Care Home: Home Farm Trust - The Elms

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What the care home does well People who use the service and who could express their opinions indicated that they were happy at the home and that staff treated them well.There was a good staff team, which worked well together to ensure the wellbeing of people living at the home. Staff were good at supporting people to make choices, take reasonable risks and maintain as independent a life as possible. The home offered excellent training opportunities to its staff, to make sure they had all the relevant knowledge and skills to provide a good service to its client group. The home has renewed its `Investors in People` award. Staff made appropriate efforts to ensure that people living at the home were able to take part in social and recreational activities, which were meaningful and enjoyable to them. What has improved since the last inspection? The home has introduced a new computerised assessment and recording tool (SPARS), which supports the development of appropriate `person centred planning`. The new care planning process allows for the recording of the care, support provided to people using the service to achieve set and agreed goals. The management of the personal monies on behalf of some people who live at the home has been improved to ensure appropriate witness signatures on all debits. The home has provided the required training to all its temporary/relief staff. The physical environment has been further improved. Bath and shower rooms have been decorated and made more pleasant. The kitchen floor has been renewed. What the care home could do better: Although staff were supporting people in taking reasonable risks, the methods used to identify risks were not robust enough. We have made a recommendation for staff to be able to record specific risks faced by individuals instead of referring to a pre-assigned and generic list of risks. Staff should be provided with further training on the new computerised assessment and recording tool to make sure they can use it more effectively. The care staffing level must be reviewed to make sure that sufficient care staff are deployed at all times to cater for the needs of people using the service. We have also made a recommendation for the duty rota to reflect only the specific staff hours that are dedicated to the care home and to keep it separate from the neighbouring `Supported Living` scheme that is run by the same provider. CARE HOME ADULTS 18-65 Home Farm Trust - The Elms The Elms Old Hay Lane Sheffield S17 3GN Lead Inspector Ramchand Samachetty Key Unannounced Inspection 11th September 2008 09.30 Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Home Farm Trust - The Elms Address The Elms Old Hay Lane Sheffield S17 3GN 0114 236 2292 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) dorothea.edwards@hft.org.uk www.hft.org.uk Home Farm Trust Mrs Dorothea Marie Edwards Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th September 2007 Brief Description of the Service: The registered providers, Home Farm Trust, are a nationwide provider of care services. The Elms is registered to provide care for 8 younger adults with a learning disability. The home is based in the South West area of Sheffield on the outskirts of Dore village. The Elms is a large detached house situated in extremely spacious, private and attractively landscaped grounds. All bedrooms are single and these have been individually decorated and furnished according to the personal preferences of each person. Several areas of the home have been refurbished over the last few years. This has recently included the refurbishment of the top floor flat (which can provide accommodation for two people), the downstairs bathroom and some external areas of the building. The Elms aims to maintain and develop each person’s independent living skills whilst providing them with regular opportunities to integrate with a wide range of local services and facilities. Information relating to the service, and staff support provided, can be found in the homes statement of purpose and service user guide. Each person living at the home is currently provided with 24-hour staff support with two staff covering each shift during the day and one member of staff sleeping in each night. Staff had their own sleeping accommodation with en-suite shower facilities provided. The fees charged by the home as at 11/09/08 were from £678.00 to £ 786.00 per week. Additional charges are made for clothing, toiletries, hairdressing, chiropody, leisure and social activities and magazines. Home Farm Trust - The Elms DS0000046512.V371779.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 that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This key unannounced inspection was carried out on 11 September 2008, starting at 09.30 and finished at 18.30 hours. The manager, Mrs D. Edwards was present throughout the inspection. The service is registered to provide accommodation, care and support for up to eight adults, aged between 18 and 65 years of age. There were eight people living at the home at the time of this inspection. Five people were out of the home for their daytime activities and we spoke to them on their return to the home. All the key national minimum standards for ‘ Care Homes for Adults (18-65) were assessed. The inspection included a tour of the premises, examination of care documents and other records, including those pertaining to complaints, staff employment, staff rota, medicines management, and maintenance of equipment and quality assurance methods. We looked at the information contained in the ‘Annual Quality Assurance Assessment’, which was submitted to us before this inspection. We also considered the views of people who were using the service and comments that were expressed by their relatives, in a recent survey conducted by the home. We gave feedback about our initial findings to the registered manager and to the operations manager. We would like to thank all the people living at the home, the staff and managers for their assistance with this inspection. What the service does well: People who use the service and who could express their opinions indicated that they were happy at the home and that staff treated them well. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 6 There was a good staff team, which worked well together to ensure the wellbeing of people living at the home. Staff were good at supporting people to make choices, take reasonable risks and maintain as independent a life as possible. The home offered excellent training opportunities to its staff, to make sure they had all the relevant knowledge and skills to provide a good service to its client group. The home has renewed its ‘Investors in People’ award. Staff made appropriate efforts to ensure that people living at the home were able to take part in social and recreational activities, which were meaningful and enjoyable to them. What has improved since the last inspection? What they could do better: Although staff were supporting people in taking reasonable risks, the methods used to identify risks were not robust enough. We have made a recommendation for staff to be able to record specific risks faced by individuals instead of referring to a pre-assigned and generic list of risks. Staff should be provided with further training on the new computerised assessment and recording tool to make sure they can use it more effectively. The care staffing level must be reviewed to make sure that sufficient care staff are deployed at all times to cater for the needs of people using the service. We have also made a recommendation for the duty rota to reflect only the specific staff hours that are dedicated to the care home and to keep it separate from the neighbouring ‘Supported Living’ scheme that is run by the same provider. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home was providing sufficient information about its services and facilities to enable people to choose it. Assessments of needs were carried out before people were admitted to the home, in order to make sure that their care needs could be met. EVIDENCE: The statement of purpose and service user guide were available to people who lived at the home and to other people who needed them. These documents were written in a way which made them accessible to people who have communication difficulties. They were published in an easy- to- read and pictorial form. They contained the necessary information to help people understand the services, which were provided by the home and this helped them in making their choice of a service. Care records checked at the inspection, showed that full assessments of individuals’ needs were carried out before their admission to the home. These assessments were undertaken by placing social workers and also by staff at the home in order to make sure that the needs of people could be met. Home Farm Trust - The Elms DS0000046512.V371779.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People living at the home were provided with comprehensive care and support plans to ensure that they all their identified needs were met. Although people living at the home were supported in taking reasonable risks, the identification of those risks was not always as robust as it could be. This could affect the wellbeing of people living at the home. EVIDENCE: The care plans of two people who used the service were checked. They contained comprehensive information with regards to the care and support that should be provided to the individuals concerned. The care plans were developed in a person-centred way and there was evidence that the people who used the service and their representatives had been involved in planning their care. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 11 The care plans included the individual’s preferences, aims and goals and these were followed by appropriate action. Risks faced by people who lived at the home were usually assessed and managed. However, in some instances, the risks, which were assessed were those laid out in a generic manner and therefore did not refer to risks that could be specific to individuals concerned. This practice could potentially lead to risks not being identified and addressed. The recording of care and support that is provided to people has been improved. The home has introduced a new computerised assessment and recording tool (SPARS). Care records were more comprehensive and were relevant to the actions specified in individual care plans. The care plans that we checked had been reviewed on a regular basis. The reviews had involved the person using the service or their representatives and their key worker. We noted that the care plans of each person living at the home were computer generated and maintained. Care staff had access to computers based in the home. However, we found that staff had difficulty accessing some of the information held on the computer. People who use the service who were able and willing to express their views told us that they were happy with the care and support that they were receiving at the home. In discussion, care staff told us that most people living at the home were able to express their preferences and choices and were able to make decisions regarding their daily living activities. We noted that people living at the home were actively encouraged and supported in planning their day-to-day activities and other events, which were important to them. Staff would also support them in making such choices and decisions, in line with their care plans. The manager confirmed that a few people who used the service were not able to manage their personal allowances. They were supported in dealing with the management of their money by staff. The home had set up appropriate systems to ensure that all income and expenditure incurred on behalf of individuals concerned were recorded with the necessary witnesses and receipts. We noted that accounts were regularly checked and independently audited and were appropriately maintained. Home Farm Trust - The Elms DS0000046512.V371779.