Care Home: The Old Farm House Residential Home

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What the care home does well This home has many more strengths than weaknesses, and is judged well run and safe. The location of this home is judged suitable for its existing registered purpose, convenient for visitors and a very satisfactory level of compliance with the National Minimum Standards is being maintained throughout the property and site. All areas of the building inspected were well decorated and furnished, clean and odour free. Staff are to be commended. Records indicate that the health and personal care needs of the residents are generally adequately provided for. There is input from a range of healthcare professionals and some evidence of equipment and adaptations throughout the home. There appear to be sufficient management and staffing resources in place to keep people safe. The meals tend to be traditional English. There is a choice of meals and some special dietary needs can be catered for. The standard of catering was judged one of this home`s key strengths. This home is generally viewed very positively by those using its services. Residents are consulted and are afforded choices on a day to day basis. What has improved since the last inspection? CARE HOMES FOR OLDER PEOPLE The Old Farm House Residential Home 48 Hollow Lane Canterbury Kent CT1 3SA Lead Inspector Jenny McGookin Key Unannounced Inspection 14th March 2008 09:30 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 The Old Farm House Residential Home DS0000023301.V361840.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. The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Farm House Residential Home Address 48 Hollow Lane Canterbury Kent CT1 3SA 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) 01227 453685 Mr Paul Straker Mrs Vivien Fuller Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2007 Brief Description of the Service: The Old Farm House is privately owned and is registered to provide accommodation and personal care to 23 older people. It is located about a mile and a half from Canterbury town centre, with all the community resources and transport links that implies. What was originally a rural setting (hop fields), this is now a residential area, but the home retains views of the cathedral. There is ample car parking space. The home comprises an older detached building with a purpose built extension, set within an enclosed garden. The accommodation is on two floors, linked by a passenger lift and staircase. There are nineteen single rooms and two rooms with shared occupancy, although these are sometimes used as larger single rooms. Each bedroom has a private toilet, wash hand basin, and (with the exception of the shared rooms) a bath or shower. All rooms are connected to a call bell system, and each bedroom also has a T.V and telephone point. The current fees for the service at the time of the visit range from £345-£515 per week. Additional charges are made for dry cleaning, dentist, optician, reflexology, chiropody, hairdresser and toilet items. Fruit is supplied for lounges and for individual bedrooms, where residents stay in their rooms during the day. A top up payment may in some cases apply. Information on the Home’s services and the CSCI reports for prospective service users should be detailed in the Statement of Purpose / Service User Guide. The e-mail address for this home is: paul@strakerp.fsnet.co.uk The Old Farm House Residential Home DS0000023301.V361840.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, which was used to inform this year’s key inspection process and to check on any developments since the last available inspection report (January 2007), given all the timeframes had run their course. The inspection process took eight and quarter hours. It involved meetings with four residents (including one group of three over lunch), two relatives, the manager and proprietor, as well as a care assistant and the cook. Interactions between staff and residents were observed throughout the day. The inspection also involved the examination of records and the selection of three residents’ case files, to track their care. The home had submitted an Annual Quality Assurance Assessment (AQAA) in advance of the site visit, as required. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives some numerical information about the service. This was judged a well written, comprehensive account of the issues raised, which reflected provision fairly. A selection of feedback questionnaires was taken to the inspection for distribution to residents and other stakeholders, but not in time to include responses in this report. But account was taken of the home’s own quality assurance feedback exercises from 2007 (residents, visitors and in respect of food). Six bedrooms were inspected for compliance with the National Minimum Standards on this occasion, along with communal areas / facilities. What the service does well: This home has many more strengths than weaknesses, and is judged well run and safe. The location of this home is judged suitable for its existing registered purpose, convenient for visitors and a very satisfactory level of compliance with the National Minimum Standards is being maintained throughout the property and site. All areas of the building inspected were well decorated and furnished, clean and odour free. Staff are to be commended. Records indicate that the health and personal care needs of the residents are generally adequately provided for. There is input from a range of healthcare The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 6 professionals and some evidence of equipment and adaptations throughout the home. There appear to be sufficient management and staffing resources in place to keep people safe. The meals tend to be traditional English. There is a choice of meals and some special dietary needs can be catered for. The standard of catering was judged one of this home’s key strengths. This home is generally viewed very positively by those using its services. Residents are consulted and are afforded choices on a day to day basis. 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. The Old Farm House Residential Home DS0000023301.V361840.