Care Home: Tablehurst Farm Cottage

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What the care home does well Residents live in a homely environment with a family atmosphere. They are able to say how they want their care to be provided, and about the way they want to live their lives. They are able to speak directly to the manager and the staff. Residents are give a healthy and balanced diet, and they have choice over the food they are given and are involved in the making of meals for the entire farm staff. Residents said they were very satisfied with the lifestyle they lead and how the home they live in is run. Residents also indicated they were satisfied with how their emotional needs, and health care needs are met. Residents are supported to have an active and varied social life with many opportunities to be included in the local community. Opportunities exist for residents to further their educational and occupational activities. Staff are enthusiastic and are safely recruited for the jobs they do. Residents made very positive comments regarding staff and made comments such as "I have known peter for many years he is so kind to me," and "The people who live with me look after me good" What has improved since the last inspection? There has been decorative work carried out in the cottage and all areas seen were in good repair and in a good decorative order. Staff confirmed and we saw through staff files that training had been provided in safeguarding adults. The information available in the statement of purpose and service user guide was up to date and provided information to prospective residents and their relatives. What the care home could do better: There were no requirements made following this inspection visit. It is recommended that the quality assurance programme is further developed so that other stakeholders such as Doctors and other health and social care professionals can give their views on the operation of the service. CARE HOME ADULTS 18-65 Tablehurst Farm Cottage Tablehurst Farm London Road Forest Row East Sussex RH18 5DP Lead Inspector Kathryn Emmons Unannounced Inspection 18th March 2008 10:30 Tablehurst Farm Cottage DS0000021383.V362519.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 Tablehurst Farm Cottage DS0000021383.V362519.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. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tablehurst Farm Cottage Address Tablehurst Farm London Road Forest Row East Sussex RH18 5DP 01342 823536 01342 824873 tablehurst_farm@talk21.com 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) Tablehurst Farm Limited Mr Peter Brown Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number must not exceed three The people accommodated will be adults between the ages of 18 and 65 years on admission 11th January 2007 Date of last inspection Brief Description of the Service: Tablehurst Farm Cottage is a family run home, providing accommodation for three adults with learning disabilities. The property is situated on a community organic farm, which is currently working 500 acres. There is a popular farm shop on site, which is used to sell the produce. Accommodation consists of three single rooms, a bathroom with bath and toilet and a separate toilet. There are currently two live-in staff members. The kitchen and lounge areas are shared with the live-in carers. The residents work on the farm and take part in the daily activities needed to run it. The Registered Provider and Registered Manager lives in the main farmhouse. All farm staff and residents join together for meals that take place on a rotational basis in the different farm properties. There is also emphasis on integration into the wider community. Support is available to enable residents to go shopping, the cinema, swimming, and to undertake various other activities. Family and friends are made welcome and may join the small community for meals. Tablehurst Farm is inspired by Christian ideals as articulated by Rudolph Steiner and is based on the acceptance of spiritual uniqueness of each human being, regardless of religious or racial background. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The current weekly fees at Tablehurst Farm Cottage, as of 18 March 2008, are £620.00. Additional charges are made for hairdressing, chiropody, toiletries, newspapers/magazines and certain leisure activities, including swimming and outings. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 5 Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A visit to the service took place on 18th March 2008. This visit was unannounced and took place over three hours. The registered manager was present and assisted the inspector with the visit. Care received by two residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general home records and staff detail records. Staff were spoken with and the care they provided was observed. We received a completed self-audit document completed by the registered manager, to provide information before we did a site visit. We also looked at how the provider makes information about their service, including CSCI reports available to prospective service users. During the visit we spoke with three members of staff and 2 residents. What the service does well: What has improved since the last inspection? Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 7 There has been decorative work carried out in the cottage and all areas seen were in good repair and in a good decorative order. Staff confirmed and we saw through staff files that training had been provided in safeguarding adults. The information available in the statement of purpose and service user guide was up to date and provided information to prospective residents and their relatives. What they could do better: 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. Tablehurst Farm Cottage DS0000021383.V362519.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 Tablehurst Farm Cottage DS0000021383.V362519.