Inspection on 23/01/07 for Cherry Orchard

This inspection was carried out on 23rd January 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 16/10/07

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 Peter J McNeillie Unannounced Inspection 23rd January 2007 09:00 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.V321444.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.V321444.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 Glynis Rosalind Addington Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/08/05 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 adaptions 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. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A number of sources of information/evidence were considered in producing this report including a visit to the home, reading previous inspection reports, notifications to the Commission for Social Care Inspection (C.S.C.I.) under regulation 37, reports covering management visits to the home as required under regulation 26, examining service users assessments/care plans, staff recruitment/ training records, policies / procedures comments by management, staff, service users and the results of an in house service user satisfaction survey. This key unannounced visit was the first inspection for the year 2006/07 and took place on 23/01/07 between the hours of 09.00 am and 1.15 pm. During the inspection at which the Registered Manager assisted the inspector all of the key standards for care homes for older persons were assessed. The results/findings contained in this report will determine the frequency and type of future inspections. At the time of the inspection charges per person were £392.00 per week. What the service does well: What has improved since the last inspection? What they could do better: There were no areas of concern noted during this inspection. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Cherry Orchard DS0000037319.V321444.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.V321444.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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a system of assessing and identifying residents needs which ensures residents safety and their assessed needs can be met. Intermediate care is not provided. EVIDENCE: A random sample of three residents records chosen by the inspector were viewed. All of the files viewed included an external care management as well as an in house assessment of individual needs and risk, which would normally be carried out during a days visit to the home by the prospective resident. The inspector was informed no admissions would be permitted without a care management assessment apart from an emergency admission which would be followed by a placement review/assessment within 48 hours. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 9 Following the last inspection the report noted that where a risk had been identified the measures to minimise the risk were not explicit. Since the last inspection the assessment process has developed and previous shortfalls /criticism addressed. Plans seen included confirmation that the resident had been consulted and participated in the formulation of the assessment. Intermediate care is not available within the home. Cherry Orchard DS0000037319.V321444.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. This judgement has been made using available evidence including a visit to this service. The arrangements for planning care are clear ensuring that the health, personal care and medication needs of residents are met and their privacy and rights respected. EVIDENCE: Residents whose files were viewed were spoken to as were a number of others both individually and in a group. No responses were received from residents, residents representatives/relatives or visiting health care professionals to the satisfaction survey sent out by C.S.C.I. despite blank copies being available in the home however, the inspector did have access to and viewed residents comments made as a result of an in house satisfaction survey which mirrored comments made to the inspector. All of the residents spoken with expressed total satisfaction with the care they Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 11 were receiving and the manner in which it was delivered, comments to the inspector included ”The best”, “What more could we want?” “ Its lovely here”, “Every one is so kind” “plenty to do”, Good food plenty of choice”. Residents also confirmed they were aware of and consulted about the contents of their care plan a copy of which is always kept in individual bedrooms. User friendly and comprehensive care plans, which were reviewed monthlyincluded information on how identified needs including any special needs were to be met. Following the last inspection the report stated “Care is not being delivered consistently due to lack of detail in the plan”. Plans viewed indicated that this matter had been addressed and that a great deal of effort had gone into overcoming and correcting the previous criticisms. Residents confirmed any personal care was given in private and staff always knocked and waited before entering their bedroom. The inspector observed this practice. Residents are able to make and receive telephone calls in private. Approximately ten residents had made arrangements to have their own telephone installed. Files seen and comments made by staff confirmed consultation with a range of external health care professionals such as doctors, district nurses, occupational therapists, physiotherapists, continence advisors and community psychiatric nurses. Other professionals would be consulted dependant on need. Records viewed confirmed all resident’s drugs, which are dispensed in a blister pack by a local pharmacist, are administered and disposed of in accordance with the homes medication policy and procedure by trained staff. All medication is stored securely. No residents were self-medicating following a risk assessment. Residents spoken with confirmed this was their choice. The pharmacist also visits the home on a regular basis and gives advice on all drugs/medication related topics including staff training. Resident’s, care staff, records viewed and the pre inspection questionnaire all confirmed residents were free to choose their own GP and sources of other personal services such as dentists, opticians and chiropodists. At the time of the inspection up to approximately 50 doctors from 5 local practices were visiting the home Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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. 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 The social activities, family contacts and the provision of varied and nutritious meals were well managed and reflected service users interests and choices. EVIDENCE: A selection of in house and community based activities was available, which normally take place in a designated large comfortable room previously occupied by a day centre. Residents confirmed they were consulted about the type of activities available and confirmed they had a choice whether or not to participate. As can be seen from comments reported earlier in this report, residents found there was always plenty to do. Activities on offer include, quizzes, cooking, bingo, cards, pets (the home has its own cats), keep fit, music, library, gardening plus a wide range of visiting entertainers (organised by age concern). Future plans include an I.T. project that will allow residents access to a computer and the Internet. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 13 The home recognises that some residents do not wish to participate in-group activities; they are therefore developing a programme of individual one to one activities. Progress will be evaluated at a future visit to the home. At the time of the inspection a member of staff has been designated as an activities coordinator and is undergoing specialist-training equivalent to a National Vocational qualification (N.V.Q.). Residents confirmed they were fully consulted and were able to exercise choice in all aspects of their lives i.e., when to get up and go to bed, mealtimes and where meals are taken. Visitors are welcome at all times, residents confirmed they were able to meet with and talk with any visitor they wished in private. The quality, quantity, presentation and choice of food served came in for particular praise from the residents. A full and varied menu based on individual likes, dislikes and was available. The cook speaks to each resident on a daily basis and establishes the person’s choice for meals the following day. The inspector in checking the daily menu confirmed that there was a wide selection of food available and observed that the midday meal was well presented and served in a calm unhurried manner. At the time of the inspection no residents from minority ethnic groups with special dietary needs were resident. Assistance with feeding is available. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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. 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. The home has clear policies and procedures in place which ensures residents are protected from abuse. The complaints procedure was satisfactory with evidence that residents feel their views will be acted upon. EVIDENCE: A corporate Hampshire County Council Adult Protection policy/procedure designed to protect vulnerable residents from abuse was available as were records to confirm all staff had received training. Records viewed, management and staff spoken with confirmed they had received training in recognising abuse and demonstrated they knew what to do should they witness or suspect the abuse of any resident. The homes complaints procedure was which was also included in the service users guide included information on how to contact The Commission for Social Care Inspection (C.S.C.I) was seen as was a record of complaints. Residents spoken to stated they felt comfortable in discussing any concerns they had with the homes management and confident any matters raised would be dealt with fairly and promptly. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. EVIDENCE: A tour of the home indicated it was safe, well maintained meeting residents individual and collective needs. Furniture was comfortable and homely and in keeping with the décor. Residents commented how satisfied they were with the accommodation. All areas of the home were accessible to residents including the garden. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 16 The home was clean, hygienic and free from adverse odours. An infection control policy and procedure is in place. All staff have access to aprons, gloves and antiseptic hand gel. Since the last inspection an activities room has been created from the old day centre and a meeting room for staff and /or residents from the old day centre office. At the time of the inspection four bathrooms have been programmed for upgrading as they currently lack aids to assist residents. Despite this there are still four other bathrooms available. Progress will be evaluated at a future visit to the home. Other work due to take place is the upgrading and extending of the fire safety equipment, which will entail the addition of more smoke detectors and alarm points. Apart from the above an annual maintenance programme is in place. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all service users. EVIDENCE: Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 18 The staff rota provided as part of the pre inspection documentation, indicated that normally at least six staff plus the manager, three domestics, a cook, a laundry assistant and one administrator were available in the morning reducing to four in the afternoon and evening prior to the night staff commencing work. The manager or an assistant manager was available twenty-four hours every day. When asked if they felt whether there were sufficient staffs and if they appeared to be well trained and residents commented, ”We never have to wait. ” “When we want help it is always there” and “ The girls know what they are doing and know us all so well. Staff were observed to carry out their duties in a calm unhurried manner taking time to talk with and assist residents. The manager confirmed that staffing levels are closely monitored to reflect the assessed needs of residents and would be increased if the need arose. The inspector viewed three staff files, which included evidence confirming staff are employed in accordance with a robust recruitment and selection procedure designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, satisfactory Criminal Record Bureau, Protection of Vulnerable Adults and reference checks followed by the satisfactory completion of an in house induction training and probationary period of employment. Files also included a copy of a job description and contract together with evidence of all training undertaken. Hampshire County Council have a comprehensive staff training programme covering all aspects of care for the elderly including, care and administration of medication, manual handling, basic first aid, health and safety, dementia, risk assessment, coping with aggression and infection control etc. All care staff are given the opportunity to undertake N.V.Q. in care to at least level 2. At the time of the inspection 45 of staff had been trained to at least level 2 with a further six (21 ) due to complete N.V.Q. level 2 by April 2007 Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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. 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 management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. EVIDENCE: The service is well managed, the manager is qualified and experience and has cared for the elderly for a number of years. Comments made residents suggest that nothing is too much trouble for the staff and management, and every effort is made to meet their changing needs and to improve the service. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 20 This view that was also echoed by the staff that confirmed management have an open door policy, and encourage them to share any concerns or ideas they have. There are clear lines of accountability within the home all staff were fully aware of there responsibilities. The inspector viewed responses to a ‘Service User Questionnaires’, as a part of the home’s quality assurance programme, which confirmed resident’s satisfaction with the services provided. Responses mirrored those given to the inspector and commented on earlier in this report. Currently the surveys do not seek the opinions of visiting professionals. The manager gave a verbal undertaking she would ensure the survey was expanded to reflect these views. This matter will be reviewed at a future visit. The home’s manager stated that no monies were held on behalf of residents. The inspector observed no immediate obvious hazards to health and safety during the inspection. Cleaning materials and chemicals were securely stored. Protective clothing, supplies of hand disinfectant gel and gloves were available to staff. A health and safety policy and procedure was in place. Control of substances hazardous to health (COSHH) assessments, risk assessments, equipment servicing and accident records were available as were records to confirm all staff have receive training in the techniques of moving and handling first aid health and safety and the procedures to follow in the event of fire, including evacuation. The home has a laundry procedure and a washing machine, which is capable of disinfecting soiled items. All of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered. Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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 X X X 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 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. Refer to Standard Good Practice Recommendations Cherry Orchard DS0000037319.V321444.R01.S.doc Version 5.2 Page 23 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.V321444.R01.S.doc Version 5.2 Page 24 - 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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