experienced staff in their early weeks and months of working at the home. They said their induction had been thorough and objective in preparing them for the work they do and the people they work with. The manager said, and staff and the duty rotas confirmed, that they maintain a high level of staff on duty to enable staff to have quality time with the residents and not be rushed in their duties. Staff said they have received lots of excellent and interesting training and feel able to deliver a good quality of care to the residents. Certificates for training undertaken are held in staff files. Residents said the staff are lovely, theyll do anything for you; staff respond to calls Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: on time and always give us attention when we want it. Staff told us there is a very good team spirit, that they support each other within the staff team and are well-supported in their duties by the manager. They also said, and we saw, that they communicate well within the home, especially at handover periods and when staff are going out with residents. Records confirmed that the staff have regular, formal, one-to-one sessions with the manager or a senior staff member. They said that supervision helps them to look at their personal development, and they are able to voice their views and opinions. Care Homes for Adults (18-65 years) Page 22 of 27 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. Comprehensive quality assurance and auditing covers all aspects of gaining and acting on the views, opinions and wishes of residents, relatives and staff. This ensures that people are happy and satisfied, and are cared for in accordance with their wishes and needs at all times. Evidence: The manager has been in post for eight years. She has achieved relevant qualifications as a manager and in the care of people with disabilities. The provider visits the home monthly, unannounced, to check that everything in the home is safe and to the satisfaction of the residents. They report their findings to the manager each month. The manager conducts a satisfaction survey for residents to check that the service provided is what they want and need. These she analyses to continually improve the facilities and care provided. Regular meetings are held for the residents to discuss their wishes for the running of Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: the home. Staff have regular meetings to encourage them, hear their views and share with them how the service could be improved. We saw that a comprehensive health and safety policy is in place. This includes environmental health, electrical, water and equipment testing and management, fire drills and fire alarm testing and food management. The Expert by Experience was of the opinion that the home is a very nice place to live. The staff were seen to be friendly to all service users and know their needs. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 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. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!