Care Home: The Manor Farm House

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What the care home does well The home has a friendly and relaxed atmosphere and all residents surveyed and spoken with confirmed that they are happy living in the home. Daily routines are flexible and staff accommodate individual lifestyle choices, whilst enabling residents to remain as independent as possible. Care planning records clearly evidence the home`s person-centred approach to the care of the people living there. The home has an open culture that values residents and staff. It works in partnership with residents, their families and other professionals, seeking their views on the service in order to continually develop and improve the quality of the service. Comments made by residents and their relatives include: "Lovely place to be", "The home is staffed by local people for local people", "Makes them feel at home and one of the family", "Very good service when mum had a fall" and "Very impressed with the service and how they have helped my mum settle in. A good family home". Comments made by health professionals confirmed that the home works in partnership with them and staff have the experience to know when to ask for intervention from District Nurses to ensure that people`s health care needs are met.The home has good staff retention and staff moral is high. Staff are well trained and supported and all show enthusiasm and commitment to providing a good service to residents. What has improved since the last inspection? The requirement made at the last inspection to carry out a care needs assessment for privately funded residents has been met. The home has put in place a format that is now used for all new residents, whether referred by social services or privately. The residents contract has been updated in line with the standards. Care plans are now being dated and there is a clear audit trail of when changes have taken place. A systematic programme for regular supervision of staff has been developed and implemented and is up to date. CARE HOMES FOR OLDER PEOPLE The Manor Farm House Church Street Radstock Bath Bath & N E Somerset BA3 3QG Lead Inspector Carole White Key Unannounced Inspection 29th November 2007 11:00 X10015.doc Version 1.40 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 DS0000065524.V354314.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 Older People. 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. DS0000065524.V354314.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor Farm House Address Church Street Radstock Bath Bath & N E Somerset BA3 3QG 01761 436127 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) ARTI Services Ltd Ms Amanda Jayne Allen Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places DS0000065524.V354314.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 20 persons aged 65 years of over requiring personal care 9th November 2006 Date of last inspection Brief Description of the Service: Manor Farm House is a privately owned care home in Radstock, which is an exmarket town some eight miles from Bath and the Somerset village of Frome. The property itself is an attractive 18th century converted farmhouse. Radstock offers a range of shops and facilities, including a bank, post office, library, college, churches of different denominations, a local museum, hairdressers, a dental surgery and a good bus service, all of which are just a few minutes walk away from the home. The home offers one communal lounge, a conservatory/lounge overlooking the rear garden, a dining room and a spacious hall. All of these communal facilities are located on the ground floor. There are fifteen bedrooms, ten single and five shared rooms, although currently two shared rooms has single occupancy. There are no en suite facilities, but all rooms are equipped with hand basins. The home has an attractive enclosed rear garden, small front garden, and car parking to the side of the home. There is also a free public car park directly opposite the home. The range of fees for the home are £380-£410 per week. DS0000065524.V354314.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit that took place over one day totalling six hours as part of the key inspection. A tour of the premises was conducted and records were examined. The inspector spoke with the members of staff on duty and with several residents. On the day of the inspection the home had 18 residents. Surveys forms were sent to the home prior to the inspection and given to residents. 15 surveys forms were returned from residents and 5 from relatives/visitors and 5 comment cards from health professionals. The inspection also took into account the Annual Quality Assurance Assessment (AQAA) self assessment document completed by the manager. What the service does well: The home has a friendly and relaxed atmosphere and all residents surveyed and spoken with confirmed that they are happy living in the home. Daily routines are flexible and staff accommodate individual lifestyle choices, whilst enabling residents to remain as independent as possible. Care planning records clearly evidence the home’s person-centred approach to the care of the people living there. The home has an open culture that values residents and staff. It works in partnership with residents, their families and other professionals, seeking their views on the service in order to continually develop and improve the quality of the service. Comments made by residents and their relatives include: “Lovely place to be”, “The home is staffed by local people for local people”, “Makes them feel at home and one of the family”, “Very good service when mum had a fall” and “Very impressed with the service and how they have helped my mum settle in. A good family home”. Comments made by health professionals confirmed that the home works in partnership with them and staff have the experience to know when to ask for intervention from District Nurses to ensure that people’s health care needs are met. DS0000065524.V354314.R01.S.doc Version 5.2 Page 6 The home has good staff retention and staff moral is high. Staff are well trained and supported and all show enthusiasm and commitment to providing a good service to residents. What has improved since the last inspection? 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. DS0000065524.V354314.