Inspection on 28/05/08 for 208 Cherry Tree Road

This inspection was carried out on 28th May 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

208 Cherry Tree Road 26/06/07

208 Cherry Tree Road 08/06/06

208 Cherry Tree Road 05/01/06

208 Cherry Tree Road 04/08/05

208 Cherry Tree Road 17/08/04

208 Cherry Tree Road 15/04/04

Similar services:

Sunny Bank (P.R.S.) Ltd

Ashwood Court Unit 1

Clover House

Thornton Lodge

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 208 Cherry Tree Road 208 Cherry Tree Road Blackpool Lancashire FY4 4PT Lead Inspector Mrs Jackie Riley Unannounced Inspection 28th May 2008 09:30 208 Cherry Tree Road DS0000009973.V361214.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 208 Cherry Tree Road DS0000009973.V361214.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. 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 208 Cherry Tree Road Address 208 Cherry Tree Road Blackpool Lancashire FY4 4PT 01253 693101 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) Ms Deanna Neal vacant post Care Home 2 Category(ies) of Learning disability (1), Mental disorder, registration, with number excluding learning disability or dementia (1) of places 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th June 2007 Brief Description of the Service: 208 Cherry Tree Road is close to all local amenities and facilities. A wide range of shops and supermarkets are in walking distance and a bus stop is immediately outside the premises. The premises are in keeping with the local community and domestic in character. Accommodation within the house are single rooms for the two residents, with lounge and dining areas, as well as a garden area which is not overlooked. There is a Statement of Purpose and Service User Guide provided to both residents, informing them of the services they can expect to receive whilst living at the home. At the time of the site visit the range of fees were £283.52 to £299.00. Additional charges are incurred for Hairdressing, Newspapers and additional toiletries. 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means people using this service experience Adequate quality outcomes. This was an unannounced visit that took place on the 28th May 2008, over a period of approximately 3.30 hours as part of the inspection process. We spoke to the registered provider and both residents who live there. This is a small home of a domestic nature and both residents living at the home have conditions, which are of a mental disorder. The comments made in this report are based upon what we saw and what we were told at the time of the visit, although comments will be included from other sources including relative surveys. During the time spent at the home we made general observations of the interaction between residents, and the owner. We did this by spending time in the lounge area, and with individual residents in their rooms, so that we got an overall snapshot of the service on the day we visited. There are no additional staff employed at the home. We looked at care plans, records, and daily notes for both residents, this is called case tracking. We also toured the home to look at the environment. There was a good response from surveys sent to people who use the service for their views on how the home is run. Comments were positive about the standard of care and support provided by the homeowner. What the service does well: This is a small service where both residents live as part of the family. They have their own rooms and have the use of the home and garden for their comfort and convenience. They told us they like to live there and that they feel well cared for. Comments included, “nothing much changes but I like living here, I have been here for a long time”, “I like my own space and I can get that here”. Comments we received from relatives told us they are happy with the care their relatives receive, they included, “the lady in charge is very caring and our relative couldn’t be happier. He has been at the home for a very long time and would not want to consider being in any other circumstances. The way the home is run is very flexible and meets the needs of the two residents living there, comments included, “I like to go out every day at some time, and I can do this”. 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 6 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. 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 7 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 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 8 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): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is limited information included in the assessment records including lack of review by the home, having the potential to disadvantage people living there. EVIDENCE: We spoke to the residents living at the home; they have lived there for a number of years and said they liked the way they were cared for. Comments included, “I can do what I want to really, we can come and go as we please”. We spoke to the person who runs the home, who has had many years experience in caring for one of the residents living there. The other resident has been living there as part of the family for a number of years now, and the owner showed us evidence of her knowledge of the two residents and specifically their needs and how they can be met. We looked at the way information is written down about their assessed needs. These records were limited in what they told us, but there was evidence the 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 9 families of the relatives are pleased with how they are being cared for, comments included, “everything as far as our relative is concerned is done well”, “the lady in charge is very caring and our relative is well cared for”. We saw Social Workers and other professional have been involved in the assessment and reviews of the two residents, however reviews by the home were not evident and must be in place so that there is a record of the changing needs of the residents living there and how those changing needs are met. 208 Cherry Tree Road DS0000009973.V361214.