Inspection on 11/07/06 for Cherry Blossom

This inspection was carried out on 11th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cherry Blossom 02/02/06

Cherry Blossom 02/06/05

Cherry Blossom 17/02/05

Cherry Blossom 12/08/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Cherry Blossom 252 - 257 Arctic Road Cowes Isle Of Wight PO31 7PJ Lead Inspector Liz Normanton Unannounced Inspection 11th July 2006 10:05 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 Cherry Blossom DS0000012474.V296987.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. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Blossom Address 252 - 257 Arctic Road Cowes Isle Of Wight PO31 7PJ 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) 01983 293849 01983 293849 Islandcare Ltd Mr Laurence Woodford Gustar Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (4), Physical disability over 65 years of age (8) Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can accommodate one named individual in the PD category Date of last inspection 2nd February 2006 Brief Description of the Service: Cherry Blossom is a residential care home providing care and accommodation for up to 35 older people including those within the categories of physical disability and mental disorder. The registered manager left the home in June 2006 and the home is currently being managed by Judith Dawkins on behalf of the owners Islandcare Ltd. Judith intends to submit a registered manager application form to the Commission in the near future. The property is prominently situated overlooking the river Medina in Arctic Road, Cowes. The town centre with its shops, ferry and bus terminals, is approximately half a mile from the home. The premises consist of a large two storey purpose built building and an older property, which has been incorporated. Residents’ accommodation consists of mostly en-suite rooms on both levels, accessible via a passenger lift from the ground to the first floor. The weekly fees range from £365.40 - £460.00 Cherry Blossom DS0000012474.V296987.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 inspection, which took place on Tuesday 11th July 2006. The theme of the inspection was to audit the key standards for residential homes for older people. The inspector was in the home for six and half hours. The information in this report has been gathered from a variety of sources which included direct discussions and written feedback from residents/ relatives, discussion with the manager and staff, reading staff and residents’ files. A sample of the home’s policies and procedures was received prior to the visit. A brief discussion was held with the home’s proprietors who called at the home during the inspection. The overall outcome of the inspection was that residents are satisfied with the service that they receive. What the service does well: The manager ensures that all prospective residents are interviewed and a needs assessment is undertaken to ascertain whether the home can meet, the needs of prospective residents and does not admit anybody whose needs the home could not meet. Prospective residents are welcome to visit the home to enable them to meet with residents and staff and to help them determine whether the home will suit them. Written information is available which explains the services that the home provides. The home ensures that every resident has a contract of the home’s terms and conditions. Residents’ care and health needs are documented and are regularly reviewed and any changes in care are altered. The home has good relationships with external health professionals who regularly visit residents at the home. The home has robust procedures in place for the administration of medication. The privacy and dignity of residents is upheld. The home provides a range of activities, and residents who are able can come and go from the home independently. Visitors are made very welcome. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 6 The communal lounge/dining areas are well decorated and furnished and provide clean comfortable surroundings. The home employs experienced, trained and qualified staff in sufficient numbers to meet the care needs of the residents. The home is well managed and the residents and staff are confident in the management of the home. What has improved since the last inspection? What they could do better: Several fire doors were propped open to provide easier access around the home for residents and staff. The purpose of fire doors is to prevent the spread of fire and smoke inhalation. It would be advisable for the home to consult with the local fire officer and undertake a risk assessment in relation to these doors. If the outcome is that there is a risk and the home wishes to continue having these doors open, self-closing mechanisms would need to be fitted. Two baths have become badly damaged through use of assisted bath seats and have become unsightly, the damage does not pose a health risk. The baths will eventually need to be replaced and the proprietor may wish to consider this as a priority in any plans for refurbishment of the home. The refuse bins are currently kept in the garden close to the kitchen and are unsightly as they can be seen from the garden where residents sit out. It would be advantageous to cordon off the bin store area with the installation of a fence and gate. The garden is not secure, and those residents with short-term memory loss who may wander would be able to access the garden without the constant supervision from staff, and would benefit if a gate were fitted to the side access to the garden. The manager should consult with the environmental health department prior to having the kitchen re-decorated, as the use of painted walls may no longer meet environmental health standards. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 7 Also seek advice from environmental health re: infection control (sluicing) in the laundry area. The cat should not be allowed into the kitchen under any circumstances and alternative arrangements should be made for it to access its meals. 