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): 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People using the service were well supported in taking part in a range of social, recreational and developmental activities, which helped them to maintain their preferred lifestyle and as good a quality of life as possible. EVIDENCE: The manager described the wide range of recreational and developmental activities that were available to people using the service. Opportunities to participate in such activities were offered on the basis of ability, individual goals and personal preferences. These activities included employment placements, physical exercises, keep fit sessions, participation in clubs and social networks and outings. People who use the service also told us that they liked undertaking shopping trips with members of staff. Staff said that they were supporting one person Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 13 with his ‘volunteering’ work on two days a week. Another person was supported with his work placement at a day centre for one day a week. The manager confirmed that the home had the support of an ‘employment officer’ employed by the service, to assist people living at the home, as required, with regards to finding appropriate and supported employment. People who use the service told us that they were happy with the way their daily activities were organised. They felt that it was good that they always had something to do. We noted that staff were providing a good level of support to people with developing and maintaining their personal and family relationships. Staff pointed out that one person had gone to visit her parents for a few days. Staff had encouraged her and helped her prepare for the visit. The manager stated that people who use the service had been provided with three to seven days’ holiday during the year. People who use the service had paid for their transport and accommodation and the service had paid for all other costs. Care records that we checked contained details of activities undertaken by people who use the service. Some of the activities, like household tasks, were referred as ‘aims and goals’ to be supported and evaluated by staff. People who live at the home said that they were satisfied with the meals provided to them. They said that they had a good choice of food items at all meal times. Although there was a menu for the meals prepared and served at the home, people could alter it to suit their preferences. We noted that staff prepared meals in consultation with the people living at the home. In some instances, staff would support individuals in preparing their preferred meals or drinks. Home Farm Trust - The Elms DS0000046512.V371779.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People living at the home were receiving appropriate personal and health care support in order to maintain and improve their health and wellbeing. EVIDENCE: The individual care and support plans that we checked showed that all aspects of personal and heath care were adequately identified and actions to be taken to meet them were also specified. A number of people were described as having complex and challenging needs and the support required in these instances were laid out. These included the management of particular behaviours, appropriate methods of communication and support required from staff and other health care professionals. Care plans indicated that people who use the service were supported in a proactive way to access the appropriate community heath care services. These included the support of psychologists, dieticians, opticians, GPs, dentists and chiropodists. Staff commented that one person was referred for ‘bereavement support’ to an appropriate professional. A section of the assessment document Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 15 of each person was used as a ‘health plan’. Staff stated that visits by or to health care professionals and their outcomes were recorded in the care files, which were kept on the computer. We spoke to a few people who used the service and they said that were happy with the service. They said it was flexible enough to allow them to do the things they want and to receive care and support in ways that they prefer. The storage, handling and administration of medicines were checked and were satisfactory. Only one person was administering her own medication. A risk assessment had been undertaken to make sure she was able to take her prescribed medicines. Staff who, administer medicines, had received the appropriate training to do so. Home Farm Trust - The Elms DS0000046512.V371779.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Information about the home’s complaints and adult safeguarding procedures were available to people who use the service in a manner that they could understand. This raised their awareness of how to get help when they needed it, in order to stay safe and well. EVIDENCE: A copy of the complaints procedure was displayed at the home. It was written in simple English and was illustrated with pictures to make it easy for people who use the service to use. Staff commented that copies of the complaints procedure were also made available to relatives or other representatives of people who live at the home. There was a whistle blowing policy in place to encourage the reporting of any abuse or bad practice. People who use the service told us that they could tell somebody if something was not right for them. They indicated that they could talk to the manager and to other members of staff, who they find friendly and helpful. The home has not received any complaints. Staff said that they usually deal with concerns in a prompt manner and this helps in avoiding complaints. Adult protection procedures were in place in order to protect and safeguard people who live at the home. These procedures were in line with those of the local multi-agency adult safeguarding team. We noted that care staff had Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 17 received training on the ‘Protection of Vulnerable Adults’ and on the prevention of adult abuse. We spoke to a few members of staff and they showed an understanding of the procedures in place. The manager confirmed that there had been no referral with regards to adult safeguarding issues at the home. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home was well maintained and clean. It provided a pleasant, comfortable and safe environment for the people who lived in it. EVIDENCE: The Elms is a large detached house situated in a spacious and attractively landscaped grounds. The front entrance to the building is accessible to wheelchair users. We carried out a tour of the building in the company of the manager. The bedrooms and communal areas were located on the ground and first floor. The cellar area was used for offices and the laundry. Access between the floors was by stairs only. The communal areas included the dining area and lounges. The kitchen was also located on the ground floor. We viewed two bedrooms with the permission of their occupants. They were well decorated and clean. People living at the home had brought personal memorabilia and were able to personalise their bedrooms. The communal Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 19 areas were nicely decorated and were in good state of repair. The furniture and fittings were domestic in style. The bathrooms had been refurbished and decorated to make them more homely. The kitchen floor in the top flat had been replaced. The visitors’ s room had also been refurbished and well decorated. People living at the home told us that they liked their bedrooms and the communal areas. They said that the home was comfortable and pleasant. We found both the private accommodation and communal areas to be clean and pleasant during our visit. The grounds and the patio areas, at the back of the house, were tidy and appropriately maintained for the time of the year. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. There was a committed and competent care team in place and was able to meet the needs of people who used the service. However, on certain occasions, the staffing level was not related to the dependency of the people using the service and was therefore not sufficient to fully promote their welfare. EVIDENCE: The home was registered to care for up to 8 adults with learning disability. There 8 people in residence at the time of this visit, five of whom were out for the day or visiting their relatives. We met the three people who were present. Besides the manager, there were two care workers on duty for the day (07.45 –15.15 and two other care workers- 15.15- 22.30 hours). The manager confirmed that one member of the care team was scheduled to sleep in at the home during the night hours. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 21 We looked at the duty rota for the service. Five members of the care team were identified as being ‘supported living workers’. They were employed to provide support to a person who lived independently in a nearby flat. This was a separate ‘supported living’ service. It was not clear whether the hours worked by these persons were included in the care hours provided by the home, to its 8 residents, and if so, the number of hours provided. We noted that two care workers were always on duty and were able to look after the people who stayed at the home during the day. Five of the people who used the service had various day- time commitments outside the home. These commitments were not always regular and their duration varied in length of time. One person was provided with a one-to-one staffing facility, once a week, to be able to undertake his preferred recreational activities. The manager stated that this had been made possible by his funding authority providing the extra resources. The manager also explained that social and recreational activities were organised for each person living at the home. Dedicated staff hours were provided to make sure that these activities were carried out. People who were using the service and who could speak with us said that they had taken parts in various activities and were happy with what staff were doing for them. We checked the duty rota and we noted that there were only two care workers on duty during the weekends. This was the period in which most of the people had no outside daytime occupations or activities to engage in. We looked at the care plans and the level of needs that people had. A few people who lived at the home required a fairly high level of support and supervision. We noted that care staff had to undertake cooking and cleaning tasks as well as providing care and support to people in the home. In discussion, staff said that they were able to meet all the identified needs and where they needed help, they received it from staff allocated to the ‘supported living’ scheme. Also, information from the annual quality assurance assessment that the service provided to us prior to the inspection, confirmed that the home was still using temporary staff, but to a lesser extent. The latter had provided 56 care hours in the last three months before the end of July 2008. We had made a requirement in our last inspection, that the staffing level be reviewed with regards to the promotion of appropriate recreational and social activities. This requirement referred to the needs of all the people who lived at the home. In discussion, the manager confirmed that, in response to this requirement, the service had negotiated additional resources from one client’s funding authority to buy in some hours of additional staff support for the person concerned. We spoke with a number of care staff. They told us that they were very satisfied with the training opportunities that they were given. Training records showed that staff, including temporary ones, had undertaken