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 The Old Farm House Residential Home DS0000023301.V361840.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 1, 2, 3, 4, 6 The home can evidence that incoming residents (and their representatives) are being given written information about the home, to help them decide whether this home will meet their needs. The home’s Statement of Purpose and Service User Guide will only require some minor attention to ensure they provide all the information prescribed by the National Minimum Standard, so that it can be fully confident that prospective residents and their representatives are fully informed. Prospective residents benefit by assessments carried out before their admission, to ensure that the home can meet their needs. The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home’s Statement of Purpose and Service User Guide have been combined into one document, which usefully provides a range of information on the home, its principles of care and its facilities and services. A statement on the first page of the Service User Guide states that it can be made available in tape, but this is not currently the case and should be removed from the text so as not to raise expectations unduly. The Service User Guide also states that it would also be available in other languages and, as these documents are generated electronically, it would also be possible to provide this in larger print. The manager was advised to use the home “Enquiries” folder to evidence whether other languages or formats are in practice warranted. These documents have been amended since the last inspection, but a few minor matters still require attention in respect of these documents, to obtain full compliance with all the elements of the National Minimum Standards, so that the home can be fully confident that prospective residents and their representatives have all the information they should have to make an informed choice of home. The detail has been reported back to the home separately. The residents spoken to on this occasion were able to recall the preadmission process in some detail, but this is generally not representative, which is why homes are advised to keep their own records. Records confirm that an assessment of needs is carried out before each admission, which records confirm would also take into account assessments and care plans set up either by the relevant funding authority or by other providers, and are developed thereon. There are opportunities for residents or their representatives to visit the home before admission to assess its suitability for themselves, and there is a trial stay. Each admission is confirmed by a contract. This home does not provide intermediate care. See sections on “Environment” and “Health and Personal Care” for findings in respect of the home’s capacity to meet the needs of its residents. The Old Farm House Residential Home DS0000023301.V361840.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 7, 8, 9, 10 Residents benefit from the health and personal care they receive at this home, and records reflect the level of care given. The principles of respect, dignity and privacy are put into practice EVIDENCE: Three residents’ files were selected for case tracking on this occasion, to represent the latest admissions (i.e. over the past year) and these were followed through with discussions with residents (where they were able and willing) and staff. This inspection generally confirmed the findings of the previous inspection (January 2007). That is to say, each resident has a plan of care based on the initial preadmission assessment or previous care plan. The care plans properly set out, in generally good practical detail, the action, which needs to be taken The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 11 by care staff to ensure that all aspects of the health and personal care needs of the residents are met. And care plans are properly underpinned by daily reports and a range of risk assessments, both generic and specific - covering the individuals, their behaviour, activities and their environments. Checklists on each file confirmed that each care plan was being reviewed inhouse, at least monthly and whether changes were warranted. It was not clear, however, to what extent residents or their relatives / representatives are actively engaged in the care planning process, except in respect of reviews carried out by care managers – matter raised for attention at the last inspection. Only one of the three files selected for case tracking contained a formal review carried out by the home, identifying the participants. Two of the residents and two of the relatives spoken to on this occasion were familiar with this process, though others recalled being asked questions about their care on a day-to-day basis. The home’s own quality assurance feedback exercise a sound level of satisfaction with the level of care given. With two exceptions, all the bedrooms in this home are single occupancy, which means health and personal care can be given in privacy. Residents and relatives confirmed that the daily routines are as flexible as healthcare needs and staffing levels will allow. Records conform that the residents’ health is monitored regularly. This home is served by seven GP practices, so that residents have some choice. And records confirm they have access to a range of medical services, according to need. Residents would need to pay for chiropody, physiotherapy or any special or private treatment of medication themselves. The home uses the Boots Monitored Dosage System of medication, over a 4week cycle. At the last inspection, the home’s medication policy and procedures were reported to have been submitted to the home’s pharmacist for scrutiny, to ensure it complies with best practice. There were no apparent gaps or anomalies in the medication administration record (MAR) charts seen, but one section needed better securing against loss or disarray. The home also has ready access to the latest copy of The Royal Pharmaceutical Guidance, for reference, but its list of signatures of staff authorised to administer medication and its copy of the British National Formulary will both require updating, to properly safeguard the arrangements. The home’s Medication trolley is kept properly secured when not in use. The Old Farm House Residential Home DS0000023301.V361840.