Inspection on 10/11/06 for Cherry Tree House

This inspection was carried out on 10th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cherry Tree House 05/11/08

Cherry Tree House 24/01/06

Cherry Tree House 31/08/05

Cherry Tree House 15/02/05

Cherry Tree House 03/08/04

Cherry Tree House 30/01/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Cherry Tree House Collum Avenue Ashby Scunthorpe North Lincolnshire DN16 1TF Lead Inspector Beverley Hill Unannounced Inspection 10th November 2006 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 Tree House DS0000002879.V295652.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 Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree House Address Collum Avenue Ashby Scunthorpe North Lincolnshire DN16 1TF 01724 867879 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) Barton Medical Services Limited Ms Anji Gibson Care Home 34 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (34) of places Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: Cherry Tree House is situated in the Ashby area of Scunthorpe close to local shops and amenities. It is owned by Barton Medical Services, a small private company providing a number of care homes in the area. The home is registered to provide care and accommodation for up to thirty-four older people with a broad range of needs including twenty people who may have needs associated with dementia. In addition they provide a day care service for up to five people per day. District nurses attend to those people who require day to day nursing support. The home has two floors serviced by both stairs and a passenger lift. The home has four lounges, two quiet rooms and two dining rooms. All bedrooms are single occupancy although none have en-suite facilities. The home is divided into four units, each with two toilets and either a bathroom and/or a shower room. The garden has a secured lawned area with seating and a patio is accessible from one of the dining rooms. There is ample car parking facilities for visitors. According to information received from the home on 18.09.06 their weekly fees are £327 to £380.63p. Items not included in the fee are toiletries, hairdressing and chiropody. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day. Throughout the day the inspector spoke to five service users and two relatives to gain a picture of what life was like for people who lived at Cherry Tree House. The inspector also had discussions with the manager, care staff, catering staff and a visiting professional. The inspector looked at assessments of need made before people were admitted to the home, and the home’s care plans to see how those needs were met while they were living there. Also examined were medication practices, activities provided, nutrition, complaints management, staffing levels, staff training, induction and supervision, how the home monitored the quality of the service it provided and how the home was managed overall. The inspector also checked with service users to make sure that privacy and dignity was maintained, that people could make choices about aspects of their lives and that the home ensured they were protected and safe in a clean environment. The inspector also observed the way staff spoke to service users and supported them, and checked out with them their understanding of how to maintain privacy, dignity and choice. Prior to the visit to the home the inspector had sent out a selection of surveys to service users, family members, a selection of staff members and professional visitors to the home. These were checked and comments used throughout the report. There were generally more positive comments about the staff and care provided although there were some comments that needed to be addressed. Complimentary comments were, ‘staff are very polite and helpful at all times’, ‘they all do a marvellous job’, ‘the staff are excellent’, ‘I always get medical support needed from the staff’, ‘the meals are good and there is always a choice and variety of menu’, ‘the cleaners are very good’, ‘the staff in my opinion are very nice, kind and thoughtful including kitchen staff and cleaning staff, always polite with a cheery disposition which keeps a sense of humour’, ‘I have been very happy since I have been here’. Other comments from service users were, ‘we do not get checked enough between tea-time and supper time’, ‘we could do with more staff’, ‘sometimes staff are run off their feet’, ‘it varies, some staff listen and some don’t’, ‘activities could be better, some of those organised were a bit childish’, ‘the dining room is not always hoovered properly at weekends’, ‘there is too much ice-cream in different forms for dessert at lunch and tea’. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 6 Both sets of comments were discussed with the manager to feed back to staff members and check out. Staff members indicated they had support and direction from the manager and received training. However three of the eleven surveys received back also commented on staff shortages. Four of the five relatives surveys commented that there seemed to be staff shortages at times. However four of the five surveys received from relatives had ticked the box to say they were satisfied with the overall care. One person stated that their relative had not seen the manager during their first few weeks at the home. Two surveys from care managers replied with positive comments and one stated, ‘I have always been dealt with in a professional and courteous manner when visiting the home and feel it offers a high standard of care, presented in a warm and friendly manner by all the staff’. What the service does well: There was a core group of staff that had worked at the home for several years and knew the service users well. People who lived at the home said that the staff members were caring, kind and they looked after people well, respected their privacy and