CARE HOMES FOR OLDER PEOPLE
Cherry Holt Care Home Welham Road Retford Nottinghamshire DN22 6TN Lead Inspector
Stephen Benson Unannounced Inspection 13th February 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 Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 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 Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cherry Holt Care Home Address Welham Road Retford Nottinghamshire DN22 6TN 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) 01777 710347 01777 710499 Mr K Sooriah Mrs L M Sooriah Diane Brett Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability (3) of places Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16/08/05 Brief Description of the Service: Cherry Holt is a care home providing personal care including nursing care and accommodation for 52 older people or up to 3 beds can be used for people with a physical disability. The home provides short and long term care. The home is owned by FBC care homes which is run as a family business The home is located on the outskirts of Retford where there are shops, pubs, post office and other amenities. The home was opened in 1996 and consists of a purpose built building. All of the homes bedrooms are single with en suite facilities. Bedrooms are located on 2 floors and there is a passenger lift. The home has a garden to the rear that is well maintained and easily accessible. There is car parking available for 16 cars. Since the last inspection the home has achieved Investors in people status. Further information about the home can be found on its website at www.fbccarehomes.com. Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the second of two unannounced inspections carried out between April 2005 and March 2006. The inspection lasted for 4 hours and the inspection focussed on key standards not inspected at the last visit. The main method of inspection used was called case tracking which involved selecting 3 residents and tracking the care they receive through the checking of their records and discussing this with them. Other residents were spoken with and additional records were seen. A discussion was had with the proposed new manager, then provider, care staff on duty and care practices were observed. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the service does well: What has improved since the last inspection?
Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 6 There were six requirements set at the last inspection all of which have been complied with. There is now a pro forma for assessing the needs of any newly referred resident. A clear record is made in the care plans of any care required and a record is made of residents preferred funeral arrangements. The correct recruitment procedures are adhered to when recruiting new staff. A new form has been introduced to record any training undertaken by staff on. An application has been submitted to The Commission for Social Care Inspection for a new manager of the home to be registered. 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 Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 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 Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 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): None EVIDENCE: Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 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 and 9 Care plans would be improved through better organisation. There are good arrangements in place for seeing to residents’ healthcare needs. EVIDENCE: Care plans contain assessments, risk assessments, plans of care, evaluation and reviews. There were clear descriptions of care, however the plans could be better organised and involve residents more. Residents said that they do not have their care plans discussed with them, Care plans contain details of any healthcare received and assessments are used to monitor residents’ well being. These showed that regular health care appointments take place including opticians and dentist. Staff said that a doctor is called if felt needed and residents said that staff err on the side of caution if they are unwell. They felt that their healthcare is well looked after. There is a designated medicine room where medication is stored in locked trolleys. A monitored dosage system is used and records were well maintained. One resident said he is responsible for administering some of his own medication with staff support. Other residents said that they are given their medication by staff who watch them take them.
Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 10 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 Activities are well organised which residents are involved in. Residents are able to maintain relationships with friends and families and exercise control over their lives. The standard of catering needs to be raised. EVIDENCE: An activities coordinator works in the home who arranges group and individual activities. There is an activities programme, which is displayed around the home. Residents said they play dominoes, do group crosswords and have quizzes, which are fun as they play in teams. The activities coordinator also spends individual time with residents, which includes escorting them to appointments or reading to them. One resident said he had introduced other residents to a dice game, which is now regularly played. One resident said he would like the opportunity to play whist. There were flower arrangements made by residents displayed around the home and one resident showed some damson vodka he had made. Some residents go out into the local town centre and others go out with relatives into the local community when they visit. Residents said they are able to choose how and where they spend their time and that staff only provide them with assistance when it is needed. Staff said that they listen to what residents ask them to help with.
Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 11 The kitchen was clean and organised, but no record is kept of alternative meals provided. There is a 4 week menu in the kitchen which shows a choice of main meal, however there are four dining rooms in the home, only one had a menu displayed and this did not show a choice of meal, although alternatives are provided if a resident does not like the main meal on offer. Residents had a number of suggestions of food they would like to be included in the menu (including cauliflower cheese and pilchards) and felt that food was not always cooked to their liking. Residents also said that they would like more variety of vegetables including green cabbage. There were some catering practices seen which were raised with the management of the home. Vegetables were being prepared for three days ahead and some residents were going to be given ham that had been cooked four days previously. When this was bought to the attention of the provider he arranged for another alternative to be provided. The manager and provider said that they are waiting for a new chef to start work who will work to improve the standards of the catering service. Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 12 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): None EVIDENCE: Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 13 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 The home is kept clean, tidy well maintained. An efficient laundry service is provided. EVIDENCE: The home was well decorated, maintained and clean. A handyman is employed to carry out any minor repairs and any jobs needed are recorded in a repaired book. Residents said that the home is well maintained. Everywhere seen was clean, tidy and fresh. The laundry was well organised and staff said they ensure that clothes are marked to prevent them from going missing. Residents said that that the laundry service was excellent and that clean clothes are returned ironed on the same day. Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 14 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): 28 The percentage of staff who have achieved NVQ’s needs to be increased EVIDENCE: Three care staff have successfully completed NVQ level 3 and a further three level 2. Problems have been experienced with the college used to asses staff on NVQ’s but the provider said it is intended to have a big push on staff undertaking NVQ’s so that the required percentage is achieved. Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 15 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 38 There are measures in place to promote the health, safety and welfare of residents and staff with the exception of the prevention of risk against Legionella. EVIDENCE: There are some proposed changes to the current management arrangements for the home and an application has been received by the Commission for Social Care Inspection for a new manager to be registered and this is currently being processed. There are contracts in place for servicing and testing the electrical and fire safety equipment although there has not been an assessment carried out as to what safety checks and tests are required in order to prevent the risk of Legionella. Mandatory training concerning safe working practices is provided. Residents said that they were aware of safety practices in place through hearing the fire alarm being tested, seeing people checking equipment and having stickers on electrical possessions to indicate they are safe.
Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 16 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 4 STAFFING Standard No Score 27 X 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 17 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. 1 2 3 Standard OP7 OP15 OP15 Regulation 15 16 16 Requirement Ensure that care plans are kept in an ordered fashion and seek to involve residents in their plans Keep a record of all food provided Review current catering practices to ensure the best nutritional benefit from food provided is gained and that residents preferences are accommodated Increase the percentage of staff who have achieved NVQ qualifications Undertake an assessment on the water storage system in order to identify what measures are needed in order to prevent the risk of Legionella Timescale for action 01/06/06 01/03/06 01/05/06 4 5 OP28 OP38 18 13 01/04/07 01/05/06 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 Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 18 1 12 Provide residents an opportunity to play whist Cherry Holt Care Home DS0000024634.V283432.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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