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): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home are encouraged to live their choice of lifestyle, however limited risk assessment has the potential to be detromental if potential hazards are not identified and addressed. EVIDENCE: We saw evidence the residents living there are fully involved in the day-to-day planning of their lives. This is carried out informally, with conversation between the residents going on all the time as seen during the inspection. We saw the care plan in place for one resident, which included information about their likes and dislikes, visitors and how they like to live. One resident commented on how involved they are with this. Information for another resident was not available and the provider is currently organising a revised file in conjunction with the residents themselves, so that they are not 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 11 disadvantaged. There was no evidence of review of this plan by the provider, however reviews do take place with other professional with involvement with the residents living there so that their changing needs are identified. The last time we inspected the service we asked for a risk assessment to be carried out for the residents. We saw this has been done, however there must be a risk assessment made for both residents on an individual basis, so that their individual risks can be managed effectively. We spoke to both residents living at the home who said they were happy they could make decisions about how they lived their lives. 208 Cherry Tree Road DS0000009973.V361214.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): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support provided to residents enables them to maintain their choice of lifestyles in and outside of the home. EVIDENCE: Both residents have lived together at the home for a number of years. The ethos of the home is based upon an extended family, and we found there are no rules, which would stop them making decisions that would have an adverse affect on them or others. The way the home is run is flexible, by way of having no set times to do things, although the residents do need some continuity so that they have some formality and structure in their day to day lives. Both residents told us they like to go out independently on a daily basis. The local supermarket is a 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 13 favourite calling place for both residents who said, I go out every day, like going to Asda,“I like to go out every day at some time, and I can do this” “I can do what I want to really, we can come and go as we please”. The residents have a range of activities available to them, which they enjoy and include a variety of board games; music, and television. One resident has a particular hobby and this is promoted and assisted by the registered provider who actively encourages both residents to key into their own personal interests as well as doing things together, so that they retain their own personal identity. We received information from relatives and their comments were positive, they included, “the care home is ideal for my relative because it is small, he would be overwhelmed in a large place”. “He has been at the care home for a very long time and would not consider anywhere else”. We found that resident’s respect each others individual space and do not go into each other’s room unless invited. This was confirmed through observations and their permission was asked before a tour of the home took place. Both residents said they have their meals together although they do have the choice of eating in their room if requested although this is not encouraged as the registered provider feels mealtimes are a time when there can be positive communication for all parties. I eat wherever I want to, usually with the other resident”. 208 Cherry Tree Road DS0000009973.V361214.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): 18,19,20 Quality in this outcome area is The health and personal care needs of residents are met by providing acces to services when needed good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are met by providing acces to services when needed. EVIDENCE: The way the home operates on a day-to-day basis means that there are no restrictions. We saw that residents move freely around the home and garden. We spoke to the registered provider who told us that she promotes privacy and dignity by making sure the residents respect each others space, and that they have privacy in meeting their individual personal needs, by provided space and locked facilities for this so that nobody living at the home is disadvantaged in any way. Comments included, ”I always knock and shout if the bathroom door is closed or their bedroom door is closed to, I never just go in, that’s rude”. We found there have been no changes in the administration of medication to one resident. The storage and administration and recording are being maintained in a satisfactory way. 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 15 Both residents have access to healthcare professional including dentists, optitions etc. In instances where a resident refuses to go to have regular checks including dental checks this should be recorded so that it shows the home owner is encouraging screening for healthcare for both residents. 208 Cherry Tree Road DS0000009973.V361214.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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that the residents are aware of their rights and have a complaints procedure. Systems are in place to safeguard the people living in the home so that people are protected. EVIDENCE: There have been no changes in the way the complaints procedures in the home are made available. We spoke to both residents who said they knew what to do if they weren’t happy about something, and they felt comfortable in telling the owner if they are not happy with something. They both said they feel if they raised any issues it would be looked at and something would be done. Residents have available to them contact numbers and addresses of outside agencies if they have any problems to discuss issues that cannot be settled by the home owner. The surveys we received from relatives confirmed they are satisfied with the homes complaints procedure, and they felt comfortable if they had to use it. The home has in place advice and guidance about how people are protected from abuse. We spoke to the provider about this who said they had the procedures in place from the local authority and felt comfortable using them should abuse be suspected in any way. 208 Cherry Tree Road DS0000009973.V361214.