Inspection on 18/07/07 for Cherry Tree Lodge

This inspection was carried out on 18th July 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 24/03/09

Cherry Tree Lodge 16/02/07

Cherry Tree Lodge 27/06/06

Cherry Tree Lodge 23/01/06

Cherry Tree Lodge 26/09/05

Cherry Tree Lodge 21/03/05

Cherry Tree Lodge 18/11/04

Cherry Tree Lodge 01/03/04

Cherry Tree Lodge 04/12/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor 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 100 Wick Lane Southbourne Bournemouth Dorset BH6 4LB Lead Inspector Debra Jones Key Unannounced Inspection 18th July 2007 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 DS0000003929.V346454.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 Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree Lodge Address 100 Wick Lane Southbourne Bournemouth Dorset BH6 4LB 01202 429326 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) Mrs Audrey Martha Watts Mr John William Watts, Mr Simon John Watts Mr Simon John Watts Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2007 Brief Description of the Service: Cherry Tree Lodge is registered as a care home, providing accommodation for up to twenty older persons. The home is situated in a quiet residential area of Wick, approximately 10 minutes walk from the shops and facilities of Tuckton. The home is registered in the name of Mr and Mrs Watts and their son, Mr S Watts. Mr S Watts is in day-to-day charge of the home. Accommodation at Cherry Tree Lodge is arranged over two floors. On the ground floor there are nine single bedrooms all with en-suite WC and wash hand basins. There is also a communal bathroom with WC and two further communal lavatories. On the first floor there is one double and nine single bedrooms all with en-suite WC and wash hand basin. Two also have baths in the en-suite facilities. All bedrooms have been personalised by their occupants and reflect individual taste. The communal space on the ground floor comprises a lounge with adjoining dining room. Both rooms are attractively furnished and have a welcoming, relaxed atmosphere. A stair lift is available to assist residents between floors, leaving just one step to negotiate to access the first floor. There are also some other single steps around the home. The home has level, well-maintained gardens surrounding it and limited off road parking. There is also ample parking on the roads surrounding the home. The home has a number of pets including a cat, dogs and a parrot. Fees range from £431 to £450 per week. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 18 July 2007. Debra Jones was the inspector who carried out the visit. Simon Watts (registered manager) and staff at the home helped the inspector in her work. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for and to review progress in meeting requirements and recommendations made as a result of previous inspections. The inspector was made to feel welcome in the home throughout the visit. A tour of the premises took place and a variety of records and related documentation was examined, including care records. Time was spent talking with residents and relatives in the lounge and in their rooms. Two new requirements were made as a result of this visit. Some good practice guidance was discussed at the inspection and is referred to in the report, intended to encourage improvement in an already well-rated service. The management of the home has demonstrated through their recent success in complying with previous requirements that there is capacity for the service to further improve. The following are comments from residents on the day of the visit. ‘We are extremely well looked after.’ ‘It could not be better.’ ‘I have everything I need.’ ‘We manage well here. It is a good set up.’ ‘I am happy here and my sons welcome me staying here and not being alone.’ ‘We are well fed, well cared for and looked after.’ ‘I am very happy, I’ve been here 2 years.’ ‘It is a home from home.’ ‘I can’t think of anything they could do better. If you want anything they do it immediately. ‘ ‘Hard to think of anything they could do better. There are always smiling faces asking how you are.’ Prior to the inspection the home submitted to the Commission a thoroughly completed annual quality assurance assessment (AQAA). This gave information about the service and its performance. This document was also helpful in the planning of the inspection visit. The home also sent out comment cards on behalf of the Commission. Seven were returned by residents, 2 by relatives and 3 by GPs. When asked ‘what do you feel the care home does well?’ Relatives commented as follows:- Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 6 ‘Making it a ‘home’ for the residents. Good home- cooked fresh food. I particularly like the animals (dogs, cat, parrot) that are in the home – again making it more like a home for residents. I appreciate being offered a cup of tea when I visit – a small gesture but my friend enjoys sitting and having a ‘cup of tea and a chat’ with me!’ ‘Mum is well fed, her clothes are kept clean.’ What the service does well: Cherry Tree Lodge provides a homely, relaxed and comfortable environment with a welcoming and friendly atmosphere. The home is well presented and has attractive gardens. Pre-admission assessments are carried out to ensure that only people whose needs can be met are offered places at the home. The outcome of such assessments is confirmed in writing, so prospective residents are fully assured that their care needs will be met. Cherry Tree Lodge has a care planning system in place to ensure that staff have the information they need to meet the health and personal care needs of residents. Residents also get good support from community health professionals, such as GPs and district nurses. Staff were observed throughout the inspection to be treating residents with courtesy, patience, kindness and respect. Residents confirm that they are treated with respect and their right to privacy is upheld. Residents are supported in maintaining contact with family and