Inspection on 19/07/05 for Cherry Tree House

This inspection was carried out on 19th July 2005.

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 22/09/08

Cherry Tree House 31/10/07

Cherry Tree House 09/05/07

Cherry Tree House 18/09/06

Cherry Tree House 04/10/05

Cherry Tree House 02/09/04

Cherry Tree House 29/04/04

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

CARE HOMES FOR OLDER PEOPLE Cherry Tree House 29 St Johns Road Farnham Surrey GU9 8NU Lead Inspector Kerry Fell Unannounced 19 July 2005, 14:00 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 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 H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cherry Tree House Address 29 St Johns Road Farnham Surrey GU9 8NU 01252 734417 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Gillian Margaret Nicholls Mrs Gillian Margaret Nicholls Care Home 6 Category(ies) of DE(E) Dementia - over 65 - Number: 2 registration, with number OP Old age - Number: 4 of places Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Up to 2 (two service users may be in the category: dementia for older persons DE(E). Date implemented: 1 April 2002 Date of last inspection 2 September 2004 Brief Description of the Service: Cherry Tree House is a privately owned detached house that is situated in a quiet road near the centre of Farnham. The property is the family home of Mr and Mrs Nicholls. The home is managed and staffed solely by Mr and Mrs Nicholls and their family. The home has a domestic feel, and service users are accommodated in attractively decorated single rooms. There is a small parking area at the front of the home, and attractive well-maintained gardens are available for use by the service users. The service is registered to provide personal care for up to six older people, two of whom may have dementia. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection for the inspection year 2005/2006. The inspection was unannounced, which means neither the staff nor the service users were aware that the inspection was going to take place. The inspection undertaken by Mrs Kerry Fell commenced at 14.00 and took two hours to complete. The inspection involved observations of a sample of service users records, including care plans, health records, contracts and review documentation, the home’s health and safety records, and service user’s finances held by the home. The inspector was also shown the repairs to the bathroom, the kitchen, and the lounge during the inspection. The inspector spent time talking with four service users, and one service user invited the inspector to see their bedroom. It is important to note that the home is managed and staffed by Mr and Mrs Nicholls and their family. The inspector was advised during the inspection that Mrs Nicholls had recently been unwell, and that the family had worked hard to ensure the continued smooth running of the home, and that as a result some of the records may not have been reviewed as regularly as they had hoped. What the service does well: What has improved since the last inspection? Service users had been asked to complete questionnaires about the service provided to them. A simplified list of people who can be contacted in the event that a service user or their relatives wish to make a complaint had been made available since the last inspection. Repairs had been completed as required at the last inspection. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 6 A table of review of records had been added to the service users’ files since the last inspection. This recorded that reviews were continuing to take place, however, the home did recognise that this had not been managed as well in the last few months. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2&3 In most cases assessments and contracts were available. EVIDENCE: Service users files were sampled during the inspection. The home had admitted one new service user since the last inspection. This service user had originally been admitted on a short-term placement, which had now been extended to become a permanent placement. The inspector was informed that the Local Authority was funding the new service user’s placement was being funded on a deferred payment contract. The home was still awaiting a copy of this contract from the Local Authority, however the inspector observed that the home had issued there own contract, which had been signed by the service user’s daughter who acts as the service user’s power of attorney. The home had not received a care management assessment for the newly admitted service user, and must ensure that this is obtained from the Care Manager. However, the inspector observed that a care assessment and single assessment document had been completed for a service user resident at the home whose placement was now to be funded by the Local Authority. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 9 Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 Service users are supported in a dignified and friendly manner. Health and care needs are met, but records need to be reviewed regularly. EVIDENCE: The inspector observed that those files sampled contained care plans for all apart from the newly admitted service user. The inspector was advised that the maintenance of records had slipped in the recent months, because the Manager had been unwell. Charts had been added to the files to evidence when service user’s records had been reviewed. The inspector observed that the files sampled had last been reviewed in May 2005. The registered persons must ensure that the care plans continue to be reviewed on a monthly basis, and that the care plan for the newly admitted service user is completed. The inspector was advised that the home continued to receive support and input from a range of health professionals as required, including the GP, the district nurse, optician and chiropodist. The inspector observed records of these appointments on service users files. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 11 The inspector observed that service users received support in a positive and dignified manner. Service users spoken to during the inspection informed the inspector that they received friendly support. Service users specifically stated that the proprietors and the staff were nice and that support was offered in the right way and maintained the service users’ dignity. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, & 15. Service users can freely move around the home as they wish. Friends and family visit service users regularly. EVIDENCE: Service users were observed spending time in the lounge. The inspection took place shortly after lunch, and some service users were sleeping in their chairs, some were watching television and others were resting in their bedrooms. Service users stated that they were able to choose where they wished to spend their time, and some spoke about having spent time in the sun in the large garden. Those service users spoken to were happy with the routine within the home. The inspector was advised that relatives and friends regularly visit service users. Service users confirmed this in conversation with the inspector. Several service users had recently had or were due to have birthdays. The service users stated that they would spend the day with their families, and the home would put on a birthday tea. The home continued to receive support and input from local churches, and the local Girl Guide/Brownie/Rainbows pack. Service users are supported to Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 13 attend church social groups during the week, and the inspector was advised about a range of trips and holidays planned with friends and family. Service users informed the inspector that there was always plenty of high quality food available. Service users stated that they always enjoyed meals. The inspector was informed that service users had requested specific meals, and that the home will endeavour to introduce these into the menu offered. Menus were not observed at this inspection, but will be looked at in detail at the next inspection. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. Service users were aware of how to raise concerns, and that they would be heard. EVIDENCE: Service users informed the inspector that they did not have any complaints about the home or the support provided. The service users also stated that they knew that they could raise concerns with the home, and were happy that they would be listened to. Additional and simplified information about making complaints has been added to service users files and made available to relatives. This form clearly details who can be contacted in the event that relatives or service users wish to make a complaint about the home or support provided to them. The full complaints procedure continued to be displayed in the home. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, &24. The home continued to be neat and orderly, and service users were happy with their bedrooms. EVIDENCE: The home continued to be neat and orderly. The home was decorated to a high standard, and the inspector was advised that the providers had plans to redecorate the lounge. Service users spoken to were very happy with the décor and furnishing in their bedrooms, one service user stated that their bedroom was “super”, stating that they could not imagine anywhere better to go. One service user invited the inspector to see their bedroom, which was clean and furnished to meet their needs. The service user stated that they had seen the furniture delivered as they had arrived to be admitted to the home. The bedroom was observed to be personalised, with family photos and some small items of personal furniture and their own television. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 16 The bathroom ceiling had been repaired since the last inspection. Tiling had recently been removed to repair the WC, and the inspector was advised that this was in the process of being repaired. The inspector was advised that all of the commodes had recently been repainted. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: None of these standards were assessed at this inspection. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 37 & 38 Service users opinions about the service provided are sought. The service users finances were found to be correct. Evidence of health and safety checks was held but fire records must be kept up to date. EVIDENCE: The inspector observed that service users had completed questionnaires as part of the homes quality assurance programme. Some service users met during the inspection were aware of the role of CSCI. The home’s development plan was not discussed during this inspection. Service users finances were checked at the time of the inspection. The finance for two service users was observed – accounts of what had been spent were held. The expenditure was mainly on chiropody and hairdressing. The inspector was advised that any personal toiletries requested are generally supplied by the home. The accounts were checked and found to be correct. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 19 The inspector was provided with certificates from the environmental health check completed the week prior to the inspection, and the food safety check completed in November 2004. The home held certificates for the annual fire extinguisher check, and the home was keeping records of the weekly fire system checks and fire evacuations. More recent records of weekly fire system checks had not been recorded, although the inspector was advised that these had been completed. These records must be maintained. The home had purchased a computer package that contained policies and procedures, formats and records for the day to day running of a care home. The home continued to have problems with the way that this programme worked on their computer, and were working closely with the supplier to resolve this. The inspector was informed that the home aimed to resolve this soon so that they can mange their records electronically, and so that they could adapt the formats to meet the homes needs better. In the meantime these documents were being used and reviewed in hard copy. Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 x x 3 x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x 3 x x 2 Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? 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 2 Regulation 14 Requirement Timescale for action 19/09/05 2. 7 15 3. 4. 7 38 15 23(4) The home must obtain a copy of the care management assessment for the most recently admitted service user. The registered persons must 19/07/05 ensure that the care plans continue to be reviewed on a monthly basis. The care plan for the newly 19/08/05 admitted service user must be completed. Fire records must be updated 19/07/05 and maintained on a weekly basis. 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. Refer to Standard Good Practice Recommendations Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cherry Tree House H58 H09 S13597 Cherry Tree House v240214 190705 Stage 4.doc Version 1.40 Page 23 - 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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