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): 1,2,3,and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that their assessed needs can be met by the service. Contracts are in placed so residents can be clear on what service they can expect. Up to date information provides residents with information about the service. EVIDENCE: We could see from looking at care files that residents had contracts in place. We saw from residents comment cards that they had been involved in trial visits to the home. One said “Came for trial visit so I new it was right place” and another resident said “. I came here 10 years ago I said I wanted to be here”. All three residents who live at the service have been residents for at least 8 years. The manager confirmed that they were not planning to admit any new residents. Pre admission information is available such as statement of purpose and service user guide. The manager regularly updates these. Tablehurst Farm Cottage DS0000021383.V362519.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their needs met and are able to make decisions regarding how they spend their time. Staff are clear from records maintained, what residents needs are and how to meet these. Residents are empowered to be as independent as is possible EVIDENCE: We saw care files for two residents both of these contained written assessments, care plans and risk assessments. It was clear what the residents needs were and how these were going to be met. Staff told us that they have access to the care plans and wrote progress notes at least daily. One resident had his own diary, which he wrote in each day to show his parents what activities he had been involved in. This enables staff to be kept up to date on the resident’s welfare. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 11 There was evidence that reviews had taken place for one of the resident’s case tracked and there were reports in place from relevant people such as a care manager and key workers. We could see that residents had been involved in their care plan and that they were also involved in reviews. Tablehurst Farm Cottage DS0000021383.V362519.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to maintain family and friendship relationships. Residents are able to enjoy a lifestyle, which takes their choices and preferences into consideration. Dietary needs and choices are catered for. EVIDENCE: At the time of the visit one of the three residents was visiting their relatives. Residents told us that they often went home on weekend trips. One of the residents said he had made friends with residents at another service nearby. This resident attended a music exercise class at the nearby home. Records showed visits to the shops, cinema and pubs and entries in the diary showed recent visits to garden centres and the seaside. The farm the residents live on has a shop and provides opportunities for residents to be involved in purposeful activities. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 13 On a daily basis residents sit and talk with the manager and staff. One of the residents said, “I choose what I do” and “I didn’t want to go to the pub so I stayed at home with max (staff). Staff gave examples of how residents are empowered to make their own decisions as far as is possible. Pre inspection information stated that residents are consulted on all routines of the house and are able to choose how they spend their time. At the residents request one of the staff is working with a resident to source an evening club where he can make friends with other residents from other services who have learning difficulties. Discussion with two residents identified that cooking is a pastime which all of the residents thoroughly enjoy. Where possible the service use organically grown vegetables and all of the meat is organic and where possible all food is homemade. Residents told us, “I like this food the best”, “I get help and make bread for everyone”. We saw they was a good supply of fresh fruit and vegetables. Tablehurst Farm Cottage DS0000021383.V362519.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in the support they receive. A holistic approach is taken to care provided. Medication systems keep residents safe. Health Care arrangements are good. EVIDENCE: Residents gave examples of how they spent their day. . At the time of the visit one resident was in the kitchen making the main midday meals with a house parents help. Elsewhere on the farm site another resident was making bread for the farm staff. One resident told us “can do what I want during the day and evening”. Residents are involved in their care and told us they “get the help I need, and “they always help me with things”. An holistic approach is taken to the care provided to ensure that emotional and spiritual needs are met as well as physical support being given. An example of this is one resident is taking a homeopathic medication with the doctors Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 15 guidance as this has less side effects than traditional medication. The resident is happy with this arrangement. The medication records were seen for those residents who receive medication. The records were in good order and we could see that staff were clear how to dispense medication safely. Staff confirmed that residents were registered with a local doctors surgery. We saw records, which indicated that residents had seen an optician and a dentist. Tablehurst Farm Cottage DS0000021383.V362519.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints policy enables people to know how to make a complaint. A Safeguarding adult’s policy provides staff with a working awareness of what constitutes abusive practice. Residents are cared for by staff who have received training in safeguarding adults. EVIDENCE: We spoke with residents about what they would do if they had any concerns about living at the service. One resident said “I like it here but I would go to Peter”. A complaints procedure is in place which residents have access to. Staff were also able to say how they would respond to any concerns raised. Prior to the visit pre inspection self-audit information was sent to the commission. This recorded that there had been no complaints since the last inspection in January 2007 and no safeguarding adult referrals. A safe guarding adults policy is in place. Staff confirmed that they had received training in respect of safeguarding adults procedures and we saw this on the pre inspection self audit information. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and pleasant service, which they have control over. Décor and furnishings are residents’ choice and provide a homely atmosphere. EVIDENCE: The home is a detached cottage overlooking woodland and farmland. The décor is of a good standard. Residents have their own room. Three of the staff, who are called house parents live at the home. This enables the residents to live in a homely environment. A resident said “It’s like being at home” and “I have my own room with my things in it”. We were able to look at two of the resident’s bedroom. These had been personalised by each of the residents. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 18 Since the last inspection visit radiators have been painted as recommended. The whole home was clean and tidy and no obvious hazards were noted. From observation of the resident and houseparent working in the kitchen there was a clear awareness of minimizing cross infection in the kitchen area with aprons being worn and residents washing their hands while dealing with food. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An enthusiastic and trained care team cares for residents. The service’s recruitment procedures ensure residents are cared for by safely recruited staff. EVIDENCE: We spoke with three staff during our visit. Staff were clear on residents individual needs and how to meet these. The staff aim to provide an environment where residents can learn new skills and have worthwhile lifestyles and opportunities available to them. One of the staff told us how they had been recruited and what their induction had consisted of. Comments on one of the staff surveys also evidenced that training had been given, “ I didn’t have any special training before I came to work here but I have been helped to understand the individual needs of the service users. Another staff member told us “I am currently doing NVQ level 2 in social care”. We were also told and we could see from pre inspection self audit information that a NVQ (national vocational qualification)assessor visits the service to assess how the care staff is working with the residents. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 20 Two recruitment files were looked at. A recruitment policy is in place and all files seen contained the correct checks such as references, completed application form and Criminal Record Bureau checks and identification. This means that staff have been recruited safely and residents can be confident that they are cared for by people who have the necessary skills and attitude to care for them. Interactions we saw between staff and residents were valuing and staff were patient and encouraging towards residents. Residents told us “its good. Peter used to live with me and Max and Lucy live here and look after me they are nice to me and I like them”. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39, 41and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent and experienced manager manages the service. Polices and procedures protect residents and staff and the service is managed well. This provides residents with a safe and positive environment which to live in. EVIDENCE: Mr Peter Brown who is the registered manager and provider manages the service. Mr Brown has many years experience of working with people who have learning disabilities. Previously Mr Brown used to live in the house with the residents as a full time house parent. Residents spoke very warmly of the manager and made comments such as “I have known Peter for a long time”, “I like Peter he is my family and I can tell him anything”. Staff said they had a very good relationship with the manager and that they felt they could discuss Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 22 any issue with him. Staff have weekly update meetings where they are able to discuss any issues regarding residents and the house and minutes are maintained . Additionally there are mentors for staff who are not directly involved with the running of the house and staff said they could discuss any issue with them. These mentors also provide two monthly supervision for staff. A quality assurance system is in place so residents and visitors to the home can see how the manager intends to keep improving the service. This takes into consideration the views of residents and relatives. Discussion took place regarding further development of the system to obtain the views of other stakeholders such as social and health care professionals who came into contact with the service. Pre inspection information evidenced that polices and procedures are maintained. Records are in place at the home, which show that servicing of equipment and systems such as the fire safety system and heating system are up to date. Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 x 5 3 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 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 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 4 13 3 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x 3 3 x Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA39 Good Practice Recommendations It is recommended that the quality assurance system is further developed to provide more views on how the service operates in the best interests of the residents Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Tablehurst Farm Cottage DS0000021383.V362519.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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