made their relatives feel welcomed. Training for the staff was given on a regular basis and care staff had had a wide variety of training to help them do their job safely. The home had well developed policies and procedures in place to assist the staff in their work. Medication was well managed and all staff that administered it had received training. People who lived at the home stated they liked the meals and drinks provided. They said they had plenty to eat and drink and they always had choices at each meal with fresh fruit and vegetables. Service users specially mentioned the full English breakfast, available daily. The home had gained the Local Authority Gold Standard Award for quality monitoring. They managed complaints well and investigated them properly. The manager made sure that service users could express their views at meetings and these were listed to and acted on. The home was clean and tidy and service users were able to bring in items of furniture to personalise their bedrooms. The home had a friendly and homely feel and there were lots of different areas for people to sit. The way the home recruited new staff members was good and they kept clear recruitment records. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: One person had been admitted into the home without a thorough assessment of their needs. The person had not had an assessment by social services as they were funding the placement themselves. The assessment was really important as it helped the home to decide whether they were the right place for the person and whether they could meet their needs. On this occasion the home was the right place but they must complete assessments first. Generally the care plans drawn up reflected service users needs but in one file examined a person with dementia did not have these needs planned for. It was important that staff had clear tasks identified to meet all the needs or important care could be missed. The home did have some activities organised but not everyone was happy with them. The home needs to make sure that a bigger range of activities was available to suit all needs and capabilities. The homes refurbishment plan was progressing but some toilets and bathrooms still need to be addressed. Service users were complimentary about the staff and there were enough staff in terms of numbers but some people perceived that there were shortages. Some staff and relatives had also mentioned this in surveys. One person also felt that they were not checked enough between tea and suppertime. The home needs to look at how the staffs’ workload is organised to see if this resolves the situation. Staff training in a certificated course for care of older people was progressing but they had to reach a target of 50 of care staff trained to this level. With the staff that have completed the course and two further progressing they were still short of this figure. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 8 Some service users reported that they did not see enough of the manager and staff spoken to felt they had little contact and feedback from the directors when they visited. The manager could try to make themselves more visible to service users and the directors could indicate on their visit reports which staff have been spoken to. 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 Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 9 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 Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 10 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 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all service users needs are fully assessed prior to admission which may mean the home is unable to determine whether they are able to meet needs. The home provides an opportunity for service users to have trial visits. EVIDENCE: Five care files were examined during the inspection and it was clear that the home obtained assessments of need prior to admission for those service users funded by care management and generally pre admission assessments were also completed by the home. The homes assessments were not consistently comprehensive and one service user who was self funding their placement had assessment documentation in their file but this had not been completed at all. There was evidence that the home formally wrote to service users or their representatives following assessment to state they were able to meet needs. A Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 11 letter had been sent to the self-funding service user or their representative stating the assessment had been completed and the home were able to meet their needs but this clearly had not been done. The home had sufficient equipment within the home to meet a range of needs and specialist equipment was obtained via district nursing services as required. The home had a training plan in place that covered mandatory, dementia care and service specific training and staff members were prepared to participate. The manager stated that a respite service was available to enable people to stay for a short while and try out the home and several people attended for day care. The first four to six weeks of admission were seen as a trial period before the service user made up their mind about permanent residency. The manager stated this could always be extended if necessary. Documentation examined confirmed this. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 12 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. Care plans generally reflected service users needs and the home met health and personal care needs in ways that promoted privacy and dignity. Medication was well managed. EVIDENCE: Three care files were examined in depth and two further files perused. The home collated a wealth of information from assessments and risk assessments in order to formulate care plans. The care plans were generally comprehensive and reflected the health, personal and social care needs highlighted at the assessment stage. A summary of care plan needs was held at the front of the care file for ease of access for care staff. One care plan supported a recently admitted service user with dementia. Most needs had been covered in the care plan but their dementia care needs had not been addressed. Behaviour monitoring charts were being completed for a visiting professional to assess and the manager confirmed these would be used as the basis for a management plan for the service user. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 13 There were clear tasks for staff in care plans and they reflected how staff members were to promote privacy and dignity. Care staff spoken to described care that put into practice these values and service users spoken to confirmed it, ‘the staff are good when caring for you’, they knock on doors and yes respect your privacy’. Care plans were evaluated on a monthly basis and there was evidence of in-house reviews and those completed by care management. The service users signed care plans where possible. Care staff spoken to all confirmed the importance of care plans, ‘we must read them, and we must know what the service users needs are’. Care files examined contained individual risk assessments for a range of situations and there was evidence that service users were weighed on a monthly basis and professional support obtained. Separate hygiene charts were completed, daily records maintained of the care provided and evidence of pressure area and nutritional intake charts for some people considered to be at risk. The home maintained a record of clinical visits by health professionals to each service user and any appointments with health services. A district nurse spoken to during the visit confirmed that staff members were helpful and the home was quick to contact them if they had any health concerns. Medication was checked and was signed on receipt into the home and on administration to service users. All medication was stored appropriately and stock was controlled. The staff that administered medication had completed accredited training. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 14 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. Generally the home ensured that service users were able to make choices about aspects of their lives and provided flexible routines and nutritional meals. Improvements in social stimulation for service users would enhance the quality of their lives. EVIDENCE: There was evidence that the home provided some activities for service users to participate in and outings to local venues had taken place. Comments from some service users spoken to and information in surveys received indicated that the home had not got it quite right with the provision of activities. One person stated that some activities were, ‘a little childish’ and this prevented them from participating. Records maintained highlighted that a lot of people declined to participate but some joined in reminiscence sessions, dominoes, chats and crafts. There was also evidence that one person cared for in bed had received hand and foot massages. The home was in the process of obtaining references for a new activity coordinator for five, three hourly sessions a week and this appointment should address the shortfalls. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 15 Service users spoken to confirmed that their relatives were able to visit at any time and were made welcome. Surveys received and two relatives spoken to during the visit confirmed this. One visitor commented that their relative still received visits from local clergy and they were able to maintain long distance contact with them by regular phone calls. They had been impressed that the cook came in on their day off to make sure everything was prepared for their relative’ special birthday celebration. One service user spoke about how a staff member was assisting them with Christmas cards to send to relatives’ abroad and how lucky they were to have this person as their key worker. Staff members spoke about how they supported people to make choices about their lives. For example, the cook visited people after admission to find out their food preferences and dietary needs and care staff ensured people had a choice about clothes, bathing, make up, whether to stay in bed or in their bedroom and times of rising and retiring. Service user meetings and reviews were held and there was clear evidence in minutes that people had expressed their views about the service. The majority of service users spoken to and surveys received commented on how good the food was. The menus were six-weekly rotating and offered variety and choice at each meal including a full English breakfast everyday. The cook described how the home catered for special diets such as diabetics, gluten-free, liquidised and supplemented. One service user had commented that there appeared to be a lot of ice cream on the menu and when checked this was the case, but it was as part of a range of options for dessert after the evening meal. The meal sampled on the day was well prepared and presented and the inspector saw evidence of alternatives to the two main choices on offer being served. Staff members visited service users daily to find out what they wanted for the evening meal and the next days lunch options. Cherry Tree House DS0000002879.V295652.