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000065524.V354314.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current and prospective residents are given good information about the services that the home can offer. Residents have had their needs assessed and they know that the home has the ability to meet their personal care needs. EVIDENCE: The home’s Statement of Purpose has detailed information about the services and facilities that the home provides. The home has also developed a Service Users’ Guide, which is given to the prospective resident or their representative prior to moving into the home enabling them to make an informed choice. Five files were examined and all had evidence that the manager had visited the prospective residents prior to them moving into the home to carry out an assessment of their needs. Since the last inspection the home has developed a format for carrying out a care needs assessment for all residents prior to them moving into the home. DS0000065524.V354314.R01.S.doc Version 5.2 Page 9 The needs assessments give comprehensive details of the resident’s daily living, social activities, likes and dislikes, family involvement, spiritual and emotional wellbeing and medication. In conjunction with the residents and their relatives the home details a life history of the individual to enable staff to have a greater understanding of the person. Since the last inspection the residents contract has been updated in line with the standards. Each file examined showed a clear inventory of the items that each individual had brought into the home. Evidence from speaking with residents and their relatives and surveys received confirms that residents feel that the home can meet their needs. DS0000065524.V354314.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs are recorded in a care plan that is developed with the residents. Resident’s health care needs are fully met. Residents feel that they are treated with respect and their privacy is upheld. EVIDENCE: All of the files examined had a photograph of the resident and a copy of their care plan with evidence of monthly reviews. Care plans give clear information about the areas that residents require assistance with and the actions that staff need to take to meet those needs. Care plans also clearly evidence the home’s person-centred approach to the care of the people living there. Care plans are now being dated and there is a clear audit trail of when changes have taken place. Appropriate risk assessment are carried out, including for manual handling and risk of falls. DS0000065524.V354314.R01.S.doc Version 5.2 Page 11 The home has developed ‘advanced care plans’, with residents that wish to do so, recording details of their wishes with regard to resuscitation and any funeral arrangements in the event of death. Individual contact books are used to maintain daily records for each resident. Each book has a personal profile of the resident and a photograph at the front of the book. Entries made by staff were seen to be comprehensive and informative and written in an appropriate manner. Comments made by health professionals confirmed that the home works in partnership with them and staff have the experience to know when to ask for intervention from District Nurses to ensure that people’s health care needs are met. Medication is administered through a dosage system and a senior care worker administers the medication to the residents. Medication is stored appropriately and records examined were found to be correct. Evidence from speaking to residents and from the comment cards shows that service users feel that they are treated with respect and their right to privacy is upheld. DS0000065524.V354314.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11 - 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a range of activities within the home that enables them to have choice and flexibility in their lifestyle and residents are able to receive visitors at their convenience. The home offers a balanced choice of meals in a relaxed and pleasant environment. EVIDENCE: The home has residents meetings every 6-8 weeks and at these meetings discussions take place to agree activities that residents would like to take part in or trips that could be arranged. A meeting took place on the day of the inspection and most residents participated, giving their views on future events and raising any issues they had. The home has two lounges and staff conducted separate meetings in each lounge so as to include all residents. DS0000065524.V354314.R01.S.doc Version 5.2 Page 13 One care worker works 6 hours a week as the activities co-ordinator and facilitates activities such as bingo, sing-a-longs and card games. A visiting activities co-ordinator holds weekly group exercise classes, flower arranging and gardening. The visitor’s book confirmed that residents receive regular visits from relatives. Resident’s spoken with confirmed that their visitors are always made welcome. The home has a relaxed, friendly and homely environment and all residents spoken with and surveyed confirmed that they are happy living there. The interaction observed between residents and staff is good and staff are kind and attentive to their needs and wishes. Daily routines are flexible and staff accommodate individual lifestyle choices, whilst enabling residents to remain as independent as possible. The home offers a varied menu, which allows for individual choice and preferences, and residents enjoy their meals in a relaxed and pleasant dining room. Discussions with the cook confirmed that the home prepares freshly made meals each day. The kitchen staff keep a record of each resident’s likes and dislikes in relation to each mealtime and this is regularly reviewed and updated if necessary. Residents spoken with and surveyed all confirmed that they like the food and clearly enjoy meal times and see it as a social occasion. During the visit to the home residents were observed being offered regular drinks and jugs of water or squash were placed in each room. DS0000065524.V354314.