Inspection on 02/02/06 for Cherry Blossom

This inspection was carried out on 2nd February 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 11/07/06

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 Neil Kingman Unannounced Inspection 2nd February 2006 10:00 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.V249093.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 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.V249093.R01.S.doc Version 5.0 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 296084 Islandcare Ltd Mr Laurence Woodford Gustar Mrs Sarah Ann Woodford Care Home 35 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (4), Old age, of places not falling within any other category (35), Physical disability over 65 years of age (8) Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2 June 2005 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. Mrs Sarah Woodford manages the home on behalf of the owners Islandcare Ltd. The property is prominently situated overlooking the river Medina in Arctic Road, Cowes. The town centre with its shops, ferry and bus terminals is within walking distance of 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. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two unannounced inspections for the year at Cherry Blossom and took place over 8 hours. On arrival at the home it was clear to the inspector that staff morale was extremely low. Lengthy discussions with staff and management to establish the cause meant that the inspection could not be completed, and a further visit was made on 8 February to speak with the manager and more residents. Core standards not assessed on this occasion had been assessed at the last inspection. The inspector toured the building, examined a selection of records and spoke with six residents in the privacy of their rooms, two visitors, six members of staff, the manager and the proprietors. Comments about the service from residents and visitors were very positive and no concerns from them were raised. What the service does well: What has improved since the last inspection? What they could do better: While there were no requirements arising from the inspection there was a recommendation to ensure that care records contain ongoing significant information about changes in residents’ care needs. Additionally, the home would benefit from improved management/staff relationships, which, as described in the staffing section of the report has already begun to be addressed. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 6 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.V249093.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 6 Cherry Blossom ensures that prospective residents and/or their representatives have sufficient information about the service to help them make a choice about where to live. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. EVIDENCE: Cherry Blossom is owned and operated by Mr and Mrs L W Gustar of Islandcare Ltd. A statement of purpose sets out in plain English what the home aims to provide for residents and includes details of the environment, and management and staffing arrangements. A service user’s guide gives details of facilities, services, complaints procedure and contractual aspects. Both documents were readily available for inspection. The manager said that except in emergency situations prospective residents or their representatives are given a copy of the service user’s guide to help them make a choice about the home. Those who are privately funded are given a document outlining terms and conditions of occupancy, while those referred through social services Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 9 funded arrangements are given a copy of the local authority ‘Schedule 3’ contract. Most residents at Cherry Blossom are long term. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. However, short stay or respite care is offered where accommodation is available. There was no evidence that the provision of this service has a negative impact on the resident group. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8, 9 and 10 The practice in the home ensures that residents’ health care needs are met according to their assessed needs. Medication is securely held and appropriate records are maintained. The home ensures that staff respect residents’ privacy and dignity at all times, especially with regard to the arrangements for health and personal care. EVIDENCE: The home has equipment in place to enable appropriate pressure area management. The manager said that four residents had superficial pressure sores that were responding well to regular dressing by the District Nurse and management by staff. She pointed out that three of the four residents had developed the sores whilst away from the home. While the home has two hoists to assist with the transfer of residents with mobility difficulties care staff felt there were not enough slings to cope fully with the needs of residents. Additionally, they showed concern at the removal Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 11 of a stand-aid from the home. Following meetings with the manager and proprietor both issues have been addressed. The inspector looked at a selection of care plans, which provide information on medical and nutritional needs, likes, dislikes, social history and professional visits. While plans were seen generally to be of a good standard they could be improved with more information being recorded about ongoing significant events. This was discussed with the manager who recognised the need to evidence the quality of the care provided. All residents have access to an optician who provides a domiciliary service, as does the chiropodist. Due to difficulties in accessing a dentist in the area the manager said that the emergency helpline is used. All residents are registered with one of several GPs who practice at the newly built medical centre a short distance from the home. The home’s system of storage, administration and recording of medicines was assessed at the last inspection and found generally to be in order. However, a discrepancy was found in the records of administration of controlled drugs for one resident. The home responded with the result of an internal investigation and the measures that had been put in place to minimise the risk of a future recurrence. At this inspection records were found to be in good order. Since the last inspection a metal cabinet has been installed to increase the security of controlled drugs. The home has a policy in respect of residents’ dignity and privacy, details of which are included in the statement of purpose. The subject is covered in the induction programme of newly appointed staff. During the inspection the inspector noted that staff at all times treated residents with respect and addressed them by their preferred name. Several have their own telephone installations; those with sight impairment have a phone with large numbers. A portable phone is available for residents’ use and allows for privacy if required. Residents’ rooms generally have space in which to receive personal care, consultations and examinations by health and social care professionals. All rooms are for single occupancy. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13 Residents are supported to maintain their independence and to exercise choice with a range of activities provided. They are encouraged to pursue interests inside and outside the home. Visitors are welcome at all times and are able to meet with residents in private. EVIDENCE: The manager said that routines for residents are as flexible as possible within the constraints of group living. Most take the main meal of the day in one of the dining rooms but some prefer to take meals in their rooms. While meals are scheduled between times there is flexibility around the individual. The home supports residents to remain as physically and socially active as possible, but in conversations with staff it was clear they felt residents’ dependency levels had increased in recent times. Trips out tend to be arranged by residents’ families. There is a range of activities offered to residents, details of which are advertised on both the ground and first floor notice boards. Activities include musical entertainment, reminiscence, bell ringing and exercises, all provided by ‘Independent Arts’. Of the six residents that the inspector spoke with only two showed any interest in the social activities offered in the home. During the afternoon of the inspection it was noted that one member of staff spent Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 13 time with some residents individually manicuring their nails and chatting to them. This appeared to be very well received by the individuals concerned. The home provides for residents’ spiritual needs with a visiting vicar who will take communion with them in their rooms. Details of visiting arrangements can be found in the service user’s guide and on a notice in the hall. Generally there are no restrictions. Residents can receive visitors in their own rooms, any of the communal areas, or if privacy is required a small quiet room is available on the first floor. There are no volunteers currently visiting the home. On the day of the inspection a number of relatives visited residents throughout the day. One couple on a visit from the mainland spoke very highly of the service provided. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: The home has an adult protection policy and procedure which links with the guidance provided by the Isle of Wight Social Services. Specific in-house adult protection training is provided for all staff. Experience since the last inspection shows the procedure to be robust in the home’s response to issues of concern. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 15 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 Cherry Blossom is a 2-storey purpose built home with accommodation for residents on both floors. The location and layout of the home is considered suitable for its stated purpose in providing a safe and comfortable environment for those who live and work there. EVIDENCE: Cherry Blossom has been a home for older people for many years, during which time it has been regularly maintained and decorated. Ramps and a passenger lift afford residents access to all areas of the building and outside. Since the last inspection a new carpet has been laid throughout the hall and corridors, which has been damaged in two places by the home’s hoist. The proprietor confirmed that arrangements are being made with the supplier to resolve the problem. The manager said that the Company employs a maintenance man to address maintenance issues and decorate parts of the building as and when required. At the time of the inspection the home was structurally sound and in good decorative order. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 16 Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 17 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 and 29 Staff are deployed in adequate numbers to meet the needs of the people who live there. The home provides an ongoing programme of NVQ training for staff to ensure service users are in safe hands at all times A robust recruitment procedure ensures residents are protected. EVIDENCE: On the day of the inspection there were twenty-nine residents in the home, and a full complement of staff on duty. Cherry Blossom operates a varied shift pattern with up to six care staff on duty during the morning. The home employs additional catering and domestic staff and a deputy manager who divides her time between management duties and work on the floor. While the proprietor considered staffing levels to be more than adequate care staff described their work as stressful, especially at peak times of the day, e.g., early mornings. They said that many residents had increasingly higher care needs requiring two care staff to assist with transferring and bathing etc. Having regard to the numbers and needs of the residents and with reference to the Department of Health staffing guidelines it is considered that safe staffing levels are maintained. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 18 Since the inspection on 2 February 2006 the inspector has held meetings separately with the manager and the proprietor with a view to resolving the problem of poor management/staff relationships. Issues of concern raised by care staff were fed back and discussed. Following the meetings the manager has confirmed the following positive action taken to improve the situation: • • • • • • The review of shift patterns to provide additional care hours at peak evening times. The deputy manager to work more days on rota with care staff. The manager to work one day a week on rota with care staff. The purchase of a new stand-aid to assist with transferring residents with mobility difficulties. The purchase of an extra sling for the hoists. A review of formal staff supervision sessions and other systems to improve communication between staff and management. The manager said and records showed that at the time of the inspection 58 of care staff (seniors and care assistants) had achieved the NVQ at level 2 or 3. Two carers are currently undertaking the NVQ at level 2. Three new staff members had been recruited to the home since the standard was last assessed. All recruitment records were in order, including the required security checks, which had been an issue at the last inspection. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 19 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 and 33 The registered manager has the experience and qualifications to run the home and meet its stated purpose, aims and objectives. She has registered to complete the four remaining units of the Registered Managers Award. The home has effective quality assurance systems for measuring its performance based on seeking the views of residents. EVIDENCE: The manager Mrs Woodford has been in post for almost three years and is working towards achieving the Registered Managers Award. Having already achieved the NVQ at level 4 in management she has only four units to complete. She is a level 2 and 3 NVQ assessor and keeps up to date with statutory training and service related subjects. The manager said that short stay residents are regularly asked about the quality of the service and views are sought via questionnaires. A sample was Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 20 available for inspection. Survey sheets are prominently displayed in the hallway for visitors to make comments about the service. Regular residents meetings are held and minuted. Issues brought up at the meetings are addressed wherever possible. A file of thank you letters and cards is also maintained. Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 21 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 x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x x x x x Cherry Blossom DS0000012474.V249093.R01.S.doc Version 5.0 Page 22 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 Refer to Standard OP8 Good Practice Recommendations To ensure care records contain ongoing significant information about changes in residents’ care needs. 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