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. This judgement has been made using available evidence including a visit to this service. Service users are able to complain about services and are protected from abuse by staff members’ knowledge of policies and procedures and adult protection training. EVIDENCE: The home had a complaints procedure that was displayed in the home. Staff members were aware of the procedure and the documentation used to record complaints. Service users spoken to said they would complain if necessary and some mentioned the manager and other staff by name. Seven of the eight surveys received from service users stated they ‘always’ or ‘usually’ knew how to make a complaint. One person stated they felt more confident speaking to some staff than others if they were unhappy with anything. Two of the five surveys from relatives indicated they did not know how to complain but they hadn’t needed to so far. Complaints that the home had received were dealt with appropriately and a complaint received by the Commission was investigated by the providers and most of the points unsubstantiated. A further complaint received amounted to a difference in opinion about the level of care required for one service user and, although not fully resolved for the complainant, was investigated thoroughly. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 17 All staff, apart from newly recruited staff members, had received training in the protection of vulnerable adults from abuse. The home had policies and procedures that linked to the multi agency policies and procedures and in discussions staff were aware of what to do if they suspected abuse had occurred. The manager was aware of referral and investigation procedures. Cherry Tree House DS0000002879.V295652.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, 20, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided a clean and homely environment for service users with plenty of space and the opportunity to personalise their bedrooms. EVIDENCE: Generally the home was well maintained although some of the toilets were in need of refurbishment. The home maintained a redecoration and refurbishment log and there was evidence that several bedrooms had been redecorated since the last inspection and some had new flooring and furniture. Nine bedrooms had been fitted with new double glazed windows and further refurbishment was planned. New flooring had been installed in one bathroom and two of the toilets. The home had plenty of communal space with two lounges and a dining room on each floor. There were also two quiet rooms for visitors to see their relative in private. All were homely in appearance and when checked, bedrooms, Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 19 bathrooms, toilets and communal rooms were clean and tidy. Service users spoken to were happy with the cleanliness of their room, the laundry service and the home in general. One person spoken to compared the cleanliness of the home very favourably to another home they once visited and stated, ‘its beautifully clean here, I’m really pleased with this place’. Another mentioned they could not find fault with the laundry but a further service user did state that the dining room was not hoovered as much as it should be at weekends. This was mentioned to the manager to check out and monitor. Service users were able to personalise their bedrooms with furniture, pictures and ornaments and this was seen to varying degrees. One person talked about having their own telephone and how this enabled them to keep in touch with family overseas. All bedroom doors had privacy locks and lockable facilities were provided. Cherry Tree House DS0000002879.V295652.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. This judgement has been made using available evidence including a visit to this service. Service users are supported by a well trained and appropriately recruited staff team. A re-examination of how staff are deployed throughout the home may address perceived shortages. EVIDENCE: Staffing rotas were examined and showed that there were sufficient staff members on duty in terms of numbers. Staff confirmed that there were four staff and a team leader in the morning and in the afternoon. There were two staff at night and one sleep-in staff member on call. The manager was supernumerary to the rota. On examination the rota indicated that occasionally staff cover was three and a senior for morning and afternoon shifts but this was not a regular occurrence and the number of service users in the home had fluctuated at times. The layout of the building meant that staff had a lot of floor space to cover when supporting people. However four of the five surveys received from relatives indicated the home appeared to be short staffed at times and one relative stated staff members were ‘overstretched’. One service user stated they did not appear to be checked enough between the evening meal and supper. Another service user stated the staff members were, ‘very obliging and kind when there are enough staff’. Other comments about the staff team were very complimentary although one service user survey did state that it depends which staff is on as Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 21 to whether they listen to you. These comments were discussed with the manager to address and they will look at staff deployment throughout the home. Three staff members also stated there were staff shortages at times. Four staff files were examined and evidenced good recruitment processes. Files were organised and appropriate references and criminal record bureau checks were in place. Staff confirmed that induction consisted of shadowing more experienced staff, discussing their previos skills, working through skills for care standards with questions and answers and being observed by senior care staff who then signed off the record. One person stated this gave them a good introduction into the homes way of working. A training plan was in place and a log maintained of training completed and when the renewal date was due. Training consisted of in-house training, distance learning and external facilitators. Service specific training had been accessed by some staff, for example, dementia care, risk assessment, challenging behaviour, pressure area care,ethnicity awareness, recruitment and selection, continence and diabetes awareness, foot care and diet and nutrition. All staff had completed training in adult protection and those administering medication had completed an acredited medication course. Mandatory training was up to date regarding fire, moving and handling, first aid, health and safety and basic food hygiene. Some updates were required in infection control but overall the home provided good training opportunities for staff. National Vocational Qualification training was progressing with six care staff members out of twenty having completed the course and a further two progressing through it. This means that currently 30 of care have completed NVQ level 2. The target to reach is 50 . Staff were clear about the training courses they attended and felt they were equipped with skills to perform their role. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 22 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, 32, 33, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The regstered manager is proactive in providing a safe environment for service users who live at Cherry Tree House and staff who work there. EVIDENCE: The manager had completed her Registered Managers Award in May 2005. They managed the home well and staff surveys indicated that they received support and guidance from the manager. Some staff members stated they were aware the directors visited the home but did not always have an opportunity to converse with them or receive any positive feedback for their work. This was mentioned to the manager to discuss with the directors. The directors completed visits under Reglation 26 of the Care Homes Regulations but reports did not indicate which staff were interviewed only if any action was required from the discussions. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 23 Service users spoken to knew the managers name and some mentioned they would tell her if they had any complaints. One relative survey did highlight that their relative, when initially admitted, had not seen the manager for seven weeks and a recent complainant had expressed that they would like to see more of the manager. This was discussed with the manager and whilst it was acknowledged that their role was an extremely busy one they have tried to make themselves more accessible to service users each day. Service users meetings were convened and there was evidence that complaints were dsicussed and actions fed back to the meeting. People were given the opportunity to express their views about the services provided and there was clear evidence that this happened and was actioned. Service users views about the home were also obtained via the homes quality assurance processes. This consisted of audits completed by various staff members and questionnaires sent out to service users, relatives, professional visitors and staff. Action plans were produced to address shortfalls and staff were informed of the results and the action required to put things right. Results of the survey were distributed around the home. The home had achieved the Gold Standard Award for quality monitoring awarded by the local authority. The propristors produced a business service plan on an annual basis and made this available to the home and the Commission. The management of service users finances were not assessed at this inspection but information received from the home was that families managed finances and a small amount of personal allowance was held at the home for several people. Supervision records indicated that this was happening regularly and was well recorded. Staff participated in monthly meetings and there was a good exchange of information. Care plans focussed on risk assessments and how to maintain a service users individuality. Any bedrails were supplied by an occupational therapist and fitted by a district nurse. Fire training and weekly equipment checks had been completed and service users welbeing and safety was observed by staff. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 24 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 2 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 3 X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X X 3 X 3 Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 25 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 OP3 Regulation 14 Requirement The registered person must ensure that thorough assessments of service users needs are carried out prior to admission, especially those people who are self funding with no assessment from care management. The registered person must ensure that a specific service user with dementia care needs has a care plan that reflects these needs with clear tasks for staff and a behaviour management plan based on information gained from the monitoring process and professional input. The registered person must ensure that a range of appropriate social stimulation and activities are available for service users. The registered person must ensure that the progress of refurbishment continues with toilets and bathrooms part of the plan. The registered person must DS0000002879.V295652.R01.S.doc Timescale for action 31/12/06 2 OP7 15 31/12/06 3 OP12 16 31/01/07 4 OP19 23 30/04/07 5 OP27 18 31/12/06 Page 26 Cherry Tree House Version 5.2 ensure that the deployment of staff is reviewed to address the perceived shortages. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP28 OP32 OP32 Good Practice Recommendations The home should continue to work towards 50 of staff trained towards NVQ Level 2. The directors should indicate on the regulation 26 reports, the staff members they have had discussions with. The registered manager should ensure they are more visible to the service users. Cherry Tree House DS0000002879.V295652.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Tree House DS0000002879.V295652.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. 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!