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple, clear complaints procedure and residents know how to access it. The home promotes the protection of residents from abuse through the training and awareness of staff. EVIDENCE: Appropriate procedures are in place for the management of any complaints. The home has not received any complaints since the last inspection and neither has the commission. It is clear that the open culture of the home encourages residents to feel confident about raising concerns. The complaints procedure is clearly displayed in the entrance hall and is written in an informal and friendly way. All staff are given training in the Protection of Vulnerable Adults as part of their initial induction, and then attend alerters training with an external trainer. Staff spoken with demonstrated that they had a good understanding of how to identify potential abuse and report it. DS0000065524.V354314.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 & 26 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 safe, clean and well-maintained environment with comfortable bedrooms, that they are able to personalise with their own furniture and possessions. EVIDENCE: The inspector conducted a tour of the premises and overall the home was clean, hygienic and odour free. Residents spoken with and surveyed also confirmed that the home is maintained in a clean and hygienic state. Some rooms are small but the home encourages residents to make the most of the available space and residents had personalised their rooms with pictures and ornaments. Each bedroom has a washbasin and there are sufficient bathroom and toilet facilities to meet the residents’ needs. DS0000065524.V354314.R01.S.doc Version 5.2 Page 16 Since the last inspection the dining area has moved back into the conservatory in response to requests from the residents. However, seating around the edge of the room has been removed keeping this area free for dining. The home also has two lounges, the larger lounge is used as the ‘quiet lounge’ and the smaller lounge has a television in it. Again in response to requests from residents at one of their meetings covers have been put on the back of most chairs with the name of the individual resident embroidered on the cover. Residents spoken with on the day said that they liked this arrangement because most people had their favourite place to sit and wanted to feel that this would be available for them. The home employs a maintenance person who comes in every day. A log is kept of any repairs that are needed and the maintenance person carries these out each time he comes in. DS0000065524.V354314.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment practices and numbers of staff working protect residents. The home ensures that staff are trained and competent to carry out their work in order to meet residents’ personal care needs. EVIDENCE: Four staff files were examined and all found to have the relevant documentation. The training files were also examined for the same four members of staff and statutory training was up to date. Staff receive training in manual handling, food hygiene, fire safety, first aid, infection control and dementia awareness. The home has sufficient staff on each shift to meet the residents’ needs. The home is fully staffed and retention rates are high, with a team of long standing members of staff. The home does not use agency staff as staff work together to cover for holidays and sickness. Staff spoken with on the day of the visit clearly enjoy working in the home and they work well together as a team. The dedication and commitment of the staff team creates a happy relaxed atmosphere that clearly benefits the residents. DS0000065524.V354314.R01.S.doc Version 5.2 Page 18 Since the last inspection the home has increased the numbers of staff who have either completed or are working towards NVQ level 2. The home now has over 50 of staff that have completed NVQ level 2 and there is an on-going programme in place to recruit the remaining members of staff. All residents and relatives spoken with and surveyed confirmed that the staff are competent to do their jobs. Staff spoken with at the inspection all confirmed that they felt that they had been well trained to carry out their work and are encouraged to develop their skills with on-going training. DS0000065524.V354314.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager communicates a clear sense of direction and leadership, ensuring that the home in run in the best interests of the residents. The health, safety & welfare of the residents and staff are promoted and protected. Residents’ financial interests are safeguarded. EVIDENCE: It is clear that the home is run in the best interest of the residents. The relaxed and homely environment and open culture ensure that residents enjoy a good quality of life. DS0000065524.V354314.R01.S.doc Version 5.2 Page 20 The manager and staff work in partnership with residents, their families and other professionals, seeking their views on the service in order to continually develop and improve the quality of the service. The home has good staff retention and staff moral is high. Staff are well trained and supported and all show enthusiasm and commitment to providing a good service to residents. A systematic programme for regular supervision of staff has been developed and implemented and is up to date. Appropriate risk assessments are in place to ensure the safety of residents and staff, these are reviewed monthly. Records relating to the testing of the home’s fire alarm system and equipment were up to date, and staff are up to date with fire drill training. Most residents are able to manage their own money. The home facilitates the safe keeping of money for those individuals that require help from their relatives. For residents who require the home to manage small amounts of money appropriate records are kept. Since the last inspection the home has carried out a survey of the residents views of living in the home. Residents and their relatives/friends were asked 15 different questions about their care plans, the cleanliness of the home and how it is maintained and if they are happy living in the home. All of the questions from both the residents and their relatives/friends were answered as good or excellent. DS0000065524.V354314.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 DS0000065524.V354314.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000065524.V354314.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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