Inspection on 18/04/07 for Cherry Tree Lodge

This inspection was carried out on 18th April 2007.

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

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

Other inspections for this house

Cherry Tree Lodge 20/04/06

Cherry Tree Lodge 08/11/05

Cherry Tree Lodge 27/06/05

Cherry Tree Lodge 30/03/05

Cherry Tree Lodge 17/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Cherry Tree Lodge 133 Macaulay Drive Lincoln Lincs LN2 4ET Lead Inspector Mr Toby Payne Key Unannounced Inspection 18th April 2007 08:55 Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 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 DS0000002605.V335004.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 Adults 18-65. 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 DS0000002605.V335004.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree Lodge Address 133 Macaulay Drive Lincoln Lincs LN2 4ET 01522 545580 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) info@prime-life.co.ukwww.prime-life.co.uk Prime Life Limited Ms Debra Jayne Mogg Care Home 19 Category(ies) of Learning disability (19), Learning disability over registration, with number 65 years of age (19) of places Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of persons to be accommodated at Cherry Tree Lodge is 19 20th April 2006 Date of last inspection Brief Description of the Service: Cherry Tree Lodge is situated on a residential housing estate approximately one and a half miles north of the city centre of Lincoln. It is close to local facilities and has public transport links to the city centre. The home is registered for nursing and personal care to 19 people with a learning disability. Accommodation is provided within a large two-storey house. The first floor is accessible by lift. There are 15 single bedrooms, and 2 double rooms, none of which have en-suite, but they have wash hand basins. There are two lounges, an activity room and a dining room. The grounds are enclosed and private. They are laid to lawns at the front and side of the property, with car parking to the rear. The fees at the inspection on the 18/4/2007 ranged from £397 to £540 each week. Extra costs were hairdressing £6.50 to £12, reflexology £20 each session and transport £11.65 each week. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.55 am. It was undertaken using a review of all the information available to the inspector about Cherry Tree Lodge Care Home. It took place over 6 hours. The inspector spoke to 5 members of staff, one visitor, the deputy manager and manager of the home and a nursing student on placement in the home. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with the care staff and observation of their care practices. A random unannounced inspection visit took place on the 16/8/2007 to follow up requirements and concerns from the previous key inspection. All requirements had been addressed and improvements had been seen. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People coming into the home receive an assessment and know their needs can be met. There is information provided to enable them or their relatives/advocate to make a decision whether or not to come into the home EVIDENCE: No new person had been admitted since the last random inspection in August 2006. There was a detailed statement of purpose and service user’s guide. The manager explained that where a request for admission occurred then the home would obtain as much information about the person and the manager meet the person and assess their needs. If acceptable written confirmation would be sent to confirm the home could meet the person’s needs. . Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care records have improved since the last key inspection. There was now detailed care planning which included risk assessments. As a result care is more person centred. People are encouraged to make decisions for themselves with the support and guidance of staff. EVIDENCE: Since the last inspection progress has continued to review and improve the care planning in the home. Two residents care records were examined. The information contained a photograph, admission details, “my health action plan”, social health care, contract, profile, physical health assessment (this was very detailed and person focussed). The care plan indicated, “needs help with”, “who will assist” and “the goal/outcome” of the care intervention. All entries were dated and signed by a member of staff. There was an evaluation entry for each aspect of care/support. Other information concerned mobility, falls prevention, weight, tissue viability, communication, eye care, mental health, behaviour, risk management, eating and drinking, nutritional risk assessment, sleep, my life, social inclusion and accommodation were also included. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 9 Care records were clear and detailed and up to date. Each care plan was reviewed every month with the key worker allocated to the person. Wherever possible this would also be reviewed with the resident. Since the last inspection efforts had been made to make care more individual and person focussed. Choice and decision making was clearly referred to in the care plans. There were also risk assessments included. Staff were seen to respond to residents in a positive manner. Resident’s financial records were checked and clear records were being kept. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Improvements had taken place in the activities and food provided by the home. Residents were involved/supported in meaningful, appropriate activities, which included recreational activities. There was a variety of nutritious food provided. EVIDENCE: Since the last inspection this aspect of the resident’s life has also been thoroughly reviewed. As a result of the change in services provided by Lincolnshire County Council’s Social Services, most activities continued to be home based.. However, some residents continued to attend the Mencap “Forget me not Club” and Fen Lane day centre two days a week. As a result of these changes the manager had introduced a review of in house activities. There was now a weekly programme, which was always subject to change. On the week of the inspection this showed, music making, trips to local shops for coffee and cake, baking or play dough, football in the garden or Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 11 flower arranging, a residents birthday, out to local pub and hair and make up and male grooming. All activities taking place over a seven day period. The home has an access to a mini-bus every week. On the day of the inspection it was a hot sunny day and residents were sat out in the garden with staff, colouring, enjoying the weather, having their lunch and later on a game of connect four was taking place with music playing and laughter. In the house staff were playing music and singing. Residents showed alertness with smiles and no sign of distress. Staff also promptly attended to their needs. The manager and staff spoke of the improvement seen in the behaviour, attention and increased sociability of the residents since these changes had taken place. Other activities planned were a visit to “Roll out the Barrel” at Retford on the 26/4/2007 and regular visits to the Pride of Lincoln “war time sing-along” with a fish and chip lunch. The manager had encouraged/empowered the staff to be more adventurous with activities and this had proved very successful. Since the last inspection a new cook had been recruited and had reviewed all the menus with the manager. As a result, there were more fresh vegetables and homemade cakes and puddings. This had also resulted in improvements. Residents were more lively and enjoying their food better. The manager is to take photographs of the food in the future so that the menu in picture form can be displayed for the residents. The last Environmental Heath Officers visit was on the 15/12/2006 and all the concerns had since been addressed. On the day of the inspection there were clear records being kept of food, cleaning and temperatures and the staff appropriately dressed and aprons outside the kitchen for staff to wear and the kitchen clean and well organised. A visitor commented that he was very satisfied with the care and support given. He visited every day, always received a warm and friendly welcome and had no concerns. He commented “It is a lovely home and the manager always had time for me”. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health and emotional needs are met. Medication storage and administration records have improved, to ensure that medication is administered to residents safely. EVIDENCE: The home operated a “key worker” system in order to give a specific member of staff responsibilities for a particular resident. Care records showed that any health or emotional needs were being met either by the community nurse or GP, psychiatrist, physiotherapist, occupational therapist and/or reflexologist. Staff also showed knowledge of the particular needs of the residents. There were no major healthcare issues. The home used a pre-dispensed system for medication administration. Medication storage was in a clinical room which was well organised. Since the last key inspection much has been done to improve the medication arrangements in the home. Records were being kept of the temperature of the clinic room and refrigerator. Medication records were well maintained with records of medication coming into the home, administration and disposal. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 13 There were arrangements for optical and dental provision. Staff were seen to be offering flexible personal support, and maintaining privacy and dignity whilst providing personal care. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Any complaints received were taken seriously and residents are protected from abuse. People feel that their views are listened to EVIDENCE: No complaints have been received by the home or the commission since the last inspection. There was a clear complaints policy available in writing with symbols. This was displayed in the home. Staff were also made aware of this in the detailed staff handbook. Staff knew what they should do if they received a complaint. The home had informed the commission in December 2006 of an adult protection issue regarding a resident’s disability living allowance (DLA). The manager explained that all DLA are paid into a Prime Life account but there is a separate account for Cherry Tree Lodge with details of each service users’ DLA. There was a clear audit trail and a monthly statement. It was also audited every 6 months. There were no concerns about the way the home had acted over this issue. Staff also knew what abuse was and what they should do if they suspected abuse was taking place. This was also covered as part of the Learning and Disabilities Awards Framework. Records for 2 staff were examined. The records showed separate files for each person with application form, 2 references, Protection of Vulnerable adults (POVA) and Criminal Records Bureau (CRB) checks, photograph, birth Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 15 certificate, terms of employment, employee handbook, policy and procedures, skills for care induction booklet and the General Social Care Council codes of practice. The Learning and Disabilities Awards Framework was part of their induction programme. Staff spoke of receiving a supported and detailed induction. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have taken place throughout the home to improve the environment and the quality of life. People live in a safe, clean and a well decorated comfortable home. EVIDENCE: Since the last inspection a great deal has taken place to improve the environment in the home. All bathrooms and toilets had been repainted in bright colours. One of the shower rooms had been converted into a wet room. Five bedrooms had been repainted with wherever possible discussion with the residents. Bedrooms have been made more individual and personalised. Residents had been taken out to buy new clothes. Pictures, collages and photographs haven been put on walls to give more personal touches to their rooms. New laminate flooring had been laid in the 2 lounges and dining area and in one bedroom. A number of bedrooms had also had new carpets. The kitchen had also been repainted. The staff remarked that this has had a major improvement in the lives of residents. Staff spoke of one person who would not sleep in his bedroom who now slept and was much happier and content. The home was clean, comfortable and odour free throughout. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are safe levels of staff and staff know how to meet the resident’s needs. There was an educated and committed team of staff. EVIDENCE: There continued to be a stable work force and staff showed awareness of the needs of the residents and acted in a professional manner. Two staff had commenced work since the previous random inspection as well as a new cook. The manager monitored the dependency and staff felt they had enough time to care and support the needs of the residents. There were no staff vacancies. Staff were undertaking the Learning and Disabilities Awards Framework, which covered positive communication, learning disability, safe practice and understanding abuse. Out of 22 care staff, 5 had obtained a qualification in care (National Vocational Qualification), 3 were studying for this and a further 3 staff were to start NVQ training during April 2007. There was therefore 46 of the staff who either had NVQ level 2 or were studying or about to start studying in the future. This was just below the 50 required. The deputy manager was also to start the studying for a management qualification in the near future. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 18 Training since the last random inspection had included moving and handling, fire prevention, COSHH, food hygiene, LDAF (Learning and Disabilities Awards Framework), first aid due 20/4/2007 and safe handling of medication. In addition, the home is a placement for nursing students from Nottingham University. One was present during the inspection and said she had learnt a lot from the placement, had a very good mentor and had received a great deal of support. Staff were very enthusiastic about the changes, which had taken place and spoke of feeling empowered, supported and working as a team. This was evident throughout the inspection. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have taken place since the last inspection to the running and day to day life in the home. The home is well lead by a competent and committed manager. This in turn has given rise to a confident, supported and trained staff team. EVIDENCE: Since the last inspection a new manager had been appointed and registered by the commission in January 2007. Although not a nurse she was ably assisted by her deputy who is a nurse and team of very experienced nurses. The manager had wide experience of both practice and managing people with mental health issues. She had obtained a management and care qualification to NVQ level 4 standards. She spoke about refocusing the home and staff on looking and supporting the people living in the home. A great deal of changes had taken place since December 2006. All staff spoke of the improvements Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 20 seen and how this had benefited the staff and residents. No one had any complaints. Staff received regular supervision every 2 months and there were regular staff meetings. Prime Life last carried out a quality assurance survey in 2006 and results were displayed in the hallway. In addition, internal audits took place concerning personnel, finance, property, medication and care records. Prime Life also made monthly unannounced monitoring visits and detailed reports were available in the home. There had also been a contract monitoring visit on the 22/2/2007 by Lincolnshire County Council’s contracting dept. There were no concerns. The manager hoped to further improve the quality in the care records and make them more person focused. She had also tried to improve, with success, relations with the local community. All hot taps had thermostatic mixing valves (some had one serving 3 basins). Records were well maintained and available. The manager did not think there was an equality and diversity policy but equal opportunities were covered in the staff handbook. Staff showed sensitivity and skill in managing and supporting the needs of the residents. There was a detailed health and safety policy and risk assessments were up to date and evident in the resident’s care records. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 X X 3 x Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 22 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA40 Good Practice Recommendations It is recommended that the company introduce a diversity and equality policy, which complements the information in the staff handbook. Cherry Tree Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincolnshire Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Lodge DS0000002605.V335004.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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