Inspection on 05/12/07 for Cherry Tree House

This inspection was carried out on 5th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cherry Tree House 18/12/06

Cherry Tree House 16/02/06

Cherry Tree House 06/10/05

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Cherry Tree House 119 Monkleigh Road Morden Surrey SM4 4EL Lead Inspector Emma Dove Unannounced Inspection 5th and 6th December 2007 12:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cherry Tree House DS0000061858.V356080.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 DS0000061858.V356080.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree House Address 119 Monkleigh Road Morden Surrey SM4 4EL 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) 020 85430331 Mrs Ann Devers Mrs Eileen Marie Hodgson Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th December 2006 Brief Description of the Service: Cherry Tree House is registered to provide care for up to three older people, three people are currently living there. The home is situated in a quiet residential area, with easy access to shops, medical centre and public transport links to larger local shopping areas. Accommodation at the home is provided over two floors, with single bedrooms, a laundry area, lounge and kitchen/ dining area. A well-maintained garden is available to the rear and front of the property. Fees for the service are from £410 per week. Information about the CSCI is available at the service. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two and a half hours on the 5th December 2007 and three hours on the 6th December 2007 by one regulation inspector. The inspection included speaking with people who use the service, the owner and manager, looking at communal areas and bedrooms and inspecting at records. An Annual Quality Assurance Assessment (AQAA) was returned in good time for the information provided by the manager to be included in this report. Questionnaires were sent to people who use the service, their relatives and social work professionals. We have received two completed questionnaires and comments from these are included throughout this report. What the service does well: What has improved since the last inspection? What they could do better: The Service Users Guide could be improved by adding photographs and including people who use the service comments. The owner and manager should attend training to keep up to date with current good practice and ensure that people who use the service receive the most appropriate care. The use of Quality Assurance questionnaires to seek the opinions of people who use the service and their representatives and other stakeholders, could improve the services provided. The Portable Electrical Appliances must be tested every year to comply with safety regulations and to ensure people who use the service and their visitors are in a safe environment. Cherry Tree House DS0000061858.V356080.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 Tree House DS0000061858.V356080.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 Tree House DS0000061858.V356080.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): 1, 3 and 5 (the home does not provide intermediate care, so standard 6 is not relevant) People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service understands the importance of having sufficient information for people when choosing a care home. It has developed clear information about the service. Assessments are completed before people move in. EVIDENCE: A Statement of Purpose and Service Users Guide have been developed, which include information about the services provided, the facilities available and the owner. This information should help people make the decision to move in. Before people decide to move in, they are invited for a ‘taster day’. This involves a visit, spending time with other people who use the service and the owner and manager and should help people decide if Cherry Tree House is right for them. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 9 When people first move in, a trial period and review is planned. This enables the individual, their representatives and the owner and manager to meet and discuss progress and confirm that Cherry Tree House is the right place for the person before the placement is finalised. Assessments have been completed before people move in and have been developed into care plans. Cherry Tree House DS0000061858.V356080.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 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans are developed with individuals from assessments and are kept under review. People who use the service have access to healthcare services. An efficient medication policy is supported by procedures which are followed. Medication records are fully complete, contain the required entries and are signed. The owner and manager demonstrated good knowledge and understanding of the needs of people who use the service. EVIDENCE: Care plans are in place, which detail what assistance and support the individual needs and how this support should be given. People who use the service confirmed that they ‘always’ receive the care and support they need in the way they want. The manager reported that people receive one to one individualised care due to the small size of the home. The owner and manager are aware of how to Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 11 maintain people’s privacy and dignity while offering support with personal care. People who use the service make decisions about their daily life by making choices about when they want to get up, whether they want a bath or a shower and the time they wish to go to bed. A review of the placement takes place after six weeks through the placing care manager. The manager reported that reviews would be held if a person’s needs were changing. People who use the service have access to appropriate health services and see the GP, optician and dentist when required. Two people who use the service confirmed that they ‘always’ get the medical support they need. A clear medication policy is in place which covers the receipt, storage and recording of medication. Medication is securely stored and correctly labelled. Medication Administration Record Sheets were up to date and signed. The manager reported that both she and the owner have completed training in the administration of medication, although they are still waiting for the certificates. Cherry Tree House DS0000061858.V356080.