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 Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 8 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 Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract which clearly tells them about the service they will receive. EVIDENCE: The home has an up to date statement of purpose and service user guide, which is kept in the home’s lobby for easy access to residents and their representatives. There was evidence that each resident had seen and signed a contract of the home’s terms and conditions. Copies of the contract are kept confidential in the office. In discussion with the manager they reported that she, and a senior member of staff, visit prospective residents prior to admission and undertake a needs Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 10 assessment. There was evidence of needs assessments on five residents’ files viewed at the site visit. The needs assessments were comprehensive and included all aspects of an individual’s care needs. Care staff spoken to reported that prospective residents come to visit the home prior to moving in. The inspector met a prospective resident and their relatives who confirmed that they had visited before and had just called in to drop off some personal belongings. In discussion with the prospective resident, they confirmed that the move had been planned and that the manager had visited them at the previous care home and a needs assessment had been done. The home does not provide intermediate care however short stay or respite care is offered when accommodation is available. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The inspector viewed five residents’ files and found them all to contain care plans, which had been drawn up using information gathered in the assessment of need. The care plans were detailed and care staff spoken to reported that they found the information in the plans very helpful. There was evidence that care plans are reviewed monthly. Residents’ files also contained evidence that risk–assessments having been undertaken. In discussion with several residents they confirmed that they felt well cared for. The inspector did have a concern regarding moving and handling practice which was observed between one resident and two staff. Whilst being assisted out of their seat staff used a handling technique, which was a demonstration of Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 12 bad practice. This was discussed with the manager who immediately spoke with the staff and told them to use the equipment which they had been provided with. There was evidence that the health needs of residents were recorded on files. All residents are registered with a general practitioner (GP) and there was evidence of doctors’ visits to the home. A chiropodist visits the home every six weeks to provide foot care as required. A physiotherapist visited the home in the morning and was observed respecting the resident’s privacy by asking them to go to their room. There was evidence that residents attend opticians for eye tests and dentists for dental treatment. One resident with a hearing impairment was observed asking a member of staff to take them to buy some new headphones for their radio. The member of staff sat and spent time with the resident and was arranging to take them shopping to purchase the headphones. There are several people living at the home who have diabetes and their condition is monitored by diet or medication. In discussion with the manager she reported that two care staff have been trained in giving insulin injections and three are still undergoing training. A resident who has diabetes told the inspector that they used to do their own injections at home but prefer it now that the care staff give this. The home has a robust policy and procedure in place for the safe storage and administration of medication. Senior care staff are responsible for administering medication and have undertaken medication training. The inspector counted the number of controlled medication against records and there were no discrepancies. The home has a policy in respect of residents’ dignity and privacy. Details in care plans inform staff how residents wish to be addressed. Several residents spoken with stated that they believed that their privacy and dignity was upheld. Care staff were observed treating the residents with dignity and respect. All rooms in the home are single occupancy and residents can meet with visitors in the privacy of their own rooms. Two recently employed staff confirmed that privacy and dignity of residents was part of their induction training. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: There are a range of activities available to residents and details of these are advertised on both the ground and first floor notice boards. Activities include, sing along, musical entertainment, bell ringing, reminiscence and exercises, which are provided by an external agency called “Independent Arts”. Whilst chatting with one resident they said, “a man had been to sing at the home yesterday”. In discussion with the manger they were hoping to arrange some trips out during the summer for the residents. A trip to Havenstreet (which is an independent steam railway station) was advertised on the notice board. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 14 On the morning of the inspection the inspector noted that there was no music being played and the television was not on. This was discussed with the manager who explained that most activities take place in the afternoon, as the mornings were usually a very busy time when residents would take a bath. Residents were observed chatting amongst themselves whilst others slept. member of staff was seen chatting with a group and there was plenty of laughter. A With regard to religious observation, all residents are asked prior to admission what their religion is and whether they are practising. The manager reported that nobody goes out to church and that a priest comes to visit a resident once a month. The home welcomes visitors and generally there are no restrictions on visiting times. Details of visiting arrangements can be found in the service users guide and on a notice in the hall. Residents can meet with their visitors in the privacy of their own room or in the communal areas. On the day of inspection a number of visitors were seen coming to and from the home. A partial tour of the home was undertaken with several bedrooms seen on both floors. There was evidence that residents are able to bring their personal possessions into the home with them, and smaller items of furniture where possible with room size constraints. A number of residents at the home choose to smoke and provision is made for this. Residents can smoke in their rooms following a risk-assessment, however there is a restriction during the night between the hours of 10.00 pm and 07.00 am, this is a hazard prevention policy. The menu offers a choice of two main courses of the main meal of which residents can choose from. In discussion with residents they confirmed that they could get up and go to bed as they wish. Care staff confirmed that they respect residents’ preferred bedtime rituals and would only ask people if they would like to go to bed if they were nodding off in their chair. In discussion with the manager they reported that one resident has asked for a lock to be provided to her room to prevent other residents wandering in. This has been done with the provision of a hook and eye fitting. There is a choice of cereals for breakfast, with toast and assorted jams, tea or coffee. The lunchtime menu offers a choice of two main courses. There is a chalkboard in the dining room, which informs residents of the courses, however this had not been filled on the day of the inspection. The care staff Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 15 ask residents early morning what their preference for lunch would be. The menu offers a wide variety of choice throughout the week and the meals are nutritious. The meal served on the day of inspection looked well presented with a decent sized portion of food. Several residents described the food as being good, with just two who felt that the menu did not always suit their tastes. The teatime meal is a light tea and is prepared by care staff and ranges from a choice of sandwiches, cheese on toast, hard-boiled egg, etc. Hot and cold drinks are provided throughout the day. In discussion with the cook they reported that residents likes and dislikes are written in their care plans, and the manager advises her of these, as well as anybody who has a specialist diet due to health or allergies. Fresh fruit and vegetables are purchased every week. The cook does not do home baking as they do not have time. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 16 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure. Residents are protected from abuse and will be better protected when the home obtains a copy of Isle of Wight Adult Protection Policy and reviews and updates its own policy and procedures to comply with the Isle of Wight Adult Protection Policy. EVIDENCE: The home as a robust complaints policy and procedure. Details of how to make a complaint are available in the service user guide. There is also a complaints procedure on display in the lobby. There has been one complaint since the last inspection, which had been made by a relative in relation to their parent’s care. The matter had been investigated following the home’s complaints procedure and a response was sent to the complainant. Residents spoken to on the day of inspection stated that they knew how to complain. In discussion with the manager she reported that residents are more than welcome to come to her at any time with complaints or issues. The home had an adult protection policy and procedure and a “whistle blowing” policy, however they did not have a copy of the Isle Of Wight Adult Protection Policy. This matter was discussed with the manager who said that they would make arrangements to obtain one and review and update their own procedure as required. There have been no allegations of abuse at the home since the last inspection. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 17 There was evidence that care staff had undertaken adult protection awareness training. In discussion with several residents they stated that they felt safe in the home. In discussion with two recently employed staff they confirmed that they had read the adult protection policy and procedures and were aware of how to “whistle-blow”. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. There were some areas for concern, which are discussed below, but overall the home is safe. EVIDENCE: A partial tour of the home was undertaken which included all communal areas and several bedrooms on both floors. The home was found to be clean, tidy, and free from offensive odours and provided comfortable surroundings to the residents. A number of fire doors were being propped open by different means including wedges, towels and a resident’s beanbag. This matter was discussed with the manager who explained that the doors are held open to provide easy access round the home to those with mobility problems who use walking aids. This matter was also discussed with the proprietor and it was agreed that the Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 19 home would consult with the fire officer to ascertain details of risk and to provide self-closing door mechanisms, where a risk was identified. There was some damage to the ground floor bath, which has been caused by the assisted bath seat, which has repeatedly caught against the side causing the paintwork to rub off. This situation is also happening to the bath in the first floor bathroom. Some