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Inspection on 12/07/06 for Cherry Garth - North Yorkshire County Council

Also see our care home review for Cherry Garth - North Yorkshire County Council for more information

This inspection was carried out on 12th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Provides a good standard of care to service users. All service users spoken to and surveyed prior to the inspection considered that they were well cared for by the staff. Good assessments are undertaken prior to admission to the home and comprehensive individual promotion of independence plans are completed with each service user. The management of the home support good access to training for all staff and over 50% of resource workers have an NVQ in care with further staff working towards the award.

What has improved since the last inspection?

There is a refurbishment programme being undertaken to convert the cubicle style toilets into individual toilets that provide privacy and dignity for service users. A private toilet had been created from two cubicle style toilets since the last inspection.

What the care home could do better:

The employment records in the home for the majority of the staff that were checked at random were comprehensive. One staff file checked had no record of an application form, references or CRB check. All staff employed in the home must have this pre-employment information available for inspection. The registered manager is to ascertain where the necessary information is filed within the organisation.

CARE HOMES FOR OLDER PEOPLE Cherry Garth - North Yorkshire County Council Chapel Street Thirsk YO7 1LX Lead Inspector Brian Hallgate Key Unannounced Inspection 12th July 2006 09:30 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 Garth - North Yorkshire County Council DS0000034497.V301996.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 Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Garth - North Yorkshire County Council Address Chapel Street Thirsk YO7 1LX 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) 01845 523189 01845527471 North Yorkshire County Council Joan Craft Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (2) of places Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The category for Physical Disability (PD) only applies to the named service users. 22nd February 2006 Date of last inspection Brief Description of the Service: Cherry Garth is a purpose built property. It is situated a few minutes walk from the centre of Thirsk. The building occupies two floors and provides for a maximum of 48 service users. There are 40 single rooms and 4 shared bedrooms, none of which has an en-suite facility. There are communal bathrooms and toilets provided on each floor. There is a passenger lift. Communal rooms are located throughout the premises. There is level access from the front and the rear of the home that provides suitable access for people with mobility difficulties. There are large grounds and service users can sit at the front or the rear of the home on garden furniture when they wish. A copy of the service users guide to the home is given to prospective service users and a visit is made to the home before a decision is made to move in for a trial period. A copy of the latest Commission for Social Care Inspection report is available for prospective service users and relatives to read. Weekly fees are £368.90. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to inform this report was obtained from the information documented in previous inspection reports, a pre-inspection questionnaire completed by the registered manager of the service, a site visit, completed survey forms and discussions with service users and staff. Seven survey forms were sent to service users and 6 were returned. Four survey forms sent to GPs and 1 was returned. Five survey forms were sent to care managers and 2 were returned. Two relatives of service users returned survey forms. The forms were complimentary in the comments made about the care service users receive. This unannounced inspection took place on the 12 July 2006, over a period of five and a quarter hours, commencing at 9.30am. During this time the registered manager, a team manger, 4 resource workers, 10 service users and two relatives of service users were spoken to. A number of records were inspected including service users’ assessments, care plans, medication and health and safety information. A tour of the home was made with a team manager and staff were observed interacting with a number of service users. What the service does well: Provides a good standard of care to service users. All service users spoken to and surveyed prior to the inspection considered that they were well cared for by the staff. Good assessments are undertaken prior to admission to the home and comprehensive individual promotion of independence plans are completed with each service user. The management of the home support good access to training for all staff and over 50 of resource workers have an NVQ in care with further staff working towards the award. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 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 Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessments prior to admission are comprehensive and provide informed decision about moving into the home. EVIDENCE: All files seen contained comprehensive assessments by care managers prior to admission to the home. A member of the management team of the home visits all prospective service users either at home or in hospital and completes their own assessment prior to arranging admission on a trial basis. A review is held after the person has been in the home for a number of weeks. One service user spoken to who had recently been admitted was fully aware of the procedures and stating that he was having his review in the next week to decide if he was to stay on a long-term basis. Intermediate care is not provided. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 9 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. There is a clear planning system in place. The health needs of service users are well met with good access to health services. EVIDENCE: Each service user has a promotion of independence plan that enables staff to care for the person as they wish to be cared for. All files examined had an up to date plan. The plans are reviewed with the service users at least monthly by the key worker. This review is recorded in the service users file. The case files examined showed that the health care needs of service users were met. All service users are registered with a GP and access to specialist services are obtained through the GPs surgery. District nurses visit on a regular basis to provide treatment and advice to staff. There was evidence on the files of service users attending appointments with dentists, opticians, audiologist and chiropodists. No service user self-medicates at the present time with the exception of one service user who keeps his own eye drops. There is a monitored dosage system for those service users who require medication. The Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 10 records and medication checked were up to date and in order. Service users spoken to considered that they were treated with respect by the staff. Staff were observed during the inspection treating service users with respect and dignity at all times. All staff observed knocked on service users own bedroom doors and waited for an answer before entering. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 11 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. Relatives and friends of service users are welcomed at anytime. There is a balanced diet with choices available for service users at meal times. EVIDENCE: Service users choose what time they wish to get up and go to bed, what clothes to wear and what to do during the day. Service users spoken to confirmed that they did what they wanted to do. A religious service is provided in the home each week on a rota basis by a number of different denominations within Thirsk. No service user wishes to attend a local church in the community. Visitors are welcome at anytime and a number of visitors were seen to come and go as they wished. The visitors spoken to stated that they were always welcome and could see their relatives in private in their own room or one of the small lounges if they wished. Some visitors took their relatives out for the day. The service users have input into the weekly menu. Service users sitting at one table in the dining room choose a dish for one meal each week and service users sitting at each table in turn on a rota basis choose a dish the following week. All service users stated that the food was good and there was always a choice. One survey form stated, “I am very pleased with Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 12 the overall care that I receive. The staff are helpful and friendly, the food is always good and wholesome. Secure, local homes like this are just what the elderly need”. Special diets are catered for. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 13 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. There are satisfactory complaints and abuse policies and staff were aware of the action to take if a complaint or suspected abuse situation occurred. EVIDENCE: The home has comprehensive policies for complaints and adult protection. Each service user has a copy of the complaints procedure given to them in their admission pack. Details of how and who to complain to are displayed around the home. No complaints have been made since the last inspection. All staff spoken to were fully aware of what action to take in the case of a suspected abuse situation occurring. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 14 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. Judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing service users with an attractive and homely place in which to live. EVIDENCE: The home is on two floors and a tour of the building showed that the environment was well maintained with suitable furniture and adequate decoration. Service users spoken to commented that the home was always clean. The home was odour free throughout. Two of the cubicle toilets had been converted into one private toilet since the last inspection providing service users with privacy and dignity whilst using the toilet. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 15 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 area is adequate. This judgement has been made using available evidence including a visit to this service. The service users receive a good standard of care from the well-prepared and motivated staff. The procedures for storing the pre-employment checks must be improved to ensure all the necessary information on all staff employed is available for inspection. EVIDENCE: At the time of the inspection there was a team manger, four resource workers, two domestic staff, three kitchen staff and an administrator on duty. The needs of the 38 service users in residence were met by the staff team. All service users commented on how good the staff were. Staff training is high on the agenda of the registered manager and over 50 of resource workers had obtained an NVQ Level 2 award in care with further staff working towards the award at the present time. Staff stated that they had undertaken a number of relevant training courses in addition to the work that they had or were undertaking in respect of NVQ. The majority of the staff files checked at random had all the necessary pre-employment checks but one file had no application form, no written references and no CRB check. The registered manager stated that she would make enquiries within the organisation to ascertain where the necessary documents were stored. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 16 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in an open and inclusive manner by the present registered manager who enjoys the support of staff and service users. EVIDENCE: The registered manager has over 24 years experience in the care and management of older persons homes. She has a Registered Managers Award and Level 4 NVQ in the management of care services. She is also an NVQ Assessor. Questionnaires have been sent to and completed by service users and relatives to ascertain the quality of the services that service users receive. The results of the surveys are discussed in the two monthly residents meeting. A new quality initiative is at present being introduced at the home. The registered managers line manager visits on a monthly basis and undertakes some quality checks. The home has a record system for keeping account of Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 17 personal money of some service users who wish to have their money stored safely within the home. Records and cash checked were up to date and in order. The health and safety records checked were all in order. Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 18 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 X X 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 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? N/A 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 OP29 Regulation 19 Requirement The registered person must not employ a person to work in the care home without the necessary pre-employment checks. Two written references and a satisfactory CRB check must be available for inspection for each member of staff employed. Timescale for action 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cherry Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Garth - North Yorkshire County Council DS0000034497.V301996.R01.S.doc Version 5.2 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!