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 12, 13, 14, 15 Residents benefit from a life style of their choosing, and are provided with occasional social activities. Residents are supported to keep in contact with family and friends. Residents benefit from a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Not unusually, residents were not able to give many examples of any particular interests or hobbies being actively promoted by the home, but were not able to suggest any others and said they were generally very content. Residents are able to have visitors at any reasonable time and there was evidence of this throughout the day of this site visit. There are some links with the local community (see also section on “Environment”). All the bedrooms have telephone points and residents can have their own phone lines installed at their own expense. There is also a cordless handset in the office, which can The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 13 be taken into other areas for privacy. Unless other arrangements have been made, residents receive their mail unopened. The daily routines in this home are flexible, to suit the residents’ individual preferences and capacities, and there are some opportunities for appropriate exercise (e.g. Keep Fit sessions), and occasional minibus trips out. Activities on site include Bingo, skittles, bowls and craft sessions such as making cards for Christmas and Easter. And there is always a good supply of videos, tapes, and reminiscence - the library visits to replenish the home’s own stocks. Since the last inspection, the home’s reading room is no longer doubling as a smokers’ room (the home now has a no-smoking policy throughout) and its refurbishment has created a very pleasant library environment. The home has also started up a reading group – the reading group identify authors and the library brings in five copies of each title for its members to read and discuss. A hairdresser comes in regularly, and a hairdressing room is planned in the proposed building works. There is also a visiting chiropodist. Two residents also attend day centres, including one run by Age Concern. Others make use of travel permits or family support to access the local community resources (shops, restaurants, cultural events). Catering needs are properly identified as part of the preadmission process and updated or amended thereon. There is a selection of menus, which is applied flexibly, usually one week in advance, and alternatives are always available. Records are maintained of the options chosen by individuals, as required. The inspector joined two residents for lunch and judged the meal well prepared and well presented. The residents confirmed this was representative, and that alternatives were readily available. The pace was unhurried and congenial. The dining room provides a pleasant setting. Some special equipment (e.g. plate guards, non-slip mats, large handled cutlery and beakers) are available but some residents choose not to use them. Staff are ready to offer assistance in eating where necessary. Since the last inspection, and as a direct result of feedback from residents, fresh fruit is readily available to them and staff have been made more aware of one resident’s request for more water to drink. Therapeutic diets are not currently warranted. When asked, the cook said she hadn’t had specialist training for the elderly or dementia (matter raised for attention in respect of the previous cook at the last inspection, who has since left - this continues to be recommended), but is reported to be producing dishes, which have been popular. The Old Farm House Residential Home DS0000023301.V361840.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 16, 17, 18 Residents have access to a robust, effective complaints procedure. Residents are protected from abuse and have their legal rights protected. EVIDENCE: This home has a simple, clear and accessible complaints procedure, which includes the stages and timescales for the process, so that complaints can have confidence in any concerns being dealt with promptly and effectively. Residents and their relatives said they knew who to talk to if they had any concerns or complaints. The home’s complaints register was judged a realistic reflection of communal living, and indicates that people are not afraid to speak up. The records show what action was taken to address any concerns raised and the timescales involved in each case. Feedback obtained on the day of this site visit, and the home’s own quality assurance feedback exercises all confirmed a high level of satisfaction. Information on local advocacy services (CROP leaflet) is on open display on a notice board, and records continue to confirm that there are residents’ group The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 15 meetings, every 2-4 months, to discuss a range of matters relating to the running of the home – and these are very well attended. The home has procedures to ensure that service users are safeguarded from abuse in all its forms, and staff continue to confirm their commitment to challenge and report any incidences of abuse, should they occur. The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 19, 20, 21, 22, 23, 24, 25, 26 The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The location and layout of the home is suitable for its stated purpose; it is accessible, safe and well-maintained. And it has retained a number of the characterful features of the old farm house it once was. When asked what made her choose this home, one relative said, “This was like a 3-star hotel – by far the best home…. The fact it is a small home was also a factor”. She said she came and had a look, and immediately liked the look of it. The home is on the A28, linking it to Canterbury City Centre and Ashford, with all the community resources and transport links that implies. Car parking The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 17 facilities are good, and measures are in place to keep the premises secure against