Care Home: The Old Farmhouse - The Briars

What the care home does well The home is divided into three parts, 4 people live in The Old Farmhouse, 3 in The Briars and 1 person has self contained accommodation attached to the home. Everyone has access to pleasant outdoor space. New staff were able to give evidence of a robust recruitment procedure which includes obtaining written references and carrying out appropriate checks. This minimises the risks of abuse to people living at the home. The home has undergone a period of high staff turnover and low staffing levels but staff remain extremely positive about their roles and the people who live at the home. Staff felt that the teamwork was excellent and standards of care remained good. Everyone stated that the new manager was very open and approachable and always willing to listen to peoples` views and opinions. What the care home could do better: Duty Rotas seen demonstrated that there are still vacancies but these shifts are being covered by relief staff who are familiar with the home. Medication Administration Records were viewed. All medication coming into the home is checked and signed in. Medication is administered by two members of staff and records were signed when administered or refused. This gives a clear audit trail for all medication. Hand written entries on medication records were not signed and witnessed in line with good practice guidelines. There were no clear guidelines in place for some people who are prescribed medication on an `as required` basis. There needs to be clear protocols in place for each individual to make sure that this medication is given consistently and to ensure that its effectiveness can be monitored. One member of staff who had worked at the home for some time said that they had not received training in the safe administration of medication. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: The Old Farmhouse - The Briars The Old Farmhouse Avishayes Lane Chard Somerset TA20 1RU two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Poole Date: 1 6 0 4 2 0 0 9 Information about the care home Name of care home: Address: The Old Farmhouse - The Briars The Old Farmhouse Avishayes Lane Chard Somerset TA20 1RU 0146066058 Telephone number: Fax number: Email address: Provider web address: LDAnderton@somerset.gov.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Somerset County Council (LD Services) care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 9 Service users may have concurrent sensory impairment There are a maximum of 5 service users in The Old Farmhouse and 3 service users at The Briars. This condition will be evaluated at each inspection. Date of last inspection Brief description of the care home The Old Farmhouse provides personal care to people on the Autistic Spectrum, many display behaviours which are challenging to manage. The total number of people living at the home has been restricted to 8. This is a condition of the homes registration and reflects long term difficulties relating to staffing levels. The home is divided into 3 areas, The Old Farmhouse, The Briars and self contained accommodation for one person. Everyone living at the home has access to outside space. The home is owned by Somerset County Council. Care Homes for Adults (18-65 years) Page 2 of 8 What we found: This random inspection was carried out by one inspector over a 2 hour period. An Annual Quality Assurance Assessment (AQAA) was completed by the home in January 09 and an Annual Service Review was carried out by the Commission in February 09. The AQAA and surveys received at the time of the Annual Service Review highlighted a high staff turnover in the home and staff shortages. This inspection was to look into these concerns. At the time of this inspection there were 8 people living at the home and 7 members of staff on duty. 2 members of staff had been working at the home for 3 days, 2 were experienced relief staff, 1 was employed at another home and 2 were experienced permanent staff. We, the Commission, were able to speak with four members of the staff team. All acknowledged that the home had experienced a high turnover of staff but felt positive that new staff were being employed. New staff confirmed that they were not being asked to work unsupervised or take on any responsibilities that they did not feel comfortable with. Staff stated that they received induction training and other training appropriate to their role. Staff said that they now had adequate staff to enable people to access community facilities and take part in activities away from the home. All staff spoken with were very positive about their jobs and said that there was extremely good team working and communication within the home. New staff said that they had been welcomed into the home and that more longstanding staff were supportive. A new manager has been appointed, who was not available at the time of this inspection. What the care home does well: The home is divided into three parts, 4 people live in The Old Farmhouse, 3 in The Briars and 1 person has self contained accommodation attached to the home. Everyone has access to pleasant outdoor space. New staff were able to give evidence of a robust recruitment procedure which includes obtaining written references and carrying out appropriate checks. This minimises the risks of abuse to people living at the home. The home has undergone a period of high staff turnover and low staffing levels but staff remain extremely positive about their roles and the people who live at the home. Staff felt that the teamwork was excellent and standards of care remained good. Everyone stated that the new manager was very open and approachable and always willing to listen to peoples views and opinions. Care Homes for Adults (18-65 years) Page 3 of 8 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 4 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 5 of 8 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 33 18 (1) The registered person 15/05/2009 must ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate to the health and welfare of service users. To ensure that people living at the home recieve appropriate care and are able to access community facilities according to their needs and wishes. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 The registered person should ensure that medication administration and recording practices are in line with good practice guidelines. All staff should receive up to date training in medication administration to ensure their competency. All hand written entries on Medication Administration Records should be signed and witnessed to minimise the risk of errors. Page 6 of 8 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Comprehensive individual protocols should be in place for the use of as required medication to ensure that this is consistently administered and effectiveness can be monitored. Care Homes for Adults (18-65 years) Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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