Inspection on 16/10/07 for Cherry Orchard

This inspection was carried out on 16th October 2007.

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 Orchard 23/01/07

Cherry Orchard 25/08/05

Cherry Orchard 04/04/05

Cherry Orchard 21/09/04

Cherry Orchard 23/04/04

Cherry Orchard 03/03/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Cherry Orchard Windsor Road Andover Hampshire SP10 3HX Lead Inspector Kathryn Kirk Key Unannounced Inspection 16 October 2007 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 Orchard DS0000037319.V347472.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 Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Orchard Address Windsor Road Andover Hampshire SP10 3HX 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) 01264 324831 Hampshire County Council Brenda Rose Barney Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - (OP) The maximum number of service users to be accommodated is 43. Date of last inspection 23rd January 2007 Brief Description of the Service: Cherry Orchard is a local authority managed care home, providing care for up to 43 older persons, all accommodated within single rooms. The home, which was purpose-built in the mid-1970s, is organised into five small self-contained units, each with their own kitchenette, dining room and sitting room. Accommodation is arranged on two floors with a passenger lift providing easy access to the first floor. Six communal bathrooms are available to service users, two of which benefit from assisted baths. Other aids and adaptations have been fitted throughout the home, to assist residents to maintain their independence. Accommodation is arranged around a central paved courtyard, providing additional seating areas and raised flowerbeds. The home is located in a quiet residential area on the outskirts of Andover, and provides easy access to the town centre, local shops and other facilities. Current fees are £403 per week. Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All key National minimum standards have been reviewed during this inspection. Evidence for this report was gathered in the following ways: The manager completed an annual quality assurance document, which provides details of how the service is currently operating. Surveys were completed by seven service users and by two staff. Information gathered during the previous inspection of January 2007 and information received by CSCI since this time was also reviewed. A visit to the service took place on 16 October 2007. This lasted for 7 hours and during this time the manager; four staff, eleven residents and one visiting health care professional gave their views about the home. The home was also toured and some paperwork was examined. What the service does well: A number of people described the home as “friendly” Good, detailed information is obtained before a decision to move to the home is made. This ensures that people’s needs could be met by the service. Care plans consider cultural needs and are written in such a way as to encourage people to maintain as much independence as possible. Views and opinions of service users are listened to and acted upon where possible. Service users like the staff Staff are provided with a good range of training to help them to do their job effectively. Cherry Orchard DS0000037319.V347472.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. The summary of this inspection report can be made available in other formats on request. Cherry Orchard DS0000037319.V347472.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 Orchard DS0000037319.V347472.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Standard 6 does not apply Quality in this outcome area is good Enough detailed information is gathered about prospective service users to ensure that they are admitted appropriately to this service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The annual quality assurance audit says that all new residents are admitted following a referral from a Care Manager. The Registered Manager recieves a copy of the pre-admission care management assessment and people are actively encouraged to visit the home informally. All people who are referred Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 9 are required to come in for a days assessment or the Registered manager visits them to carry out a pre- admission assesssment, to ensure that the service can meet the individuals needs. Assessments seen were comprehensive and covered all areas of social medical and cultural needs. Service users who completed written surveys said that they felt that they had received enough information about the home before they moved in. This was endorsed by two people during the site visit, both of whom had recently moved into the home. Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Peoples’ health and care needs are managed well, although written information needs to be improved to ensure accuracy and consistency. Privacy and dignity is respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The quality in this area was judged to be good at the previous inspection in January 2007. Written surveys confirmed that people who use the service felt that they received the care and support that they needed. Four care plans were seen during the site visit and people were spoken with about their care during the visit to the home. Those who were able to discuss their care needs agreed that the information contained in the plans were Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 11 accurate and there was evidence that they were written in such a way as to maintain as much independence as possible. For example “ able to wash all areas except back and feet” There was evidence that they had been reviewed at least every month and that they had been updated to reflect any changes in the persons needs. Consideration is given to any cultural needs and people’s faith, special events/days that are important to them, preferred method of worship and special arrangements based on cultural/religious background are recorded There were assessments of risk on files seen. One seen related to a service user who had some mobility difficulties and hearing impairment. It was discussed with the manager that the guidance given to staff could be expanded upon to assist staff, for example when/ how often to check hearing aids. Asked “do you receive the medical support you need” opinion was divided Two people said “always”, two said “usually” and three said “sometimes” comments included “not so much support in the early days much better now” and “no annual check since coming seventeen months ago” One health care professional who visits the service about two times a week said that in their opinion staff were very good at responding to health care needs and would follow advice given from health care specialists. Health care needs were seen to be detailed as part of the care planning process. The issue about annual checks was raised with the manager. She said that there were some people who had not needed to see a GP for a year and agreed to undertake a review and ask those who had not if they wished to have a check up arranged. Records seen did not always contain reference to health appointments attended although it was evident through discussions with staff that these had been kept. The manager had already identified in the Annual quality assurance audit that recording needs to be improved and so a requirement regarding this was not made. Records do need to be improved however so that they accurately reflect the health appointments attended. Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 12 A corporate medication policy is in place. The manager confirmed that all relevant staff receive specific training in the storage, administration, recording & disposal of medications. The manager said that residents may undertake self-medication where appropriate and where they wish to do so, following completion of a suitable risk assessment. It was evident that this procedure had been followed for one person who was spoken with during the visit to the home. All people spoken with said that staff knock on their doors before entering and this was also observed during the visit. All staff were seen to speak with service users in a friendly and respectful way. Staff call people by their preferred name. Cherry Orchard DS0000037319.V347472.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good The service continues to improve on the social activities available. People are consulted about their daily routines and preferences and their views are taken into account. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Quality in this area was judged to be good in the inspection report of January 2007 Service users spoken with on the day of the visit and those who replied in surveys said that there were generally activities that they can take part in if this is their wish. On the day of the visit a group of eleven people were all participating in a group solving crossword clues. Those spoken with afterwards said that they enjoyed doing this. Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 14 Two people spoken with said that they would like more activities to happen upstairs as a lot of the organised ones take place in the large lounge downstairs. One staff member spoken with has been given an additional 15 hours per week to enable a greater range of activities to be provided within the home. The annual quality audit states that a DVD player has recently been purchased this allows the residents to choose different films. The garden has been improved and that a computer is being set up and some training is being provided at the request of some service users. Service users asked on the day of the visit said that their visitors are made welcome and they were observed to be shown to peoples bedrooms so that the visit could take place in private if that was their wish. Service users confirmed that they were able to bring items of furniture to the home and those bedrooms seen had been personalised to reflect individual tastes and interests. The manager said that service users are encouraged to manage their own financial affairs, within the realms of their capability. When asked “do you like the meals at the home” opinion was divided both in the surveys and from verbal feedback from service users during the visit. People were given a choice of two hot meals at lunchtime and were observed to eat either in small groups or in their rooms, depending on their preference. Account was taken of special dietary needs. Staff were observed to cut up food where this was necessary and to provide service users with a choice of soft drinks. Service users said that they were consulted about menus and also discussed timings of meals. The annual quality assurance audit anticipates that cooks and care staff will undertake Must training (a screening tool which identifies nutritional needs of individuals) This will help to improve nutritional care within the home. Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 15 . Cherry Orchard DS0000037319.V347472.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good Service users are safeguarded by the homes adult protection and complaints procedures, although record keeping could be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the local complaints procedure is displayed on the notice board inside the front entrance, which gives details of how to complain, to whom and how any complaints will be responded to. The copy of Hampshire county councils complaints/compliments leaflet is also available in the front entrance; this can be supplied in different format/languages upon request. People who were asked, “Do you know how to make a complaint?” all replied that they did. There is a record of complaints held at the home. This contained details of actions taken but was not always very clear about timescales. The manager Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 17 agreed that these records would be reviewed and the format for recording would be made clearer. There are appropriate procedures in place for responding to suspicion and evidence of abuse or neglect. Records indicate that all staff are trained in adult protection procedures. Records also indicate that correct procedures have been followed when an allegation has been made. Cherry Orchard DS0000037319.V347472.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. Improvements, particularly to the heating and lighting of the home, are needed, to ensure the comfort of all service users This judgement has been made using available evidence including a visit to this service. EVIDENCE: Asked “Is the home clean and tidy?” Service users responded that it was. This was also found to be the case on the day of the visit. Feedback from some service users indicated that although the home was generally comfortable, it was sometimes cold in parts. One person attributed Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 19 this in part to the lack of double-glazing. Two other people also said that the lighting in the home was not always very good in the evening. It was identified in the previous report that bathrooms in the home need upgrading as, for example; only one upstairs has adequate adaptations for the bath. There is also a shower in this bathroom, although staff reported that no one currently uses it. One staff member spoken with said that they felt that an electric hoist was needed in this bathroom. The environmental issues were discussed with the manager. She was aware of them all and said that they were being looked at. She was however unable to provide a timescale for completion of the remedial work necessary. It will be a requirement that the heating and lighting situation is resolved within 12 weeks of the date of this report. It was agreed that the service needs to continue to review bathroom facilities and establish what is needed to meet collective needs. Once this is completed, appropriate action should be taken. Laundry facilities were suitable and staff had access to appropriate protective clothing to minimise the risk of spread of infection. Liquid soap and paper towels were provided in communal toilets. . Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good Well trained staff are employed in sufficient numbers to support current service users effectively. Recruitment procedures are thorough. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 21 The inspection report of January 2007 concluded that there were sufficient staff on duty to meet the needs of service users. People asked on this occasion largely felt that this remains the case. One person said that when they recently needed help in the night they had been assisted promptly and a recently appointed staff member said that they had been given plenty of time to get to know the residents and to learn about their responsibilities Staff did not appear to be rushed on the day of the visit. One staff member gave written feedback that they did not always feel that there was enough time to sit and talk with residents and a service user said that sometimes planned activities had to be cancelled due to staff shortages. The manager said that this had been mainly due to staff sickness and said that that this had now been resolved. The manager said that an experienced duty manager is on duty at all times during the day and said that a night care coordinator is on duty every night time. The service does not employ anyone under the age of eighteen. The annual quality assurance audit states that currently 15/24 staff have obtained an NVQ level 2 or above in care. This is 62.5 of the workforce. At the last inspection three staff records were checked and it was established that recruitment practices and procedures were thorough. One further staff record of a recent employee was checked on this occasion to ensure that this is still the case. Records contained evidence of all necessary checks, including a satisfactory criminal records bureau check, evidence of identity, two written references and a health declaration. Staff asked, both in surveys and on the day of the visit, said that they were given training which was relevant to their role. The annual quality assessment audit lists the training provided as follows: mandatory courses such as Abuse Awareness, Emergency aid, Moving & Handling, Food Hygiene, Infection Control, and other courses, specific to the client group with whom staff work e.g. Dementia Awareness, Risk of Falls Management and Challenging behaviour . One reasonably new staff member spoken with confirmed that they had received a comprehensive induction to the service. . . Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 22 Cherry Orchard DS0000037319.V347472.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good The home is well managed and the quality of the service is regularly monitored. Procedures are followed to help to protect service users health and safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Brenda Barney has managed other Hampshire County Council Homes and successfully completed the registration process with the Commission for Social Care Inspection. She became the registered manager of Cherry Orchard in June 2007. Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 24 There are a number of ways in which the service monitors how effective it is in meeting its aims and objectives: Residents confirmed that regular meetings are held to ascertain the views of people living at Cherry Orchard. Questionnaires for residents & external stakeholders have been sent out every 6 months. These can be completed anonymously if individuals prefer. Where a resident is unable to complete the questionnaire, appropriate support is offered via staff, relatives, advocate etc, so not to exclude their views/opinions. Completed questionnaires were seen and there was evidence that any issues arising from them had been dealt with on an individual basis. The manager said that no staff questionnaires have been sent out as yet. A senior member of Adult Services conducts unannounced inspections every month. Residents, staff and visitors are spoken with on an informal basis during the visit (and can request to speak in private if preferred) to get their views, which then form part of a written report. A copy of the most recent inspection report, completed in October 2007 was seen. It was detailed, although did not highlight the issues raised in this report about the heating and lighting within the home. As discussed in previous sections, the service does not hold any money on behalf of service users. . Health and safety issues were considered to be managed appropriately at the last inspection in January 2007 and written information indicates that they remain so, for example, the quality assuarance audit states that: “We have, records of legionella testing/ PAT testing/Fire test with procedures, an incident & accident reporting system and risk assessment procedures”. “COSHH assessments are in place….A fire manual is kept and continually updated, with specifc information on the occupation of each room, to facilitate evacuation should this be required.” “A weekly fire alarm test is carried out and all fire fighting equipment, fire alarm system is regularly serviced/maintained”. Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 25 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 2 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 3 X 3 X 3 X X 3 Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 26 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 Standard OP19 Regulation 23(2)p Requirement Heating and lighting, suitable for service users, must be provided in all parts of the care home which are used by service users. Timescale for action 08/01/08 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 Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cherry Orchard DS0000037319.V347472.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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