Care Home: Street Farm

What the care home does well The aim of the home is to support and encourage people to maintain and develop independent living skills. The home is situated in a residential area in the village of Draycott. People living at the home are enabled to lead independent lives where possible, access the community and work locally. Care plans were overall well maintained and detailed. The home is furbished to a good standard with appropriate aids and facilities. Street Farm is a comfortable home with a family feel shared amongst the people living there and staff. Staff were familiar with the likes, dislikes and individual needs of the individuals living at the home. Interactions between staff and individuals were kind and respectful. It was apparent to us that the people living at the home were empowered to come and go as they pleased. people were seen to be relaxed and comfortable in the presence of staff. One person spoken to commented `I`m very happy living here`. People are consulted with regarding the daily running of the home, and are encouraged to exercise choice. People benefit from a wide range of activities and opportunities. Regular holidays and trips out take place in the home`s vehicles. People are supported to attend regular work such as working in a cafe or charity shop. The home is maintained to a good standard of cleanliness. What has improved since the last inspection? at the last inspection one requirement was made with regard to the homes electrical wiring checks. This had now been completed. What the care home could do better: This is an excellent service for people who are able to live a fairly independent lifestyle but who require some staff support and promoting. It best suits those people who like the outdoor lifestyle as a number of the opportunities relate to horse riding or to working on the farm although other opportunities are available . No requirements have been made as a result of this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Street Farm Street Farm Draycott Cheddar Somerset BS27 3TH     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: Justine Button     Date: 0 5 0 5 2 0 0 9 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 © (2009) 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.cqc.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: Street Farm Street Farm Draycott Cheddar Somerset BS27 3TH 01934744930 01934744930 tina@bradburyhouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Neil Bradbury t/a Bradbury House care home 11 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 11 The maximum number of service users who can be accommodated is 11. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability- Code LD Date of last inspection Brief description of the care home Street Farm is owned by Mr Neil Bradbury of Bradbury House Organisation. Mr Neil Bradbury is the registered provider. The acting manager is Ms Tina Dewey. Ms Tina Dewey is currently applying to register with the Commission for Social Care Inspection. Street Farm is situated in the village of Draycott. The village has a church, two pubs, village hall and a shop/ post office, all within easy walking distance of Street Farm. The village is on a direct bus route between Cheddar, Wells and Weston-super-Mare. There are ten permanent and one assessment room at Street Farm. The main farmhouse has three en-suite bedrooms, one staff sleep in room, office, two communal lounges, dining area and a large kitchen. In addition to this, there is an annex with two Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home bedrooms both of which have their own bathrooms and an assessment room with ensuite facilities. Five service users live in the main house and annex. There are four cottages, which have been built around a large garden that contains ornamental ponds and patio area. These cottages cater for five service users. The cottages have a range of facilities to increase each service user?s independence. The current scale of charges is #699.00 to #750.00 per week. 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: This inspection was conducted using the Inspecting for Better Lives methodology introduced by the Commission for Social Care Inspection ( Now known as the Care Quality Commission) in April 2006.The inspection methodology used by the Commission for Social Care Inspection enables the us to make a judgment on the quality of the service delivery based on the outcomes for people living at the home. The inspection took place over the course of one day . We looked at selected staff and residents files, policies and procedures and other documentation related to the running of the home. We looked around the home and also viewed several private rooms and the garden. Care Homes for Adults (18-65 years) Page 6 of 27 As part of the inspection we spoke to people living at the home, staff relatives/representatives and people living at the home. The responses and comments are incorporated into this report. In addition the home sent us information in the form of an Annual Quality Assurance Assessment (AQAA). This document help us form a judgment on the improvements made at the home. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 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. Service users and their families are provided with appropriate information to make a decision regarding admission to the home. The home has developed an appropriate Admissions procedure. Evidence: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at Street Farm. The service user guide has been developed in totla communication. This makes sure the information is accessible to as many people as possible. The home has an Admissions policy. People are admitted on a three-month trial basis. People told us that were able to visit the home prior to moving in. Comments included I stayed a week before I moved in I came to street farm with my family to have a look before I moved in I stayed for a weekend before moving in Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: A copy of the service user contract was provided. This clearly states which services are included within the weekly fee, and provides details of any notice periods required. Fee levels vary dependant on the care and support provided. All people living at the home have a free bus pass. The home has its own transport. There is a charge of 35 pence per mile for the use of this transport. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has developed a detailed care plan for each individual living at the home. individuals are encouraged to exercise choice and are consulted appropriately. People are able to participate in all aspects of life within the home. Records relating to individual are appropriately maintained. Evidence: Care plans are maintained for each person living at the home. Two care plans were examined in detail. Care plans provide details of individuals needs, daily routines and preferences. Risk assessments are completed as required. Care plans are reviewed and updated appropriately. The manager and staff stated that the home in some instances aims to move people to more independent living accommodation. If this is the case then the care plans need to be developed to include some goals setting. People living at the home are encouraged to exercise choice regarding the activities Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: they participate in and their daily routine. All people have a key worker and all people spoken to knew who their key worker was. Some people living at th home do not live in the main house. A number live in the grounds in more independent living accommodation. People living in the grounds are bale to access the house for meals and all people share such areas as the laundry. The staff also support two people living in a House in the local village. peoples views are sought on a regular basis at the residents meetings. People living at the home are currently making a decision on where they would like to go on their annual holiday. Last year all people chose to holiday together with everyone going away to Spain. The home assists people in managing their monies. Records are maintained of all transactions involving personal finances. These are supported by receipts and staff signatures and are audited on a daily basis. 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. are able to participate in a wide range of activities, and have regular opportunities to access the local community. Independence is promoted. People are encouraged to develop and maintain daily living skills. Meals provided are of a high standard and offer a well balanced diet. Evidence: The homes AQAA stated We have an extensive program of day care and social activities that are designed around the individuals needs and interests and with the individuals suggestions and choices always considered, promoting independence and freedom of choice wherever possible. This was confirmed on the day of the inspection Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: with all people who live at the home being out when we arrived. A number of people had been to yoga and some horse riding. All people returned to the home for lunch. In the afternoon two people went swimming and some people went to do the house shop at a local supermarket. Following lunch which people made individually from ingredients in the fridge two people loaded and unloaded the dishwasher and one person helped staff to sort laundry. People living at the home explained that there was a rota for the household jobs to ensure that theses were split fairly. People living at the home explained that at the weekends and evening activities were less formally arranged. Time was spent watching TV in the communal areas or in the privacy of their own rooms. People living at the home also stated that they had the opportunity to go out to local clubs and a number stated that this is where they met their friends and boyfriends. These clubs ensure that people have the opportunity to meet from other homes in the local area. People living at the home explained that they are able to invite friends to their homes. Everyone at the home has a bus pass and staff have supported people to develop the skills to access community transport. This helps to promote Independence. People use the bus to visit friends, local shops and to access work placements. People at the home stated that they are able to maintain links with family members. Some people stated that they visit their families regularly and all stated that they have a mobile phone which they use to phone family and friends. In addition there is a communal phone for people to use or to receive phone calls. People living at the home again said that family members are able to visit them at the home. Some people returned home for lunch on the day that we visited. People were observed to make their own lunch. people living at the home explained that this is usually a lighter option such as sandwiches. One person who lives in a independent living house in the local village bought her own packed lunch. People living at the home explained that they plan a menu and take it in turns to cook the evening meal. specialist diets are catered for with two people currently having a gluten free diet. 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 provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. The home has an appropriate medications policy. All medications are stored securely. Evidence: People are provided with support to undertake personal care tasks as necessary although for the current group of people living at the home this is limited. The level and type of assistance required is specified in their care plan. Staff support people in accessing health care services, and ensure that specialist advice is sought as required. A record is maintained of all professional visits. The home has a medications policy. Senior staff are provided with medications training. The home has provided appropriate supervision and monitoring is provided to those people who self-medicate. All medications are stored securely. Care Homes for Adults (18-65 years) Page 16 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. The home provides service users with regular opportunities to provide feedback on the service provided. The home has developed an appropriate complaints procedure. The home has policies relating to the Protection of Vulnerable Adults and whistleblowing. Evidence: The home holds monthly meetings where people living at the home may express their views. People confirmed that they enjoyed these meetings and felt that their views were listened to. The home has a complaints procedure, which includes details of external agencies that may be contacted, including CQC. The complaints procedure is available in alternative formats to ensure that it is accessible to all. This is displayed on the noticeboard in the hallway, and has also been discussed