unauthorised access, without infringing on the residents’ freedom of movement. Since the last inspection the home has introduced a “No Smoking” policy and its library is no longer having to double as a designated smoking area. Its refurbishment has turned this into an attractive environment. All areas of the home inspected were found to be homely and comfortably furnished. Comfortable temperatures and lighting levels were being maintained throughout, accepting the use of energy saving bulbs causes some initial delay in obtaining optimum levels. The residents have a good choice of communal areas, and, with the exception of the library, these are each spacious. The furniture tends to be domestic in style and of good quality, and there were homely touches everywhere. All corridors have handrails on each side, and there is a shaft lift and staircase to access both floors, so that residents can move about as independently as possible. All areas are linked with a call bell system. Specialist equipment includes raised toilet seats; grab rails and lifting equipment, including hoists. This home is registered to provide care for up to twenty three residents, and with the exception of two double bedrooms, all the bedrooms are single occupancy, so that residents can for the most part be assured of privacy. All the bedrooms are well in excess of the National Minimum spatial standards. Six bedrooms were inspected on this occasion, and judged well maintained and personalised. In terms of their furniture and fittings, they were not all fully compliant with all the provisions of the National Minimum Standards. Five did not have lockable bedroom doors, and two did not have bedside lights. This is acceptable only if their non-provision is supported by fully documented consultation and/or risk assessment. All bedrooms have telephone points; television points and all are linked to a call system facility. There is an apartment on 1st floor, which is ordinarily for the proprietor’s use (which has its own WC, bath and kitchenette facilities) but it can also be made available for use by relatives who need to be at hand for residents who are ill or dying. This is judged caring practice. At the last inspection, the proprietor and manager were recommended to arrange periodic assessments by an OT to ensure it maintains its capacity to meet the needs of residents as they age or become more dependent. This recommendation still stands, particularly as major building work is planned. The new wing has five en-suite showers, and there is a main shower room. Other rooms have all got en-suite bathrooms, so that residents have some choice. Two double rooms have WCs and hand basins. The communal bath is a standard one with a hoist. At the last inspection an adapted bath was The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 18 recommended. accessible WC. This recommendation still stands and is planned along with an The premises are kept generally clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection. One relative said, “You never, ever have a smell here – it’s a real test”! The last inspection by an Environmental Health officer (November 2007) gave this home a 3-star rating, which means she found a generally good level of compliance. Some matters were raised for attention, but a major refurbishment of the catering facilities is already planned which should address these matters. A store room opposite one bedroom door was found not be locked against unauthorised access and should be risk assessed. All the maintenance records seen were up to date and systematically arranged. A few minor matters were raised for consideration or attention, to improve the facilities. These were reported back to the proprietor separately. The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 27, 28, 29, 30 Staff in the home are well trained and deployed, to fill the aims of the home and meet the changing needs of residents. EVIDENCE: This home’s staffing arrangements are designed to ensure that (excluding the manager) there are always at least three care staff on duty during the day (tow shifts between 8am to 8pm) and two waking staff overnight (8pm to 8am). In the absence of the manager there is always someone in charge, with an on-call system as a back up. The manager said that another member of staff was in the process of being recruited to start at 7am to assist with the peak period and to increase the working / waking day to 13 hours. There was compliance with the staffing arrangement as described on the day of this site visit (which was unannounced); and there have been no concerns raised with the Commission about the home’s capacity to maintain these staffing levels. The home continues to operate a bonus system for staff who cover shifts or come in on short notice. This helps ensure a continuity of care for the residents. An examination of three personnel records, selected in two cases to represent recruitment over the past year, confirmed feedback from staff, that this home The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 20 has a generally systematic recruitment process to comply with the key elements of the standard, and exceeds the standard in respect of supervision – to keep the residents safe. See also section on “Management and Administration” in respect of the manager’s qualifications and ethos. Two of the three personnel files had incomplete induction checklists, but the manager said she had amended key information to make it easier for new European workers to understand (which should benefit everybody), and was following this through by requiring new staff to spend with extended periods shadowing experienced staff and by testing their competency, to keep people safe. Staff and records otherwise confirmed that there is a generally adequate level of investment in mandatory training (e.g. moving and handling, medication, food hygiene, fire safety, First Aid, adult protection, Health and Safety, COSHH and infection control) to keep the service users safe, as well as some specialist training such as dementia care, epilepsy, stroke management, challenging behaviour and Parkinson’s Disease. The manager has reported having maintained something like 90 of staff accredited to NVQ Level 2 