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): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is maintained to a satisfactory standard for the comfort of residents living there. Decoration in parts of the home would improve the environment for those living there. EVIDENCE: There has been some improvement to the homes exterior in that some of the woodwork has been improved, the leak to the ground floor extension roof has now been repaired, however there now requires some redecoration where water damage has occurred. The home would benefit from general redecoration. Comments from surveys were generally good but did comment on the need for some decoration to “brighten the place up”. We saw resident’s bedrooms are furnished to meet their own preferences. Both residents spoken to are pleased with their individual rooms, which have evidence of personal collections. One resident was proud to show a personal 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 18 collection of items, which are collectable and provide a keen interest and hobby. There are no additional aids and adaptations around the home as both residents are fully mobile and do not require additional assistance with day-today living tasks. 208 Cherry Tree Road DS0000009973.V361214.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not employ any additional staff. The needs of the residents are being met at this time. EVIDENCE: The home does not employ any additional staff. The needs of the residents are being met at this time. 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 20 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): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents, however shortfalls in the maintenance of electrical systems and equipment could potentially affect the health and safety of the residents. EVIDENCE: This is a small run service without any additional staff. We found it is run as a family unit and of a domestic nature, which both residents said they liked. The provider gains views of residents and their families through informal channels such as talking to them daily and the visitors when they ring or call. This way their comments are listened to and changes can be made where identified as necessary. We say there should be some evidence of how 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 21 changes are made to the service by way of quality monitoring systems so that there is a clear audit of changes made in the best interests of people living there. The management approach is relaxed so that there is no formality in the dayto-day management of the home. Residents are encouraged to follow their individual routines, which was seen throughout the site visit, and was seen to meet the individual needs of the residents living there. From comments and observations made it was evident that they are able to make their views known and are involved in all decisions that affect them as individuals and as a group to ensure that their needs continue to be identified and met. There is now a basic fire assessment in place so that residents know what to do in an emergency and what routs are available at the home as a means of escape. One resident showed us what they would do should they have to evacuate the home in an emergency. We found there remains a requirement to make sure the electrical systems in the home are safe and fit for purpose. The provider has informed us; of work taking place to ensure the system is safe. In addition to this there is a requirement to make sure all servicing of equipment including gas servicing is carried out by qualified engineers who hold the necessary licences to carry out such work so that all the systems in the home are serviced and safe. 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 22 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 X 2 2 3 X 4 X 5 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 2 x 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 23 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. 1. Standard YA2 Regulation 13(4) Timescale for action The registered person shall make 31/07/08 sure an individual risk assessment plan is in place for both users of the service so that they are protected from hazards which may affect their safety and well being. (Partly met by 31.8.07) The registered person must ensure the home electrical systems are maintained and safe so that users of the service are safeguarded and protected. (Not previously met by 31/08/07) 31/07/08 Requirement 2. YA42 23(2)(b) 3. YA42 23(2)(b) 4. YA6 15(2)(b) 5. YA2 15 Whilst gas appliances in the 30/09/08 home are being serviced annually a registered engineer must service them so that people are protected. There must be evidence reviews 31/07/08 are taking place so that the changing needs of residents are being addressed. The information on Service User 31/07/08 plans remains limited, and must be improved so that the needs of the individual can be clearly seen and how those needs are met DS0000009973.V361214.R01.S.doc Version 5.2 Page 24 208 Cherry Tree Road are also included in the plan, so that people are not disadvantaged in any way. 6. YA39 24(1)(a) There should be recorded evidence of how the home monitors its quality assurance so that the views of users of the service are being taken into account in how the home operates. 31/12/08 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 208 Cherry Tree Road DS0000009973.V361214.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 208 Cherry Tree Road DS0000009973.V361214.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. Re-publishing this information is in breach of the terms of use of that website. 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