black insulation tape had been put around the underneath of the bath seat on the first floor, which was an infection control hazard. The matter was discussed with the proprietor who explained that the tape had been put there to prevent further damage to the bath. They did agree to remove it when the risk of water contamination was explained to them. The proprietor will consider installing a new bath to replace the one, which is badly damaged as part of the home’s improvement plan. The proprietor has future plans to install a Parker bath into the home, which is easier for the less able residents to use. There has been a new carpet laid in the entrance, hall, corridor and staircase. A ramp access has been put in place on the first floor for easier accessibility for those residents with mobility problems. Builders debris has been left in the car park, this does not pose a hazard to residents but the view from two residents’ bedrooms which overlooks the area is unsightly. The garden is to the rear of the property and is flag stoned. There was ample seating for residents to enjoy the outdoors. The wooden garden seating was in need of re-staining as the seats had mould on them. There were a few planters to offer some colour to the garden but these were minimal and the border in the far wall was sparsely planted out. In discussion with the manager they reported that they had plans to introduce more colour into the garden by planting out some climbing plants. The refuse waste disposal bins are easily visible in the garden, which was unsightly. The possibility of a fence and gate to be erected to enclose the bins was discussed with the manager. The manager had noted that there is no gate at the side of the home leading from the garden and was concerned about the safety of residents with memory difficulties who might wander off without staff knowing they had left the premises. The home has policies and procedures in place for the control and prevention of the spread of infection. There was evidence that care staff have undertaken infection control training. The home provides care staff with protective gloves and aprons. Paper towel and soap dispensers are situated in all communal facilities where hand washing takes place. The laundry is sited away from food preparation areas. In discussion with the manager they reported that the home does not have a sluice and that soiled items are soaked in the sink in the laundry. The home has been advised to contact environmental health about this practice for guidance. Residents Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 20 clothing is numbered with their room number to ensure that they are wearing their own clothes at all times. The inspector observed that radiator covers had not been painted, which has led to several of these becoming stained and unsightly. This was discussed with the manager who agreed to arrange to have them painted. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. EVIDENCE: Information sent prior to the inspection visit indicated that the home currently accommodated thirty residents with five vacancies. On the day of the inspection there were five carers on duty in the morning, including the manager and two ancillary staff. There was five staff on in the afternoon. Two wakeful night staff are on duty from 8.00pm to 08.00am. There had been some staffing issues at the previous inspection, which now appear to have been resolved, as they were not raised by the staff or the management. The staffing roster for the month of July sent prior to the inspection indicates that there are sufficient staff on duty throughout the month, with there usually being at least five staff on duty am, between four and five on a pm, and six carers on duty on Saturday and Sunday am. Records indicated that 68 of the care staff have achieved National Vocational Qualifications NVQ in care at level 2 or above. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 22 The home is an equal opportunities employer; they advertise locally and have recruited two carers from overseas since the last inspection. Their personal files were viewed, one contained all the necessary documentation which is required, whilst one only had one reference letter. Neither of the files contained a job application form. In discussion with the manager they explained that the carers were recruited via an agency, which undertake all the necessary checks. A satisfactory police check had been obtained from the police department in the country of origin. The home has also sent off for Criminal Record Bureau checks (CRB) and Protection of Vulnerable Adults (POVA) checks for both these employees. The two overseas carers were interviewed together and they both had a good understanding of English. They confirmed that they had been orientated into the way in which the home works during their induction training. They stated that they had been shadowed on duty when they first took up their employment in May 2006. They were also observed in positive interaction with the residents. In discussion with residents they thought that the staff were very helpful. Written feedback from a relative reported that they thought the home provides an excellent service to a very high standard. The home is committed to the training and development of staff. There was evidence of training certificates, training records and plans for training in the coming year in the following areas: insulin administration, fire safety, adult abuse, death and dying, medication, health and safety, and infection control. The inspector observed that several of the residents had short-term memory loss and possibly showing early signs of dementia, although there has not been a diagnosis. This was discussed with the manager who reported that the staff team have not had training in dementia care. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 23 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a competent manager. EVIDENCE: The registered manager Sarah Woodford has left the home’s employ in June 2006. The acting manager is Judith Dawkins. Judith has worked in the caring field for ten years. She has completed the NVQ in care at level 3 in 2004 and intends to enrol on to the NVQ level 4 and Registered Managers Award (RMA), which is a requirement for managers of care homes. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 24 Judith has previously worked at Cherry Blossom in the capacity of deputy manager and has managerial experience. Judith spends Tuesdays working alongside the care staff and the rest of her time is spent in the management and administration of the home. Judith undertakes supervision of all staff. Residents’ meetings are usually held once a month, and this gives residents the opportunity to voice their opinions about the service and any changes they would like. Records of the meetings are taken and kept for information. Copies of the minutes are produced in large print for the benefit of the residents with sight impairments. An outcome of one residents’ meeting led to care staff being given additional time to spend with a resident who prefers to stay in their room as they had stated that they felt isolated. The home has a questionnaire, which it gives to residents who have received respite care to seek their views on the service. In discussion with the manager they stated that there is no planned programme of renewal, however the need for repairs, redecoration etc is passed onto the proprietor who undertakes to get the work completed. There are robust procedures in place for the safekeeping of residents’ monies. Residents’ monies are kept individually and a record is kept of all financial transactions. The inspector audited three of the residents’ monies against records and these were accurate. In discussion with the manager they reported that they are an appointee, and they and two senior staff have responsibility for the safekeeping and management of residents’ monies. Those residents who do not have the capacity to manage their own money are also supported via solicitors and relatives. There was evidence of formal supervision sessions in the form of supervision calendar and supervision notes. The supervision notes were comprehensive and looked at staff training needs, ideas that staff have about the running of the home, issues with residents, issues with other staff, etc. The manager endeavours to ensure the health, safety and welfare of residents is protected. Care staff are provided with training in health and safety, moving and handling, food hygiene, infection control, first aid. Food is stored appropriately; fridge and freezer temperatures are checked twice daily and recorded. There was evidence that the home regularly maintains electrical and gas equioment. Window restrictors were not fitted to first floor windows, this was discussed with the manager who agreed to undertake a risk assessment of the first floor windows and install restrictors where a risk was identified. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 25 The kitchen was clean. There were some areas of paintwork which required re-decorating. In discussion with the manager and cook they stated that there are plans to have the kitchen repainted. They were advised to consult with the environmental health department for advice on the use of painted walls in a commercial kitchen. In discussion with the cook they raised concerns about residents having access to the kitchen, as she considers the kitchen to be a hazardous area. At present the kitchen door is open, it would be of benefit if the manager were to discuss the cook’s concerns and try to make suitable arrangements to enable residents to access the kitchen, or make the area prohibited to residents. The home has a cat, which goes through the kitchen to get to its meals, which are given in the laundry. The cook and manager were informed that they would have to make other arrangements for the cat to be fed as cats should not be in kitchens due potential risk of infection. Safety notices were posted around the home. The Control of Substances Hazardous to Health (COSHH) was stored appropriately after use. There was a COSHH risk assessment kept outside the COSHH cupboard, which is reviewed by the manager. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 26 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 x 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 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 3 x 3 Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP19 OP19 Good Practice Recommendations It would be in the best interest of the residents to replace the damaged bath on the ground floor. The refuse bins are currently kept in the garden close to the kitchen and are unsightly as they can be seen from the garden where residents sit out. It would be advantageous to cordon off the bin store area with the installation of a fence and gate. The garden is not secure and those residents with shortterm memory loss who may wander would be able to access the garden without the constant supervision of staff, and would benefit if a gate were fitted to the side access to the garden. It would be beneficial to the overall environment if the radiator covers in the home were painted. Consult with the environmental health department prior to having the kitchen re-decorated, as the use of painted walls may no longer meet environmental health standards. DS0000012474.V296987.R01.S.doc Version 5.2 Page 28 3. OP19 4. 5. OP19 OP38 Cherry Blossom 6. OP38 Also seek advice from environmental health re: infection control (sluicing) in the laundry area. The cat should not be allowed into the kitchen under any circumstances and alternative arrangements should be made for it to access its meals. Cherry Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Blossom DS0000012474.V296987.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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