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 People who use the service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to enjoy a full lifestyle. The daily routines are based around the individual’s wishes and choices. Routines are flexible and people can make choices in major areas of their life. People who use the service have the opportunity to develop and maintain important personal and family relationships. The menu is varied and meets people’s individual dietary, religious and cultural needs. EVIDENCE: The manager reported that the interests and likes of people who use the service are sought before they move in and kept under review if peoples likes change during their stay at Cherry Tree House. People were seen to sit and talk with the owner and manager, to talk amongst themselves, to read newspapers and magazines and to watch the television. People who use the service and the owner reported that during the summer months, they spend a lot of time in the garden and go out to local shops and garden centres. One person was thinking about going Christmas shopping, to Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 13 buy cards and gifts for their relatives and friends. One person was waiting for the good weather so they can get back into the garden. One questionnaire indicated that there are ‘never’ activities available and that it would be nice to have some offered. It may not be possible to offer a structured activities programme like larger homes, although the owner and manager could discuss with people what activities they might like to try in the home. The owner reported that people who use the service can attend local churches if they wish, although no one currently wants to do this. They could discuss with people who use the service about having representatives from local churches to visit the home and give a service or communion if people are unable to attend church. Relatives are welcome at Cherry Tree House and two people who use the service confirmed that they have regular visitors, who are always given drinks and offered cake. A varied menu if provided and people confirmed that ‘the food is very good’, and said ‘if I don’t like the meal, they will do something different’ and one person said ‘lunch was very good’. One lunchtime meal was seen to be enjoyed by all, with food looking and smelling appetising, with fresh vegetables and as one person said, good ‘home’ cooking. People were seen to be offered a choice of pudding and some people had pudding at the table, while others left the table and had pudding a little later in the afternoon. One questionnaire indicated that the person ‘always’ and one person ‘usually’ like the food. Cherry Tree House DS0000061858.V356080.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 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure, which is clearly written and accessible to people who use the service, their relatives and representatives. People are aware of how to complain. Policies are in place for the protection of vulnerable adults. The owner has completed training in adult protection and the manager is due to complete this training. EVIDENCE: A complaints procedure is in place which is accessible to people who use the service and their representatives. Two questionnaires indicated that people are aware of how to make a complaint and who they should speak to. People did not have any concerns but were confident that the owner, the manager or their relatives would sort things out if there was. No complaints have been received at the service or by CSCI. A policy is in place for the protection of vulnerable adults. The owner has completed distance learning on issues relating to protection, although they have not received the certificate of attendance. The manager reported that they are due to complete the local authorities training on protection in December 2007, although we have not received evidence to confirm that this training was completed. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 15 At the last two inspections Requirements have been made for the owner and manager to attend training in the protection of vulnerable adults, evidence to confirm that this has been completed is not available. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 16 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, 21, 24, 25 and 26 People who use the service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The owner and manager have ensured that the physical environment of the home provides for the individual requirements of the people who use the service. The living environment is appropriate for peoples lifestyles and needs and is homely, clean, comfortable and well maintained. People who use the service are encouraged to bring personal possessions. Single bedrooms provide privacy. Bathrooms are homely and meet the needs of people who use the service. Sufficient toilets are provided. EVIDENCE: People have access to a lounge with comfortable chairs, a television and stereo. The dining area overlooks the garden, which for one person ‘is very important’ to be close to. All areas are maintained and decorated to a high standard. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 17 Bedrooms are single and people are encouraged to personalise their rooms with photographs, pictures and belongings. One person was very happy that they had brought their belongings, because it made them more ‘at home’. One person said ‘it is close to home, but not quite the same’. People who use the service were seen to be comfortable in their bedrooms and communal areas. A toilet and shower are available on the ground floor with a bathroom with toilet on the first floor. People were pleased to have the choice of having a shower or a bath, although most people prefer the shower. Two questionnaires indicated that the home is ‘always’ fresh and clean. All areas of the home were seen to be clean and people who use the service that ‘it’s always like this’. The manager reported that they aim to improve the garden for the summer months. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 18 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 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service have confidence in the staff that care for them. No staff are employed, the owner and manager provide care and support with one person at the home at all times and both there most afternoons or evenings. These levels were seen to be sufficient to meet the needs of people who use the service. Some core training remains outstanding. EVIDENCE: The owner continues to live at the home and the manager comes in most days. The manager reported that they do not employ staff, that they have a close friend who helps cover a few hours every so often on an adhoc basis but that they are not employed. The manager is aware of what is required when they recruit staff and the checks that have to be made before a person starts work at the home. People who use the service made positive comments about the owner and the manager and the help and support they receive. Their comments included ‘staff help and listen’, ‘the carers are good’, ‘spot on’ and ‘nothing is too much trouble’. Two questionnaires indicated that staff ‘listen and act on what is said’ and that staff are ‘always’ available. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 19 A formal handover of information is not required due to the small size of the home and the small number of people involved in providing care. The owner and manager reported that they are in constant communication with each other and are able to discuss any issues or concerns. The training that the manager reported was due to be undertaken in January and March 2007 in adult protection, infection control and risk assessments did not take place. Both the owner and manager have completed distance learning in medication administration, and the owner has completed distance learning in first aid, fire safety, food hygiene and infection control. It was suggested that the owner and manager utilise training provided by the local authority and make links with other small homes in the area to see how they manage to keep up to date with training. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 20 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, 35, 37 and 38 People who use the service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has the necessary experience to run the home. Some training remains outstanding and must be completed to ensure people using the service receive appropriate care. Checks show that records are up to date. Health and safety checks are completed at the required intervals with one exception and records are up to date. EVIDENCE: The owner has previously run a small care home and has a number of years experience working with older people. The manager has worked in care homes and has been involved in this home since it registered and opened over two years ago. The manager reported that she is due to start NVQ to level 4 in Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 21 January 2008. The owner and manager both demonstrated a good knowledge and understanding of the needs of older people and how to ensure the home works with the CSCI to provide a good service. The owner and manager are available to people who use the service and their representatives to discuss any issues and make any suggestions for the future of the service. The manager reported that they do not hold any finances for people who use the service. Health and safety checks are completed as required with the exception of the portable electrical appliances which must be tested every year. The gas safety check was completed in November 2007. The electrical supply was tested in April 2005 as a part of the registration process. Appropriate insurance is in place. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 22 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 3 X 3 X 3 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 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 4 4 3 X X 4 4 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 X 2 2 Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP38 Regulation 13(5) Requirement Certificates confirming attendance at training in lifting and handling must be available to evidence training has been completed. Certificates confirming attendance at training in the Protection of Vulnerable Adults (POVA) must be available, to evidence that training has been completed. The Registered Persons must ensure that all staff working at the home receive training in first aid first aid, fire safety, food hygiene and infection control. (previous timescale of 31/08/06 not met) Portable electrical appliances must be tested every year to ensure people who use the service, visitors and staff are protected from harm. Timescale for action 08/02/08 2. OP18 13(6) 08/02/08 3. OP38 13(4)(c) 08/02/08 4. OP38 12 (1) a 08/02/08 Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 24 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 OP38 Good Practice Recommendations The temperature of the hot water from all outlets around the home should be tested regularly and recorded, to ensure that people who use the service are protected from harm. Cherry Tree House DS0000061858.V356080.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. 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