Inspection on 10/01/06 for Cherry Tree Lodge

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Lodge 13/11/06

Cherry Tree Lodge 23/08/05

Cherry Tree Lodge 21/12/04

Cherry Tree Lodge 26/10/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Cherry Tree Lodge 226/228 Bury Road Rawtenstall Lancashire BB4 6DJ Lead Inspector Mrs Julie Playfer Unannounced Inspection 10th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 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 Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cherry Tree Lodge Address 226/228 Bury Road Rawtenstall Lancashire BB4 6DJ 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) 01706 224868 Cherry Tree Lodge Limited Care Home 22 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (3), Old age, not falling within any other of places category (18) Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Within the overall total of 22 :A maximum of 18 people requiring personal care who fall into the category of OP (Old Age, not falling into any other category over 65 years of aged). A maximum of 3 people requiring personal care who fall into the category of DE(E) - (Dementia, over 65 years of age). 1 person requiring personal care who falls into the category of DE(Dementia under 65 years of age) Date of last inspection 23rd August 2005 Brief Description of the Service: Cherry Tree Lodge is registered with the Commission for Social Care Inspection to provide personal care and accommodation for 22 older people within the following categories: Mental Disorder, excluding learning disability or dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (18). The premises are detached and situated in their own grounds with car parking facilities to the side. There is also an enclosed and well-maintained garden area. The home is located on the main Bury Road and is close to local shops. Approximately half a mile away is Rawtenstall town centre with main shops, a library, banks etc. Bury Road is situated on a main bus route that offers transport to all towns in the Rossendale Valley area. Accommodation is provided in 14 single and 4 double rooms situated on two floors, the first floor being accessed by a passenger lift. Communal space is provided in two lounges, a conservatory and a dining area. Smoking is permitted in the staff room. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over seven hours on 10th January 2006. The previous inspection was carried out on 23rd August 2005. No additional visits have been made to the home since the last inspection. On the day of inspection there were 20 residents accommodated at the home, plus two additional people receiving day care. Information was obtained from staff records, care records and policies and procedures. The inspector also spoke to the residents, the staff on duty and Mrs Testa, the registered person, who manages the home on a day to day basis. A partial tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? Since the last inspection all residents had been issued with a copy of the service users guide and the registered person had informed prospective residents in writing that following the assessment of needs the home was suitable for meeting their needs. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 6 There was evidence to indicate that the residents’ relatives had been involved in the care planning process and it was noted that separate and individual risk assessments had been added to the care plans. The activities in the home had been developed in line with suggestions from the residents and arrangements were in place to ensure the residents had the option to join in an activity every afternoon. The registered person had maintained a record of meals served to residents, which clearly demonstrated that the residents’ were provided with a varied and nutritious diet. The complaints and vulnerable adults procedures had been reviewed and updated. 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 Lodge DS0000009644.V271192.R01.S.doc Version 5.1 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 Lodge DS0000009644.V271192.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3 and 4 The admission procedure was well managed. Residents were provided with appropriate written information and received assurances their needs could be met by the home. EVIDENCE: Written information was available for residents in the form of a statement of purpose and service users guide. Both documents met regulatory requirements and were presented in a readily accessible format. Since the last inspection all residents had been provided with a copy of the service users guide. All residents were issued with a comprehensive statement of terms and conditions of residence, which included details about fees, insurance and the complaints procedure. The residents’ files viewed during the inspection demonstrated that the registered person or a member of the management team had carried out preadmission assessments, which compiled with standard 3.3. Social work assessments were also carried out for those residents who were admitted Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 9 under care management arrangements. Following the assessment the registered person had informed prospective residents in writing that the home was suitable for meeting their needs. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 and 10 The care planning system addressed the needs of the residents and provided clear guidance to staff on how these needs were to be met. Care practice took full account of the residents’ rights to privacy and dignity. Appropriate systems were in place for the management of medication. EVIDENCE: The individual files of three residents were seen during the inspection. It was evident each resident had a care plan based on an assessment of needs. The plans set out in detail the action needed to be taken by staff to ensure all needs were met. It was apparent the plans had been reviewed and updated in line with the residents’ needs. It was noted that the care plans had been signed by the residents’ relatives, where appropriate. Since the last inspection, separate and individual risk assessments had been incorporated into the care plan documentation. The residents’ files seen showed that their health was monitored and promoted and they had access to all necessary health care facilities. Specialist advice had been sought as necessary in line with the needs of the residents for instance the continence nurse. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 11 The residents’ rights to privacy and dignity were respected. Staff were seen being respectful and kind to residents, and in discussion with the inspector demonstrated an understanding and knowledge about the importance of these matters. All residents who were spoken with stated that staff treated them appropriately and respected their right to privacy. The home had several policies and procedures relating to medication, however, these provided general information and did not reflect the systems operational at Cherry Tree Lodge. The home operated a monitored dosage system of medication, which was dispensed into cassette trays. Appropriate records were in place to document the receipt, administration and disposal of medication. Staff had received in-house training but had not attended an accredited training course. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 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 the following standard(s): 12, 13 and 15 Residents were able to make choices about their life at the home so that their lifestyle met their preferences. Resident’s social, cultural and recreational needs were met through links with their family and friends being maintained and opportunities to undertake activities both inside and outside the home. The meals offered at the home were varied and nutritious and to the liking of the residents. EVIDENCE: The residents said the daily routine was flexible and they were able to get up and go to bed at a time of their choosing. The plan of care gave information of the resident’s preferred daily routine and for staff to support residents to make decisions wherever possible. The residents’ interests were documented in the care plans. A range of activities were planned and implemented by staff. Activities arranged in the home included music and movement, dominoes, singing, themed discussions, quizzes and a film night. Residents were also involved in activities outside the home, which included occasionally going the pub and visiting family and friends. Since the last inspection the activities arranged in the home had been developed in line with suggestions made by residents. A record was maintained of activities and forthcoming events were posted on a notice board. A “shop” had also been introduced to allow residents to buy small items of their choice. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 13 All the residents spoken to said they enjoyed the many activities and they looked forward to them in the afternoons. Resident’s meetings were held approximately once a month and a record was made of the discussion and any agreements made. There were no restrictions made to visiting. The residents were able to entertain their guests in any area of their choice. A visitor spoken to on the day of inspection said she was “very satisfied” with the level of care her relative received in the home. The residents were satisfied with the quantity and quality of the meals, which were homemade. Residents spoken to described the food as “lovely” and “very nice”. Drinks and snacks were available at set times throughout the day and evening and at all other times on request. Since the last inspection, a record of actual meals served to residents had been maintained and it was clear from this record that residents were provided with a varied and nutritious diet. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 Systems were in place to ensure any concerns of residents would be listened to and acted upon. The procedures at the home ensured residents were protected from harm. EVIDENCE: Since the last inspection the complaints procedure had been updated to include the timescales for the complaint process and the contact details of the Commission for Social Care Inspection. The complaints procedure was included in the service users guide, which had been distributed to each resident. The procedure relating to the protection of vulnerable adults had also been updated to include details about the role taken by Social Services in the event of any allegation or suspicion of abuse. There was a whistle-blowing procedure for staff use. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 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 the following standard(s): 19, 22 and 26 The residents were provided with a clean, comfortable and well- maintained environment, which was furnished and decorated to a good standard. EVIDENCE: Cherry Tree Lodge is a detached house set in its own grounds. The home is located close to local shops and other amenities. Accommodation is provided in nineteen single bedrooms and four shared bedrooms. Two of the bedrooms have ensuite facilities. The home also provides one assisted bath, one assisted shower, a shower room and five separate toilets. Communal space is provided in one lounge/dining room and conservatory on the ground floor and a quiet lounge on the first floor. It was evident from a partial tour of the home that residents had personalised their rooms with their own belongings and decoration was good throughout. The residents said their rooms were comfortable and warm. However, it was noted the alarm facility in room 2 was not operating properly and a temporary call bell had been placed in the room, which was not linked to the main system. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 16 The home was clean and odour free at the time of the inspection. A resident said, “The home is always kept very clean”. The systems for maintaining hygiene included procedures for infection control. Plastic aprons and gloves were available to staff when undertaking care duties. There was a separate laundry room, which had sufficient and appropriate equipment to meet the laundry needs of the number of residents accommodated. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The procedures for the recruitment of staff must be improved to ensure protection for the people living in the home. Good arrangements were in place to ensure staff received appropriate training in line with the needs of the residents. EVIDENCE: A recorded staff rota was completed in advance, which indicated which staff were on duty and how many hours they had worked. All staff providing personal care were aged over 18 and all staff left in charge of the building were aged over 21. The management team had developed and implemented a staffing formula based on the needs of the residents. This meant each individual had been assessed in relation to his or her dependency needs. The assessment took into account a wide range of needs, including emotional and social as well as physical. The registered person had also used this formula to ensure staff were effectively deployed within the home. All new employees undertook an in house induction programme. This provided underpinning knowledge for NVQ level 2. At the time of inspection the equivalent of 82 of the care staff were trained to NVQ level 2 or above. A member of the management team had completed NVQ level 5 in operational management. Staff also attended both internal and external training courses. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 18 A recruitment and selection procedure for the employment of new staff was not seen. One file was inspected of a member of staff new to the home. The person had completed an application form and attended for interview. However, there were shortfalls in the recruitment procedure, these included one reference which was obtained after the person had commenced working in the home and a reference not being sought from previous employment which involved work with vulnerable adults. Appropriate police checks had been carried out prior to the person commencing employment. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 36 Staff and residents enjoyed positive relationships, which promoted an open and friendly atmosphere. In order to safeguard the residents, attention must be given to the systems in place to record financial transactions. Quality monitoring systems must be improved in order to monitor outcomes for residents. EVIDENCE: The registered person had the overall responsibility for the management of the home and had many years experience of caring for older people. The registered person had previously undertaken nurse training, but had not completed an NVQ 4 in Management and Care. Relationships within the home were good and staff spoke about the residents with respect. The residents valued the help and support they received from the staff, who they described as “kind, caring and helpful”; one person also said, Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 20 “you couldn’t get a better class of girls”. The staff received group supervision but had not received individual supervision. However, it was noted the registered person had plans to introduce a mentoring system. The home had achieved an Investor’s in People Award. In addition to Residents’ Meetings, informal systems were in place to seek the views of residents and their visitors. Satisfaction questionnaires had not been distributed to residents or their relatives. Systems to monitor the quality of the service were limited and the registered person had not devised an annual development plan. The systems in place to record money deposited with the home on or behalf of a resident were confusing and unclear. It was also noted that, according to the records, the money left with the home for safe-keeping was not available for access. There were no records seen of payments received from residents in respect of fees, apart from a statement produced by Social Services. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 1 2 X X Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 22 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. 2. Standard OP22 OP29 Regulation 23 (2) (c) 17, 19 Timescale for action The alarm facility in room 2 must 28/02/06 be repaired and linked to the main system. All records and documentation 10/01/06 relating to the recruitment of new staff must be collated and maintained in line with the requirements of the Regulations. (Previous timescale of 23/08/05 – not met). An annual development plan 01/05/06 must be devised based on a systematic cycle of planning, action and review, reflecting the aims reflecting the aims and outcomes for service users. There must also be continuous monitoring, using an objective, consistently obtained and reviewed and verifiable method (preferably a professionally recognised quality assurance system and involves the service users and an internal audit takes place at least annually. (Previous timescale of 01/12/05 – not met). Feedback must be sought from 28/02/06 service users about the services DS0000009644.V271192.R01.S.doc Version 5.1 Page 23 Requirement 3 OP33 24 4. OP33 24 Cherry Tree Lodge 5. OP35 17 Sch 4 (9) 6. OP35 17 Sch 4 (8) 18 7. OP36 provided in the home, through for example the use of anonymous user satisfaction questionnaires and individual and group discussion. (Previous timescale of 15/11/05 – not met). The records on money deposited with the home by or on behalf of a resident must be clear. Any money being held for a resident must be available at all times. A record must be maintained of all charges made of residents and all payments received in respect of fees. Staff must be appropriately supervised and receive formal supervision at least six times a year. (Previous timescale of 23/08/05 – not met). 10/01/06 10/01/06 01/02/06 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. 4 5. Refer to Standard OP9 OP9 OP29 OP31 OP33 Good Practice Recommendations The policies and procedures relating to medication should be updated and fully reflect the systems operational at Cherry Tree Lodge. All staff designated to administer medication should attend an accredited training course. A recruitment and selection procedure should be devised and implemented. The registered person should complete an NVQ 4 in both management and care. The results of residents surveys should be collated and made available to residents and their representatives and other interested parties. Cherry Tree Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Lodge DS0000009644.V271192.R01.S.doc Version 5.1 Page 25 - 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!