Inspection on 09/12/05 for 50 Cherry Orchard

This inspection was carried out on 9th December 2005.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

50 Cherry Orchard 27/06/07

50 Cherry Orchard 30/06/05

50 Cherry Orchard 11/03/05

50 Cherry Orchard 26/08/04

50 Cherry Orchard 20/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Cherry Orchard (50) 50 Cherry Orchard Highworth Swindon Wiltshire SN6 7AU Lead Inspector Bernard McDonald Unannounced Inspection 9th December 2005 08:45 Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 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 Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 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. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cherry Orchard (50) Address 50 Cherry Orchard Highworth Swindon Wiltshire SN6 7AU 01793 765090 01793 765090 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) White Horse Care Trust Ms Rachel Baxter Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (1), Sensory Impairment over of places 65 years of age (1) Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: 50 Cherry Orchard is a home in Highworth offering accommodation and care to five adults with a learning disability. The home is one of a number of homes managed by the White Horse Care Trust. The home is located in Highworth and is situated close to local shops and community amenities. All service users have the benefit of single bedrooms. There is a large enclosed garden to the rear of the property with a seating and recreational area. The home is normally staffed with a minimum of two staff on duty throughout the waking day with additional staff at peak times. There is no waking night staff. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was completed over four hours. The inspector met with four service users as one service user had already left for their day service. The inspector had opportunity to meet with one service user in private but was unable to communicate effectively with the service user although the service user did sign to indicate they were happy with the care they receive. The inspector examined the care plans of all service users together with risk assessments, medication records and health and safety procedures. The requirements made in the last inspection report had been met. The inspector briefly met with one member of staff before they left the home with the service users. The manager was available to assist with inspection and provide information on policies and documentation. Feedback was given to the manager on the preliminary findings of the inspection. What the service does well: What has improved since the last inspection? The home has updated risk assessments and procedures are now in place to ensure they are reviewed a minimum of once a year. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 6 Fire safety procedures have been improved and regular fire safety drills are now being held every three months. The home has ensured service users are made aware of the cost and terms and conditions of their care. There is a commitment to ensure service users benefit from a well-maintained environment. The replacement of the lounge and dining room carpet ensures the good standard of accommodation continues to be maintained. 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. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 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 Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5. The home is ensuring that prospective service users needs are being assessed prior to admission. Contracts provide sufficient information to inform service users of the terms and conditions of their stay. EVIDENCE: There have been no service users admitted since the last inspection. Previous inspections have found that the home had ensured service users needs and aspirations had been assessed prior to admission. Examination of all service user contracts found they had been signed on behalf of the service user. Contracts from the purchasing authority were also in place. An abridged version of the contract had been developed using symbols and text. Discussion with one member of staff confirmed she had provided support to enable service users understand the terms and conditions of their stay. A requirement was made at the last inspection that the service users contract should provide details of any additional costs for meals taken outside of the home. A draft policy has been forwarded to the Commission. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9. Care plans clearly reflected service users needs and demonstrated how their needs should be met in the home. Service users are supported to take risks, though not all risks are fully reflected in the care plan. EVIDENCE: All service users care plans were examined. The inspector found care plans were clearly written and reflected service users needs. Particular attention was being given to the communication needs of service users. One service user had over fifty signs that mainly focus on enabling the service user to make choices. The difficulties of communicating with service users were discussed with the manager and although advice has previously been sought from the speech therapist it is recommended that a further referral be made to the speech and language therapist for any additional advice they might offer. Care plans were being reviewed a minimum of every six months. As part of the care review service users goals were being reviewed to ensure they are achievable and remain suitable. Records confirmed service users are involved in their care plan and it’s review. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 10 Individual risk assessments have been reviewed since the last inspection and staff had signed to demonstrate their understanding of the risk assessment. However not all risk were fully supported by the service users care plan. In particular the use of a handling belt is confusing as it’s use as described in the in the care plan, is not supported by the risk assessment. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 15, 17. The home provides opportunities to enable service users participate in appropriate leisure activities. Service users are supported to maintain contact with people who are important to them. The home ensures service users are provided with a healthy balanced diet. EVIDENCE: The home has it’s own transport to enable service users access leisure and social activities both locally and within the wider community. On the day of the inspection two support staff were involved in supporting two service users at their day services and having their lunchtime meal out. Records examined demonstrated service users had been to cinema, bowling, ice skating, meals out and trips to the theatre. The home supports service users to maintain contact with their friends and family. One service user visits their relative once a week, while another service users is supported to make regular phone calls home. Another service user has recently been supported on a family outing for dinner. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 12 The inspector received two comment cards from the relatives of service users, which confirmed they were happy with the care provided at the home. There is a flexible approach to meals served at the home. Service users are able to choose where to eat their meal either in the dining room, lounge or in the privacy of their room. A feature of the service is the small family style service that is provided. Service users can assist with the preparation of meals and the weekly shop. The menu does not offer a routine choice though service users likes and dislikes are known to all staff. One service user signed to indicate they enjoyed the meals provided. The manager confirmed that service users are always offered an alternative if a meal is refused. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20. The home is ensuring service users receive personal support in a way they prefer. Medication is being safely managed. EVIDENCE: A feature of service users care plans is that they provide clearly written details on how they wish to be supported with their personal care. Care plans focus on providing choice and enable service users to make decisions about their daily routine such as times for getting up and going to bed. In addition one service user has been provided with an assisted shower room to aid independence. Examination of medication records demonstrated the home was accurately recording medication administered to service users. A separate record is kept of medication returned to the pharmacy. All staff that administer medication have received training in the administration of medication. In addition some staff have completed a distance-learning course in the safe handling of medication. All medication is held secure in the home. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The home is making every effort to ensure service users views are listened to and they are protected from abuse. EVIDENCE: The home has received no complaints since the last inspection. However the manager presented a number of compliments that had been received at the home that commented on the good standard of care being provided. Service users records contained an abridged copy of the complaints procedure in a format more suited to the needs of service users. The manager stated that the Trust is working in partnership with another agency to produce a video of the complaints procedure. The manager stated the video should be available early in the New Year. Policies for the protection of vulnerable adults are available at the home. The manager confirmed all staff have completed abuse awareness training. Copies of Wiltshire and Swindon “ no secrets” guidance for staff is also available at the home. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The home provides service users with a good standard of accommodation, which is comfortable, safe and homely. EVIDENCE: The inspector viewed all areas of the home and found it was clean, tidy and free from offensive odour. The home was well maintained and a contract is in place to ensure minor repairs are quickly responded to. Accommodation is provided on two floors, with one bedroom sited on the ground floor. On the first floor there are four large single bedrooms and a separate sleep in room for staff, which also doubles as the office. To the rear of the property there is a large well-maintained and secure garden, which can be accessed through patio doors in the dining room. A recommendation was made at the last inspection that the carpet in the dining room be replaced. The manager confirmed that the Trust has acted on this recommendation and is also planning to replace the living room carpet. One service user signed to confirm they were happy with the standard of accommodation provided at the home. The home is in keeping with other property in the area and is situated close to the town centre. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34. The home is failing to demonstrate safe recruitment practices are being followed. EVIDENCE: The inspector examined the recruitment records of the three most recently appointed staff. The records of one member of staff were not available in the home although there was confirmation a satisfactory Criminal Records Bureau (CRB) check had been received prior to appointment. Record’s relating to two other members of staff contained CRB, proof of identity, terms and conditions of employment and a medical declaration. Each of the records contained only one written reference. The manager stated that she was aware two references had been obtained for each member of staff and that the originals would be held at the Trust’s office. It was a requirement at the last inspection that the home must demonstrate they have received satisfactory CRB disclosures on all staff. This requirement has been met though further deficits in the recruitment records have been noted at this inspection. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 17 The home must ensure records as specified in Schedule 2 of the Care Homes Regulations 2001 are available in the home for inspection to demonstrate robust recruitment practices have been followed for the safety of service users. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. The manager has the necessary skills and qualifications to ensure the home is being run in a manner that seeks the views of service users and considers their safety. EVIDENCE: The manager has extensive experience of working with people with learning disabilities and has been registered manager of the home for over two years. The manager has successfully completed the registered managers award and National Vocational Qualification (NVQ) level 4 in care. In addition the manager has continued to update their training in first aid, health and safety, communication, and supervisory management. With support from the Trust the home has developed a quality audit. As part of the outcome of the audit completed for 2004 – 2005 the home is writing to service users next of kin to inform them of the availability of CSCI inspection reports. In addition the Trust is holding regular service users consultation Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 19 days. Within the home one service user will participate in staff meetings but no separate service users meetings are held. The manager stated, these meetings would be dominated by one service user and not be representative of the views of all service users. An abridged version of the homes business plan for 2005 – 2008 was available for inspection. Following a requirement at the last inspection fire safety drills are being completed every three months. The recent inspection by the fire safety officer was satisfactory. Risk assessments in relation to the environment and Control of Substances Hazardous to Health (COSHH) were in place. To ensure the safety of service users hot water temperatures are regulated close to 43c and radiators are guarded. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 1 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cherry Orchard (50) Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000003178.V269908.R01.S.doc Version 5.0 Page 21 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 YA34 Regulation 19(1a) (b)(i)(c) Sch2 Requirement The registered person must ensure records as specified in Schedule 2 of the Care Homes Regulations 2001are available in the home for inspection. Timescale for action 01/02/06 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 2 Refer to Standard YA6 YA9 Good Practice Recommendations The registered person should ensure a referral is made to the speech and language therapist for the one service user identified at the inspection. The registered person should review the use of “the handling belt” to ensure it’s use is compliant with the care plan. Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 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 Cherry Orchard (50) DS0000003178.V269908.R01.S.doc Version 5.0 Page 23 - 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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