Inspection on 30/07/07 for Cherry Tree Lodge Care Home

This inspection was carried out on 30th 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 Care Home 23/05/06

Cherry Tree Lodge Care Home 03/09/04

Cherry Tree Lodge Care Home 17/05/04

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 Care Home 34-36 Holme Road West Bridgford Nottingham NG2 5AA Lead Inspector Lee West Unannounced Inspection 30th July 2007 09:30 Cherry Tree Lodge Care Home DS0000008650.V340953.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 Care Home DS0000008650.V340953.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 Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree Lodge Care Home Address 34-36 Holme Road West Bridgford Nottingham NG2 5AA 0115 914 3499 0115 9143499 mgbcareservices@aol.com/ beataagoston@hotmail.com MGB Care Services Limited 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) Vacant Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2006 Brief Description of the Service: Cherry Tree Lodge provides a service to twelve people, male and female, with learning disabilities. The home is situated in two semi-detached three-storey period houses combined into one, located in a residential suburb of Nottingham. It is within walking distance of local shops, transport links and other amenities within the city. There is some on street parking at the front, with a good-sized enclosed garden to the rear of the property. Residents are accommodated in bedrooms on the ground and first floor. There is an internal staircase, and an external metal fire escape. There is no passenger lift within the property, so any person living at Cherry Tree Lodge who has restricted mobility would have difficulty accessing the upper floors of the care home. The fees currently charged are between £365 and £813 per week, dependent on the level of care needs. Information for prospective residents is available within the Service User Guide and previous inspection reports, kept in the manager’s office and the current Certificate of Registration is displayed in the foyer of the home. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit on 30th July 2007, over 4 hours, starting at 11.00am, It formed part of the inspection process, which also included interviewing residents and staff. Information from the Annual Quality Assurance Assessment completed by the manager, together with other records kept within the home and by the commission were also used. Case tracking was used, whereby four residents were asked about their experiences, care received and expectations of living at the home, and their records analysed. Staff were interviewed, and the areas of the home used by the residents were inspected. What the service does well: What has improved since the last inspection? The kitchen area has been upgraded, and the home’s refurbishment programme is continuing. Medication Administration Records were correctly completed and staff have received training in administration of medication. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 6 The acting manager has developed structured, formal, supervision with staff and records of this were kept securely in line with confidentiality. 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 Care Home DS0000008650.V340953.R01.S.doc Version 5.2 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 Care Home DS0000008650.V340953.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Information is made available, with assessments undertaken to enable prospective residents to make an informed choice about whether to live at the home and that their needs can be met. EVIDENCE: The Service User Guide was available with Widgit Rebus Symbols incorporated to make it easier to read. One new resident said, “I enjoyed a weekend at the home,” and because of this felt the home would be suitable. The records of the residents’ meetings showed positive comments from a new resident and the current residents as they spent time getting to know each other. “nice and very polite,” was one comment The Community Care team carry out thorough pre-admission assessments and copies of these were in the residents’ files, and used to form the basic care plans. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents are supported to lead their lives in the way they choose, with opportunities to take risks. EVIDENCE: One resident showed her care plan without prompting saying it’s got my photo in it and that she, helped with it. She explained all about the plan and reviews, which had taken place. Care planning was very thorough with pictures, as well as the easy read wording. Each area of care was set out separately and thoroughly with information on how to deal with issues. Regular care plan and review notes were seen in residents’ files. Information was seen, in the files, to describe what residents like, dislike, what they can do and what areas they require assistance with. They also describe any communication issues. Like how to communicate with residents with minimal verbal communication. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 10 An example described how a resident, “says a few basic words and can make you understand with facial expression and body language, including gestured swear words (two fingers.)” Difficulties in making choices were identified and addressed to make sure residents made as many choices as possible. unable to make choices if they are presented verbally, due to limited communication. can however make simple choices if presented visually. e.g. makaton, pictures, symbols,”was written in one of the care plans tracked. Residents spoken with were enthusiastic about the support they were given to make decisions and take risks. One resident explained a planned trip to Spain for a holiday and photographs were seen of previous foreign holidays. Residents also explained they had regular meetings to discuss what was happening in the home and that they were able to say whatever they liked at the meeting as the acting manager then “makes sure things happen.” There were formal, typed minutes, of these meetings, with residents comments and questions. Individual care plans included activities of daily living and were reviewed regularly. Interactions with staff and residents were observed to be very positive, with residents responding with smiles and animated conversations, when the acting manager, shift leader and other staff were with them. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 11 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): 11, 12, 13, 14, 15, 16, 17, Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents benefit from varied and stimulating social activities, with opportunities to maintain and develop relationships with family and friends. Enjoyable meals are served in pleasant surroundings at times preferred by the residents. EVIDENCE: The Annual Quality Assurance Assessment stated residents use the local day centres, have holidays in the UK and abroad and have many visits organised locally. Care plans recorded attendance at day centres, outside activities, trips to the pub, shopping, bowling and cinema. Personal preferences were identified, for example, one resident prefers to watch t.v. and interact with staff, and enjoys travel on all forms of transport. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 12 Residents confirmed their interests and activities were taken seriously and they could do most things they want to. They are encouraged to take part in domestic routines of the home and have responsibility for their own rooms, take part in menu planning, cooking and shopping, with supervision. Residents spoken with were enthusiastic about the activities in and out of the home. “I can come and go as I please,” said one resident. Another was organising a trip to the local shops with a member of staff, following lunch. Another said they were looking forward to the Karaoke, organised for the evening, as they loved singing. Residents are supported with their personal relationships, and their privacy and dignity maintained. Bedrooms have locks and residents who wish to, lock their doors, and some leave messages on their doors if they do not want staff to enter. Visitors are welcomed into the home, and residents said their families and friends were “happy to visit.” The residents meetings provide an opportunity for each resident to have their say on activities, how they find the food, rooms etc. with each being given the chance to air their views. Records of these meetings are handwritten and then transferred to typed minutes. Copies of the past few months’ meetings were seen. Lunch was served in a pleasantly furnished and decorated dining area and appeared nutritious and appetising, with residents confirming how much they enjoyed the food and that they had choices of what to eat and drink. One resident expressed a preference for hot meals all the time, this was identified within the care plan and hot meals provided when requested. Staff were observed interacting with residents and their support for them was positive and encouraging. Residents said they were very happy with staff at the home and how they help them to do whatever they want. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 13 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): 18, 19, 20, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff, who respect the resident’s preferences and wishes, and follow the care plans, the home’s policies and procedures, provide personal support and assistance with physical and emotional needs. EVIDENCE: Care plans describe what residents like, dislike, what they can do and what areas they require assistance with. They also describe any communication issues, including how to communicate with residents with minimal verbal communication. Those spoken with said they were very happy with the level of support and care they received. One resident prefers to get up later in the morning and have the television put on first to help wake up. This was included in the care planning documents, with a review to identify if it was helping and staff spoken with confirmed they continued to carry this out, unless they were asked not to by the resident. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 14 Staff spoken with said they felt it important to ensure residents were as independent as they possibly could be to, “ help with their quality of living and help them feel useful and respected.” Medication Administration records were accurate and medication is provided by Boots in a Monitored Dosage System. Staff had undertaken accredited medicines training, with records contained in the staff files. There were no residents responsible for self-administration of medication, but procedures were in place to carry out risk assessments and to support residents if they chose to do this. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 15 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): 22, 23, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns and complaints will be taken seriously and procedures are in place to protect them from any abuse. EVIDENCE: The complaints procedure, which included Widget symbols, as well as simplified instructions, was clearly displayed on the wall in the hallway of the home. Residents spoken with said they had no reasons to complain, but if they did they would tell staff in the residents’ meetings, or “I would go up to the office and tell staff,” said one resident. Records showed staff had received training in Safeguarding Adults and those spoken with were able to describe their responsibilities within this procedure. Since the last inspection there had been a safeguarding adults issue, with the challenging behaviour of one resident. Records showed the acting manager dealt with this through the correct procedures, with a satisfactory outcome. The relatives of other residents involved were kept informed of the outcome of the concern, with assurances that their relative would continue to be supported and protected. Cherry Tree Lodge Care Home DS0000008650.V340953.