or above over the past two years. This is judged exemplary. Since the last inspection, the manager has ensured that all staff are routinely being given copies of the code of conduct and practice set by the General Social Council to ensure practice complies with best practice principles, though receipt is not being certified – this is recommended. One relative said, “Staff are wonderfully welcoming”. The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 31, 32, 33, 34, 35, 36, 38 The management and administration of the home is based on openness and respect, and there is good evidence of effective quality assurance systems. EVIDENCE: Mrs Vivien Fuller has been the registered manager since March 2005 and the Commission’s registration process has established that she has a range of relevant qualifications and experience. She has completed all the elements of her NVQ Level 4 accreditation, and Assessor Award training, which should facilitate the level of staff accreditation (already judged exemplary) even further. The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 22 One relative said, “The manager is always very much on top of what is going on”. There are clear lines of accountability within the organisation and staff and residents have reported that in-house line management is accessible and supportive. See section on “Staffing” in respect of supervision of staff. The proprietor (who visits almost daily) has been able to robustly evidence compliance with his duty to carry out formal documented inspection visits of his own at least once a month (Regulation 26). One relative said, “Mr Straker is always very helpful and absolutely hands-on if anything isn’t technically working” in her relative’s bedroom. The current residents are all white British. Four are male – the rest are female. Two staff (including one part time worker) are male, all the others are female, and show slightly more cultural diversity (Bulgarian, Polish, Croatian, and black African) though it is predominantly White British. Since the last inspection, staff have been given reading material produced by Age Concern to raise awareness about sexuality in older people, so that this aspect of the service can be handled with sensitivity. Records continue to confirm there are regular meetings with the residents as a group to discuss the running of the home, and there have been periodic quality assurance initiatives (including questionnaires) to evaluate the home’s performance against its stated aims and objectives. The home’s management does not act as appointee for handling any resident’s financial affairs, but makes provision for the proper storage and accounting of personal effects and small sums of pocket money. There is a summary statement of the home’s development plan for the current financial year, which makes conspicuous links with its quality assurance initiatives and auditing arrangements (see below), to obtain full compliance with this standard. The views of service users and feedback from other stakeholders will always be crucial to the success of this. The proprietor arranged for the submission of a summary statement (dated 3rdApril 2008) in respect of its audited accounts, which indicate the business is showing food financial viability. “We have acted as the accountants for the company since its incorporation on 21 October 2003. Previously we acted for Mr Straker in his self-employed capacity trading as The Old Farm House. All of the company’s records are filed up to date. The company turnover holds constant … (and a sum was given to represent the range of figures applicable to its turnover and profits). The company maintains an acceptably stable staff and has no problems in meeting its contractual liabilities. It has a good working capital base and The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 23 the director makes excellent provision for any financial commitments made by the company. We have always found the company to be run in a professional manner; the staff and director acting with personal integrity in all financial undertakings. All relevant taxes are up to date and have been paid on time”. All the home’s property maintenance certificates seen were up to date. The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 24 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 X N/A 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 4 X 3 The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? None 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 OP1 Good Practice Recommendations The home’s Statement of Purpose / Service User Guide document should be amended to be fully compliant with all the elements of this standard. Given the poor recall of some residents, and relatives, the home should consider including the issue of a Statement of Purpose, Service User Guide and contract in the “Enquiries” folder, and whether other languages or formats were warranted. The property / site would benefit by periodic assessments by an OT to ensure it maintains its capacity to meet the needs of residents as they age or become more dependent. Care Plans. The following matters are raised for attention: There should be better evidence of active follow-up of DS0000023301.V361840.R01.S.doc Version 5.2 Page 26 2 OP1 3 OP22 4 OP7 The Old Farm House Residential Home some social care needs (interests, activities). Records should show the extent to which residents or their relatives are involved in formal reviews. 5 6 OP15 OP24 The home should consider training for the elderly or dementia for new catering staff. Bedrooms. The provision in rooms should be checked against the elements of National Minimum Standards and non-provision should be justified by documented consultation or risk assessment Kitchen. The proprietor should seek to proceed with plans to modernise and refurbish the kitchen to address the minor matters raised for attention by the Environmental Health Officer and CSCI findings 7 OP38 The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection CSCI SE 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 The Old Farm House Residential Home DS0000023301.V361840.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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