at a recent service user meeting. All people living at th home stated that they knew how to complain and all stated that they would be happy to do so if they had any complaints or concerns. The home has policies relating to the Protection of Vulnerable Adults and Whistleblowing. Staff recruitment procedures ensure that all new staff have a criminal record bureau Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: check prior to commencing work at the home. Care Homes for Adults (18-65 years) Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has been decorated and furnished to a high standard. A range of accommodation is provided at the home. There are sufficient communal areas to meet peoples needs. Bedrooms have been decorated to reflect individuals lifestyles and needs. The home is maintained to a high standard of cleanliness. Evidence: On the day of the inspection the home was warm and homely in appearance and appeared to maintain high standards of cleanliness and hygiene. We conducted a tour of the premise. Street Farm is a large detached farmhouse situated in a small village within walking distance from local amenities. The main farmhouse has three en-suite bedrooms, one staff sleep in room, office, two communal lounges, dining area and a large kitchen. In addition to this, there is an annex with two bedrooms both of which have their own bathrooms and an assessment room with en-suite facilities. Five people live in the main house and annex. There are four cottages, which cater for five people. These have been built in the grounds to the rear of the farmhouse. There is also a paved patio area with patio table and chairs and Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: a large garden that contains ornamental ponds. Three people showed us their bedrooms with their permission. Each persons bedroom was specifically decorated to their taste and interest. The bedrooms were filled with a range of decor such as collectibles, photographs of families and friends, comfortable armchair or sofa, television, DVD player, music system, fairy lights and personal memorabilia. The ensuite facilities were also personalised in a bright and cheerful manner. A buzzer system is in place should any of the indivduals wish to seek staff support at night time. Communal areas are situated on the ground floor and consist of two lounges, a large dining room and spacious kitchen. There are sufficient communal spaces for the indivduals to access and choose from. A private hallway area allows people to make personal phone calls in comfort and privacy. Outside to the rear of the house is a good-sized laundry area, which houses two washing machines and two tumble driers. It was found to be clean and well organised. Cleaning schedules were sampled and detailed what task has been completed, when and who by. People living at the home are fully involved with daily living management such as laundry, cooking and changing bed linen. It was noted that the shower in the staff sleeping in room is in need of repair. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are appropriate to meet peoples needs. Staff are competent and provide a high standard of care and support. Staff are provided with opportunities to attend training, and receive regular supervision. The home ensures that appropriate information is obtained prior to a staff member commencing employment at the home. Evidence: Duty rotas are maintained. There are generally four staff on duty during the day, in addition to one sleeping-in members of staff at night. The level of staffing has ensured that people are provided with regular opportunities to participate in social activities and access the local community. Newly appointed staff receive Induction training. Staff are provided with regular updates in mandatory training. The home has a training package, which will enables staff to cover a range of courses including fire safety, first aid and infection control. Staff spoken with stated that it was a good place to work and that they received appropriate support. Staff receive an Individual Performance Review, and receive supervision on a regular basis. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The recruitment files were examined for the three members of staff employed since the last inspection. Two references had been obtained The files examined included evidence of a POVA First checkand an Enhanced CRB disclosure being obtained. 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. The home is well run. There are appropriate systems in place for consultation with people living at the home and their families. There is a relaxed and open atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and service users. Evidence: Tina Dewey is the registered manager and has worked at the home for some time . She has a good knowledge of the needs of the indivduals living at the home. People living at th ehome and the staff were very complimentory about the managerial support that Tina provides and all stated that she was approachable. People living at the home and their families are encouraged to provide feedback on the service provided. Service User meetings are held regualry ad people living at the home Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: staed that they felt that their views were listened to and respected . A member of the senior management team visits the home regualry to provide Tina with support, to conduct a tour of the building and review the quality of care and support provided on a rmonthky basis. This is in line with Regaultion 26 of the care home regualtions. The home has appropriate policies and procedures in place to safeguard vulnerable people. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. The home displays appropriate Employers Liability Insurance. O Fire records were examined, and had been appropriately maintained. Staff are provided with regular fire safety training. Health and safety records have been appropriately maintained. All accidents have been recorded and reported as required. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 42 23 (2b) It is required that an 15/06/2007 Electrical Wiring test (5yrs) and certificate be arranged and a copy sent to the CSCI. 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: 03000 616161 or Textphone: or 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. Copyright © (2009) 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. 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