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): 24, 25, 26, 28, 30, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is clean and hygienic, providing a homely and safe environment. Any residents with poor mobility would have difficulty reaching rooms on the upper floors, as there is no lift, or stair lift access. EVIDENCE: The kitchen has been updated, set out so that residents can be safely involved in catering activities, with new cooker, cabinets and worktops. The environment was clean, homely and pleasant. The furnishings and fittings were of a good quality. The dining area had two dining tables, with a lounge area at one end of the room, where residents were relaxing, waiting for lunch. The separate lounge containing the television was also comfortably furnished and amongst all the artwork on the walls there was a digital picture of a waterfall, which when activated, produced movement and sound of water falling. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 17 Residents spoken with said they really enjoyed having the “moving picture” and some expressed an interest in having a similar one in their own rooms. Residents also said they were happy with their rooms and they suited their personal needs. The personal rooms seen, with permission of the residents, were comfortable, pleasantly furnished and decorated, with personal possessions around them. There was a maintenance programme in progress, demonstrated by the upgrading of the laundry room with new washing machine, upgrading and repairs to the bathroom facilities and the ongoing decoration of the communal areas. The bedrooms are located on two floors within the home, with first floor rooms accessed up a staircase with handrails on both walls. There was no other access to the upper floors. External metal fire escapes provide for emergency exit from each floor of the home. The office is at the top of the second flight of very steep stairs at the top of the house. Because of the distance between the ground floor and the administrative office, a system had been set up for staff to gain assistance quickly, by using a mobile phone, which was situated on the manager’s desk. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 18 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): 32, 34, 35, 36, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Recruitment practices support the protection of residents, with wellsupervised, competent, trained staff. EVIDENCE: Staff files case tracked contained records showing employment was confirmed after the enhanced Criminal Bureau check had been carried out, and two written professional references had been received, in accordance with the home’s recruitment policies and procedures. Certificates showing individual training were also seen in the staff files. Staff spoken with said they received training, including National Vocational Qualifications at Level 2. Records of formal supervision of staff were seen, showing this takes place regularly. Staff spoken with said they had regular supervision, which, “with training, help to provide a service, which meets the needs of the residents.” Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 19 The home provides work placements for nursing students and the latest student, who was working her first shift, was encouraged to sit in the manager’s office and familiarise herself with the home’s policies and procedures, before being introduced to the residents. When spoken with, she said she felt this was helpful. Residents spoken with said they were happy with the carers who help them and, “there are enough people to help me and they know what help I need.” Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 20 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): 37, 38, 39, 41, 42, 43, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Although there is only an acting manager at present, the home is run in a way that benefits the residents and their interests. Records are kept efficiently and health, safety and welfare procedures support protection of staff and residents. EVIDENCE: The acting manager was preparing application forms to apply for registration as manager, but these were not yet completed. The management team within the group provides support for the manager. The manager was attending a management meeting at the start of this inspection visit. Records of meetings and information from the management team were available in the manager’s office. Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 21 The office was very tidy, clutter free, with files suitably labelled, this current system having been set up by the acting manager. All records had been efficiently updated and residents’ files were easy to find, with all the required information in them. Staff files were also complete and thorough, with all the required checks and identification in place to support the carer’s eligibility to work at the home. Staff spoke very highly of the acting manager’s abilities to support an environment that promoted independence, whilst ensuring safety, for residents and staff alike. During our discussions, the acting manager also demonstrated her excellent knowledge of the policies and procedures, as well as being very aware of the needs and strengths of all the residents at the home, by supplying accurate information about residents, their care needs and what was in place to keep them safe and supported, without the need of any notes. The Annual Quality Assurance Assessment supplied the dates of the maintenance, servicing and safety checks of equipment and systems, and records kept in the office supported these dates. Residents and staff confirmed the ongoing work in the home, was greatly improving the environment and the use of the minibus helped them with independence, meeting others and going out and about. One resident said, “I’ve not been here long, but I feel I can be happy here.” Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 4 3 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 3 26 3 27 x 28 3 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 4 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 4 X 3 3 3 Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Cherry Tree Lodge Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Care Home DS0000008650.V340953.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!