a wide range of training to equip them with the skills and knowledge to care and support Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 22 people with a learning disability. The training included mandatory training like ‘moving and handling, food hygiene, first aid, fire safety and health and safety’. All members of the care team had also received training on adult safeguarding. Some care workers had received training on managing challenging behaviours, and the ‘valuing people’ policy. The manager stated that care workers had also been given training on the use of computers, in order to make sure that they could use the new computer system that the home was using to document its management of care. We noted that the manager had received training on the mental capacity act. Similar training was being organised for all the care workers. Information from the annual quality assurance assessment submitted by the home indicated that over 70 of its permanent care staff had achieved their NVQ (National Vocational Qualification) level 2 in care. The manager stated that the home had use of the corporate policy and procedures regarding the recruitment and selection of staff. This policy included guidelines on the practice of equal opportunities. We looked at the files of two newly care workers. The information contained in the files indicated that all pre-employment checks had been carried out and were satisfactory. These included POVA first (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) checks and written references. However, these documents could not be verified, as they were located in the central office of the company. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home was well managed and staff promoted the rights, interests and safety of people who used the service and ensured that they were treated with respect. EVIDENCE: The manager has wide experience of working in care and has achieved her ‘Registered Manager’s Award as well as her NVQ level 4 in care. She has good leaderships skills and has fostered a good and committed staff team for the benefit of people who live at the home. We spoke to a few people who used the service and to some members of staff. They all commented that they were satisfied with the way the home was being managed. They said that the manager was ‘very supportive’ and Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 24 ‘approachable’. In discussion, we noted that senior managers of the organisation were also committed to the success of the home and to the welfare of the people who use it. People using the service told us that they took part in ‘house meetings’ where they could tell staff their views and opinions about the home and its routines. The manager commented that a local ‘service user’ consultation group had been set up, comprising of people living at the home. This group would contribute to the business planning and service improvement. The home had informed us of the outcome of its recent annual service users’ survey, in which 7 out of 8 relatives had taken part. Relatives had expressed their satisfaction with the service being provided. However, they were, in comparison, less well satisfied with the specific support being provided, for their loved ones, to achieve agreed goals. The manager commented that the new system of care planning would ensure appropriate recording of the work being done to achieve individual’s set goals. The manager also confirmed that there were regular staff meetings, which helped to ensure good communications and staff support. The service had also set up a staff consultation group to assist in further service improvement and staff welfare. We noted that the home had renewed its ‘Investors in People’ award. The manager commented that there were other quality assurance methods in use at the home. These included the monitoring of accidents and injuries at the home and audit of financial accounts for people who live at the home. We looked at the reports of monthly visits by the registered provider, to the home and they were satisfactory. In discussion, staff told us that they had received the necessary health and safety training and guidance to enable them to work in a safe manner and in a safe environment. Information in the annual quality assurance assessment indicated that appropriate health and safety policies were in place. Risk assessments about the environment and various working practices had been developed and reviewed. Records showed that equipment and utilities in use at the home had been checked and serviced as required. These ensured the safety and welfare of people who lived and worked at the home. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA33 Regulation 18 Requirement The current staffing levels must be reviewed to ensure that sufficient staff are on duty at all times, including evenings and week-ends, to facilitate the provision of the necessary care and support at all times. Timescale for action 09/01/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA6 YA6 YA33 Good Practice Recommendations The process of assessing risks should be improved to ensure that risks specific to a person could be identified and managed accordingly. Care staff should be provided with more computer training to make sure that they can use the new IT system more effectively. The duty rota for the care staffing level of the home should be drawn separate from the staffing dedicated to the neighbouring ‘ Supported living’ scheme. This should show the specific care hours being used for the home. Arrangements should be made for all documents regarding the pre-employment checks carried out for staff employed DS0000046512.V371779.R01.S.doc Version 5.2 Page 27 4. YA34 Home Farm Trust - The Elms at the home, to be made accessible for verification by CSCI. Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Home Farm Trust - The Elms DS0000046512.V371779.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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