friends and appropriate assistance is given to enable them to retain their rights to exercise choice and control over their lives wherever possible. Activities and entertainment are available. Residents are able to have visitors whenever they like. All spoke highly of the food provided at Cherry Tree Lodge and residents can choose where to eat their meals. The complaints and adult protection procedures reassure residents and their representatives that the well-being and comfort of residents is important to the home and that any concerns raised will be properly investigated and resolved. Ongoing investment in the home results in an attractive, well-maintained comfortable and safe environment for residents. Bedrooms vary in size; all are well decorated and most people have taken the opportunity to personalise their bedrooms with their own items of furniture, furnishings, pictures and plants etc. The home is kept clean and smells pleasant. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 7 The staffing level is good and allows time for staff to spend time with residents. The home is well managed and organised with the care, contentment and safety of residents being central to the way the home is run. What has improved since the last inspection? What they could do better: Care plans should be formally reviewed at least once a month and a record made of this to ensure that staff are fully up to date with the residents’ needs. These plans can be further improved by adding how the home is to meet the social needs of the residents. Some improvements are needed to the medication system to underpin the safety of the system and minimise any risks to residents of not getting their medication as prescribed. For example medication records must only be completed when it is clear that the resident has had their medication; whenever medicine is administered staff must sign to say this has been done; when making handwritten changes to printed medication administration records to get a second competent person to check the changes and countersign to confirm them; there must be an assessment in place that is regularly reviewed for residents who look after their own medication. The home should also obtain a thermometer that records the minimum and maximum temperatures of the fridge that any medication is stored in. Eye drops should be kept as per their labelled instruction when they have been opened. The programme of training a minimum of 50 of care staff must be continued to help ensure that staff have the necessary skills and competencies to look after residents. It would be good if the manager completed his National Vocational Qualifications in management and care at level 4. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 8 In addition to the requirements and recommendations made in this report the following good practice suggestions are made that the home is urged to adopt and act upon. The home is encouraged to • Update the Statement of Purpose to add more information about the limitations of the building e.g. the steps around the home. • Access the clinical tools available on the CSCI website relevant to the care of residents in the home e.g. clinical triggers for the prevention and management of falls in older people; management of nutritional care; management of continence. • Keep daily records of what residents eat at the evening meal. • Provide liquid soap and paper towels for staff to use when washing their hands. • Ensure the floor to the laundry area is impermeable. • Develop a recruitment procedure based on what the home does and the documentation that has to be obtained. • Make sure that staff are aware, through inclusion in a policy, of the potential of them being referred to the Protection of Vulnerable Adults list should they be dismissed for abuse. • Update the home’s infection control policy with recent guidance from the Department of Health. • Review and update policies and procedures annually, noting when this is done. • Keep inventories of all furniture brought to the home. • Check that signs around the home e.g. door to be kept locked, are accurate and relevant. 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 DS0000003929.V346454.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough pre admission procedure is in place and assessments are routinely undertaken to ensure that only residents whose needs can be met by the home are offered places there. EVIDENCE: Two residents were spoken with who had recently moved to the home. One was there for a respite stay and the other on a long term basis. Both had families who had helped them find, and move into the home. One resident had visited the home, seen the room on offer and generally looked around. Their files were reviewed and both demonstrated that prior to moving to the home, their care needs had been assessed by the home. The outcome of these Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 11 assessments had been confirmed in writing, so these prospective residents were fully assured that their care needs would be met. Prior to the visit the home sent comment cards out on behalf of the Commission to find out what people thought about the service. One resident wrote about their experience of first coming to the home. ‘This home was recommended to my niece’s husband by a very old friend who lives in Poole. I was brought to see it. It was so clean and bright and we were received by a charming person. I was shown an extremely pleasant and bright room. I thought it was a very good home. I have never been disappointed.’ Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: All residents have a care plan based on a series of relevant assessments. A number were reviewed relating to the people spoken with. Files were well laid out and risk assessments had been undertaken. It was clear that reviews were being undertaken and plans updated with changes but this was not always on a monthly basis, and a simple method for doing this was discussed. When asked ‘do you get the care and support you need?’ 6 of the 7 residents who returned comment cards prior to the visit replied ‘always’ and 1 ‘usually.’ ‘very much so!’ Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 13 Evidence was available on file and through discussion with staff that GPs, district nurses and chiropodists come to the home whenever the need arises. All seven residents who returned comment cards said that they ‘always’ received the medical support they needed. ‘Of course I do.’ ‘The doctor is called when needed. He or she comes immediately after surgery.’ At the visit residents confirmed these views. ‘If you are worried the District Nurse comes and looks at you, or they call the Doctor.’ ‘They ask for a GP if needed.’ GP surgeries that returned feedback to the Commission prior to the inspection visit were all positive about the home and the care delivered there. Residents said that they had confidence in the way the home looked after their medication for them. The home has a written policy and procedure regarding the receipt, recording, storage, handling, administering and disposal of medicines. A local pharmacist supplies the medicines and provides computer generated Medication Administration Record (MAR) sheets. The manager said that they had asked their pharmacist for patient information leaflets relating to the medicines the residents are taking. A number of medicines and administration records were reviewed. In all cases the number of tablets on the premises accorded with how many there should have been, given the date of the visit and the date the medicines were delivered to the home. However there were gaps where those administering medication had failed to sign when medicines had been administered. In discussion it was established that the MAR sheets were being completed at the time the medication was put into containers to be given to residents rather than at the point it was confirmed that the resident had taken their medication, as should be the case. Not all handwritten entries / changes made to the printed MAR sheets were not countersigned by another competent person to confirm that the changes made were correct. Very little medication is kept in the main fridge. What is there is appropriately stored in a lockable plastic box. The home is not currently checking the fridge temperature to ensure that the medicine does not get too cold or too warm. Some eye drops that were in use were being kept in the fridge when they did not need to be, resulting in them being colder than necessary when put into the resident’s eyes. Where residents are looking after their own medication assessments were in place confirming the suitability of this system. Facilities are made available for residents to keep their medicines locked away in their rooms. All bedrooms at Cherry Tree Lodge are for single occupancy, giving residents opportunities for privacy Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 14 All residents spoken with said that their privacy is respected and that they were treated with dignity. ‘Do they respect my privacy and dignity? Oh yes!’ Staff were seen to treat residents with courtesy, patience, kindness and respect. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities is available for residents to participate in should they choose to. People are generally encouraged to make choices about their life style and to maintain contact with their family and friends. The meals in this home are wholesome and varied and are served in a pleasant environment. EVIDENCE: Cherry Tree Lodge provides occasional organised activities such as concerts from visiting musicians, exercise classes and various games such as bingo. In addition the home has a wide selection of cds, dvds and videos. A new, very large TV has been bought for the lounge. Increasing activities for residents is something that the home has identified for improvement in their annual development plan. Recently there have been more regular entertainers coming to the home. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 16 What people like doing with their time as well as their past and present interests are explored as part of the pre admission assessment. How the home is then to meet the social needs of residents is not routinely part of the care plan, despite this being a significant part of the lives of residents. Residents said that they were happy with what was provided in the home and most spoken to talked of enjoying their own company and that of their visitors, some spending their days reading and watching TV. ‘I prefer to sit and read quietly.’ (a resident) Of the 7 residents who returned comment cards 2 said that they it was ‘always’ the case that there are activities arranged by the home that they can take part in, 1 said that this was true ‘usually,’ and 4 said ‘sometimes’. The home has a visiting policy. Residents records and the visitors book demonstrate regular contact with family and friends. One resident spoken with said ‘My visitors are always welcome. There’s always tea and biscuits for them; they are very hospitable.’ A visitor commented ‘we are very happy with what we see.’ Residents are encouraged to pursue their own lifestyles within the home and make choices wherever possible. These include choosing when to get up and go to bed, what to wear, what to eat or drink and to generally do as they wish during the day. Many bring their own possessions into the home and personalise their bedrooms. Residents usually go to the dining areas for meals but can have meals in their own rooms if they wish. Notional menus seen show that residents get a varied and wholesome diet. Alternatives are always available, though not advertised. Records are kept of what people eat at lunchtime, but not supper. On the day of the visit lunch was roast beef with Yorkshire pudding, broccoli, carrots, swede and new potatoes. Pear and chocolate sponge with custard was for dessert. What is for supper is determined by how big a lunch the residents have. On the evening of this visit supper was to be a selection of sandwiches. Residents spoken with praised the food at the home ‘The food is very good.’ ‘The food is good, well cooked, varied and the meat is always tender. Everyday there are potatoes and two vegetables.’ ‘I have my breakfast on a tray in my room.’ ‘At tea time there is a choice.’ Five of the 7 residents who returned comment cards said that they ‘always’ liked the meals at the home, with 2 saying that they liked them ‘usually.’ Comments included: ‘Yes I do.’ ‘I do very much.’ Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 17 ‘Well cooked good food, fresh veg,’ ‘All meals are freshly cooked. Always good fresh vegetables and something different every day. Very good soup! Also excellent puddings and sweets.’ Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a complaints procedure. Policies and staff training in abuse protect residents from harm. EVIDENCE: Cherry Tree Lodge has a suitable complaints procedure. Since the last inspection no complaints have been made to the home or to the Commission. Residents spoken with on the day said:‘I have no complaints.’ ‘I have no complaints, but it’s not like home.’ The comment cards sent to residents asked the question ‘Do you know who to speak to when you are not happy?’ Seven residents sent back cards. Five answered ‘always’ to this question. ‘I have never been unhappy here.’ In respect of knowing how to make a complaint 6 residents said yes ‘always’ The home also has an adult protection policy and there is staff training in this topic from induction onwards. Prior to any members of staff commencing employment at the home the Protection of Vulnerable Adults list is checked to ensure their suitability. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 19 Policies do not currently alert staff to the possibility of them being referred to the Protection of Vulnerable Adults list (held by the Department of Health) should they be dismissed for abusive practice. ‘I feel safe here.’ (a resident) Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 20 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continued investment in the upkeep of the home results in an attractive, wellmaintained, comfortable and safe environment for residents. EVIDENCE: A tour of the premises confirmed that Cherry Tree Lodge is very well maintained. It is light and airy throughout and is furnished and decorated to a good standard. The atmosphere is homely and relaxed. There is an ongoing programme of refurbishment. There are communal WC’s, bathrooms and assisted baths are available. A number of bedrooms also have their own en-suite facilities. All rooms are centrally heated and have natural light and opening windows. Bedrooms are comfortably furnished and personalised to varying degrees. The Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 21 home is not currently keeping inventories of furniture brought into the home by residents. Residents generally expressed satisfaction with their rooms, one said. ‘My room opens to the garden, my outlook is so bright.’ There are a few steps around the home. While residents are able to get around the home with assistance, steps might stop people who are unsteady on their feet making their way around the home unaided. One resident commented ‘The girls are helpful with the steps. I keep my rollator to hand.’ It is suggested that the Statement of Purpose includes reference to the limitations of the building. Cherry Tree Lodge residents have all their laundry done on the premises and the home has suitable machines to launder clothes and bedding at appropriate temperatures. The laundry facilities could be improved through the floor of the laundry area, which is concrete, being covered with flooring that is impermeable. The home has an infection control policy. They are in the process of obtaining the most up to date guidance from the Department of Health e.g. Essential Steps to Safe Clean Care. Once they have got hold of this they will need to check that their policy is consistent with the guidance. Infection control practice could be improved by the provision of liquid soap and paper towels for staff to use when washing their hands. The home was clean and there were no unpleasant smells. Residents commented ‘When I first came to view the home it was so clean.’ ‘It is beautifully clean. My bedding is regularly changed and my room cleaned.’ ‘It is clean and comfortable and warm here.’ It’s kept clean.’ Six of the 7 residents who returned comment cards said that the home is ‘always’ fresh and clean, with the other saying that this was the case ‘usually.’ ‘Very.’ ‘Oh yes, definitely.’ ‘Here we are clean, comfortable, well cared for and well fed.’ Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are employed and deployed to meet the care needs of residents. Residents would benefit from more staff having National Vocational Qualification at level 2 in care so that care workers have the up to date skills and knowledge to look after them. EVIDENCE: Clear staffing rosters are in place that show who is on duty, when and what jobs they do. There are usually 2 care assistants on duty in the mornings (9am –3pm ) and 2 in the afternoon (3pm- 8.30). At times during the week there are more care assistants on duty to cover, amongst other things, cleaning duties. The assistant manager and manager work in addition to the care staff. Both have a ‘hands on’ approach to their work and are readily available to assist when needed. The preparation of meals is mostly done by the assistant manager. Two care staff are on duty at night. Residents spoken to at the visit praised the staff. ‘Staff are good and friendly.’ ‘The deputy manager is a godsend.’ ‘They are very helpful.’ Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 23 Well ordered staff records/ personnel files demonstrate the homes’ recruitment procedure in action. The files of two of the latest members of staff to join the home were reviewed. Documents that should be on file were. Prospective staff complete an application form and are interviewed. All files showed that CRB disclosures, POVA 1st checks and references are applied for and received prior to the commencement of duties. One of the three files reviewed did not contain a full employment history, and there was nothing on file to show that gaps had been explored and explained. Further files were reviewed in respect of overseas workers. All documentation relating to their rights to work and to be in the country were appropriately kept. It was suggested that the home develop a recruitment procedure based on the home’s process and the documentation they need to obtain. Fifteen care staff are employed at the home. Three have a National Vocational Qualification at level 2 in care, representing 20 . Another 4 staff are studying for this qualification. The Department of Health target is for 50 of care staff to have this qualification. An overview of training is kept that shows when staff have had training and in what areas they were trained. There was evidence to show that staff receive induction and foundation training to the industry standard ‘Skills for Care.’ Staff have training in a range of areas, including the core training that the home sees as essential for all staff, e.g. moving and handling, abuse, fire and food hygiene. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 24 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, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the daily management and running of the home centres round the care and contentment of residents. Good management practice, systems in place, and records kept, confirm the health and safety of people in the home. EVIDENCE: The home is managed by Simon Watts. Mr Watts has worked in care for many years. He is undertaking the desired training i.e. National Vocational Qualification (NVQ) at level 4 in care and management. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 25 One resident commented about the manager ‘The manager is marvellous, he is so good to me. I have four sons of my own.’ Prior to this inspection the home completed an annual quality assurance assessment (AQAA), which they submitted to CSCI. This identifies how the home have taken into account the views of residents and their supporters in the running of the home and sets out their plans for improvement over the next twelve months. In order to protect residents, it is the policy of the home not to have any involvement with their personal finances. All residents who are unable, or do not wish, to handle their own affairs, have a relative or other representative to do this for them. In practice the home pays for services such as chiropody and hairdressing and then invoices residents, relatives or representatives for payment. All records were available as requested at the inspection. An up to date insurance certificate was on display along with the home’s registration certificate. A supervision system has been set up and records are kept. The home is aiming to have at least 6 supervision sessions with each member of staff every year. These sessions look at practice in the home and assist both the supervisor and supervisee to identify training needs. Meetings take place giving staff the opportunity to share their views on the home. Practices at the home are underpinned by a good range of policies and procedures. It was not clear when these had last been reviewed, though it was thought to be 2006. Accident and incident records are kept. By the end of the visit accident reports were up to date and all accident record forms accounted for. Appropriate notifications about incidents and accidents are made to other bodies. Examination of the fire records showed that appropriate procedures are in place to ensure the safety of residents and staff. Regular maintenance of the fire warning system, emergency lighting and fire fighting equipment is taking place. Routine checks are carried out at appropriate intervals. Staff fire training and fire drills are also carried out to ensure all are fully aware of what to do in the event of fire. The fire risk assessment has been updated and submitted to Dorset Fire and Rescue Services who last visited the home in July 2007. They have been previously satisfied with the standard of fire safety at Cherry Tree Lodge. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 26 At the last inspection there were concerns that not all fire doors were closing fully. This was not the case at this inspection visit. The home is urged to review the signs around the home e.g. ‘keep door locked shut’ to ensure that they are accurate in what staff need to be doing. Staff training in mandatory areas, including fire safety, health and safety, moving and handling, emergency aid, and basic food hygiene, is ongoing. Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 2. Standard OP29 Regulation 19 Requirement The registered person shall not employ a person to work at the care home unless he has obtained a full employment history, together with a satisfactory written explanation of any gaps in employment. Timescale for action 31/08/07 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 OP7 Good Practice Recommendations It is recommended that care plans are reviewed by care staff at least once a month, updated to reflect changing needs and current objectives for health and personal care and actioned. How the home is to meet the social and cultural needs of residents should be added to care plans. 2. OP9 The temperature of the fridge used to store medicines should be monitored daily using a maximum and minimum DS0000003929.V346454.R01.S.doc Version 5.2 Page 29 Cherry Tree Lodge thermometer. Once opened, eye drops should be stored according to the instructions on their packaging. 3. OP28 A programme should be created detailing how the required minimum of having 50 of staff trained at NVQ2 will be met with the timescale in which this will be achieved. The manager should complete qualifications at NVQ level 4 in care and management. 4. OP31 Cherry Tree Lodge DS0000003929.V346454.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000003929.V346454.R01.S.doc Version 5.2 Page 31 - 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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