Inspection on 08/11/05 for Cherry Tree Lodge

This inspection was carried out on 8th November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cherry Tree Lodge 18/04/07

Cherry Tree Lodge 20/04/06

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 Mick Walklin Unannounced Inspection 8th November 2005 10:30 Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 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.V262752.R01.S.doc Version 5.0 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.V262752.R01.S.doc Version 5.0 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) Prime Life Limited Mrs Laura Pamela Bucke Care Home 19 Category(ies) of Learning disability (18), Learning disability over registration, with number 65 years of age (1) of places Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration To admit one LD(E) service user on a named basis only 27th June 2005 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 to accommodate 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. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours. A tour of the premises was conducted with the deputy manager. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. Other documents connected with the running of the care home were inspected. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to ensure that the current needs of residents are reflected. Staff are not clear on reporting adult protection issues, and require further training updates. The floor in the downstairs bathroom needs replacing, and a solution should be found to combat odours in two of the bedrooms. Water temperatures are high in some areas of the home, and this should be investigated to prevent accidents to residents. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 7 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.V262752.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 4. There are satisfactory arrangements for introducing and assessing prospective residents to the home. EVIDENCE: One resident has been admitted since the last inspection. He was admitted from another Prime Life home, which was not registered to provide nursing care, and was transferred with his existing care plans and assessments. Usually prospective residents would be invited to visit prior to admission, and a transitional package would be devised according to individual needs. However, in this case, the person had been ill so had not visited prior to admission. His care plan is currently being updated, and he said that he was settling in well, and enjoyed living at the home. Emergency admissions are sometimes considered, provided the manager is satisfied that the home is suitable for their needs. Referrals will only be accepted via the learning Disability Team, who will send details of the care package to the home. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 & 10. Care plans are of a good standard, but one had not reflected the needs of a resident over a recent period. EVIDENCE: Care plans are comprehensive, and assessments cover all aspects of daily living, and generate a care plan and risk assessment if issues are identified. However, one resident had refused to sleep in his room since August following a thunderstorm, and had been sleeping in the living room. His care plan on file, which had not been reviewed since January, contained no reference to this, or any strategies for staff to follow. Discussions with the manager after the inspection revealed that a new care plan had been written the day before the inspection, but had not been placed in the resident’s main file. However, there appeared to be no care plan for the intervening two months. Staff are clear on the process for risk assessments, and files contained a good range to ensure that potential risks to residents are identified and minimised. They are also clear on their responsibilities for maintaining the confidentiality of residents. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 17. There are adequate activities available to ensure that residents have an interesting timetable. Catering arrangements ensure that choice and dietary needs are catered for. EVIDENCE: Some residents attend external day placements, such as Social Services day centres and the ‘Forget-me-not Club’. One member of staff is allocated as activity co-ordinator for each shift, and those residents not having a regular day placement have the option of participating in a variety of in-house activities. Some 1-1 activities were taking place at the time of the inspection, such as games and colouring, and notice boards displayed photographs taken during events and outings. The kitchen was not inspected, but on previous inspections the cook demonstrated a very good knowledge of individual dietary needs, and explained how individual preferences are catered for. A newly admitted resident said that he was satisfied with the quality and variety of the food served, and that his preferences are catered for. The mealtime appeared well Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 11 organised and relaxed. Staff offered a high level of encouragement and support to two residents who were reluctant to eat, including offering food alternatives, and the cook demonstrated a good rapport with one of them in successfully getting him to eat his meal. Another resident’s diet was being carefully monitored and recorded because of concerns. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20. There are good arrangements for involving health care providers, and medication procedures are robust to ensure that medication is administered safely. EVIDENCE: There is good liaison with local health providers. The home provides nursing care, and arrangements were being made with the District Nursing Service for staff to receive training to meet the needs of a newly admitted resident. He requires a type of dressing that requires training to apply. Another resident, who is refusing to sleep in his bedroom has been seen by the Consultant Psychiatrist, and a referral has also been made to Psychology for advice on how to manage his behaviour. Medication administration records and storage facilities were well organised. The home does not use homely remedies, and no residents self-medicate. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. The complaints policy is accessible to residents, but staff require update training relating to reporting adult protection concerns, so the residents are protected. EVIDENCE: There have been no complaints since the last inspection. There is a good accessible complaints policy available in written and symbols format. These are displayed in areas of the house. The policy is also contained in the staff policy handbook, and staff were able to describe the procedure, should they receive a complaint. Staff receive training on adult protection during induction and foundation training. The induction covers ‘Abuse – who to inform. Procedure – follow guidelines’. However, staff were not clear on the procedure for reporting, other than to report to more senior staff within the company. During the discussion, it also transpired that a person had been admitted for respite care over the weekend, who had made comments about her home life, which had concerned staff. Staff stated that they had reported these concerns, but Social Services were unaware, and confirmed that they had received no notification. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. There have been some improvements to the gardens, and the home provides a comfortable environment for residents to live in, although some minor maintenance problems were identified. EVIDENCE: The requirements relating to maintenance issues made at the last inspection were attended to promptly. The home is generally well maintained and brightly decorated. Since the last inspection, the front of the house has been tidied, with new benches and attractive boarders. A compound for garden waste has been erected. The floor in the downstairs bathroom requires replacement, as part of it is lifting. Two of the bedrooms had unpleasant odours, despite the windows being left open, and a solution to this problem should be found. A protruding screw from a chest of drawers was found to be sticking out, which could cause injury to staff or the resident. Staff agreed to have this removed. The cleaner was off sick on the day of the inspection, so care staff did light cleaning, and the home was generally clean and tidy. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35 & 36. There are sufficient staff to meet the needs of residents, and there are robust recruitment and selection procedures to ensure that residents are protected. EVIDENCE: The home is fully staffed at present, and there are sufficient staff on duty to meet the needs of residents. The files of four newly recruited members of staff demonstrated a robust and thorough recruitment and selection procedure, with all the necessary documentation on file. The core staff group has remained stable, and they know the needs of the residents well, and are fully aware of their roles and responsibilities. Staff said that training opportunities are good, and a spreadsheet clearly outlines training undertaken. Most mandatory training was up to date, and 7 staff are working towards NVQ qualifications. The company also offers the Learning Disabilities Awards Framework to staff. Staff confirmed that they receive regular supervision. The manager’s records showed that although there is some slippage, supervision is generally occurring every two months, with an annual appraisal. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 41 & 42. Management arrangements have improved, and staff morale is good, ensuring a relaxed atmosphere in the home. Documentation is well organised, ensuring a safe environment, but there were problems with hot water temperatures in some areas of the building, which could pose a risk to residents. EVIDENCE: The manager is a first level registered nurse, who has completed the Registered Managers Award. A new Deputy Manager has been appointed, who the manager commented had been a “tremendous help”. Staff said that there is good staff morale and a good working atmosphere, which benefits residents. There are monthly staff meetings, which gives staff the opportunity to contribute ideas to improve working practices. Monthly Regulation 26 reports were available for inspection in the home. Health and safety and maintenance documentation was well organised. The home has had a recent Fire Officer inspection, which was satisfactory. Water in Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 17 one part of the house was being delivered at a high temperature, despite all temperatures having been measured within an acceptable range the week before. Water temperatures in basins in Bedrooms 5, 8 & 9, and the nearby shower room were measured at between 57 - 60°C, which could pose a risk to residents. The deputy manager conducted a risk assessment at the time, and will arrange for the mixer valves to be inspected. Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 3 x Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cherry Tree Lodge Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 2 x DS0000002605.V262752.R01.S.doc Version 5.0 Page 19 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. 1. Standard YA23 Regulation 13(6) Requirement Timescale for action 31/12/05 2. 3. YA24 YA42 23(2) 13(4) & 23(4) The registered person must ensure that staff receive training in the protection of vulnerable adults, so that they are aware of their responsibilities for reporting, both inside and outside the organisation. The registered person must 31/12/05 ensure that the maintenance issues identified are attended to. The registered person must 31/12/05 ensure that the health and safety issues identified are attended to. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cherry Tree Lodge DS0000002605.V262752.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000002605.V262752.R01.S.doc Version 5.0 Page 21 - 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. 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