Inspection on 14/06/06 for Cherry Tree Manor

This inspection was carried out on 14th June 2006.

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 Manor 06/06/07

Cherry Tree Manor 22/09/05

Cherry Tree Manor 26/04/05

Cherry Tree Manor 14/12/04

Cherry Tree Manor 19/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Cherry Tree Manor 8 Great Road Adeyfield Hemel Hempstead Hertfordshire HP2 5LB Lead Inspector Mrs Alison Butler Key Unannounced Inspection 14th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cherry Tree Manor DS0000019313.V299388.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 Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree Manor Address 8 Great Road Adeyfield Hemel Hempstead Hertfordshire HP2 5LB 01442 217621 01442 262955 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) Oak.care@virgin.net Oak Care Limited Carol Diane Swendell Care Home 47 Category(ies) of Dementia - over 65 years of age (47), Old age, registration, with number not falling within any other category (47), of places Physical disability over 65 years of age (47) Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: Cherry Tree Manor is a care home, which provides personal care and accommodation for 47 older people. Fees for the services are £463-£480 per week. Additional charges are made for newspapers, toiletries etc. (this was correct as at 14/06/06). The home is in Adeyfield, a residential area of Hemel Hempstead, close to shopping and local community facilities. There is a good-sized car park and access to local bus routes. This purpose built home opened in 1996. Resident accommodation is on floors reached by stairs or lifts. There is a choice of lounges and a dining room on each floor with additional kitchenettes for providing snacks and drinks. All of the bedrooms are single rooms with an en suite toilet and wash hand basin. There are additional assisted toilets and bathrooms on each floor. Residents have access to an enclosed garden area and conservatory. The home aims to meet the needs of older people who may also have physical disabilities or dementia. It does not provide a service to people who are assessed as requiring nursing care; it will however continue to provide a service for people with changing needs as long as they can be met in the home with input from the primary health care team. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by one inspector between the hours of 11:00 and 17:00. The aim of this inspection was to assess all the key standards. The majority of the inspection was spent talking to residents, relatives and staff. Care and administrative records were checked. Where information remains the same this has been brought forward from previous reports. What the service does well: The home has welcoming, calm & relaxed atmosphere. Good interaction was observed between staff & residents during the inspection. There are a number of small seating areas around the home where residents and their visitors can sit. There are a selection of books and magazines available for residents to borrow. Residents are very happy with the care at Cherry Tree and here are some of the comments received “the girls are very nice” “I am very happy here” “ I have no complaints”. Visitors to the home felt they are kept informed and feel welcomed at all times. They support the home in attending meetings and fund raising events wherever possible. Meals were seen to be a very relaxed unhurried event and residents were complimentary about the food provided at the home. The home has a complaints procedure in place and visitors are confident that their views would be listened to and acted upon. The home provides a wide range of information for families and residents for example legal and financial services. The home was clean and fresh and the main lounge was having the carpet cleaned. Redecoration is carried out as and when required. Residents rooms are personalised with photos, pictures and ornaments. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 6 There is a rolling programme in place to ensure staff have the required information and knowledge to meet the residents needs. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&3 Standard 6 is not applicable to Cherry Tree Manor. The quality outcome in this area is good. This judgement has been made using the available evidence, including a visit to the home. Information is provided to residents and they receive a copy of the terms and conditions. Information is obtained prior to admission to ensure they are able to meet the individual’s needs. EVIDENCE: A sample of contracts were examined for those residents who were case tracked as part of this inspection and were found to contain the required information. Following admission a care plan is put in place and this information has been discussed with the residents and/or their representative with their permission. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 The quality outcome in this area is adequate. This judgement has been made using the available evidence, including a visit to the home. Residents are supported to maintain independence with their health, personal and social care as far as is practicable. Staff treat the residents with respect and their privacy is upheld. Medication system is robust to support the safe administration of medicines. EVIDENCE: Each resident has a care plan in place although these give information there is a need to make them more person centred. The plans are produced centrally in a pre-populated format; staff then tick a yes/no box to state those that are relevant to the individual. It would be useful if each area of need were described in detail, of what support the individual requires and the action required by staff to meet this need. The monthly reviewing of the care plans should be more detailed to state how the needs are being met and any necessary changes and not just state “on going” or “continue” Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 10 Good interaction was observed between staff and residents and they were knowledgeable about the needs of the residents. Residents stated they were well cared for and that their needs were being met. A full inspection was not carried out on the medication procedure but the administration of the medication was observed and appeared to meet the policies with support provided to those residents who required it. A spot check on the MAR (medication, administration, record) sheet showed there were no gaps and they were signed as appropriate. Due to the temperature of medication room being in excess of 20ºC the home spoke to the pharmacist. A letter was received to state they need to ensure they get the GP to prescribe smaller quantities and hold the stock for no more than two months and any excess after this time is returned to the pharmacy for disposal. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 The quality outcome in this area is adequate. This judgement has been made using the available evidence, including a visit to the home. Contact with family and friends are maintained. Residents are provided with varied and nutritious meals. EVIDENCE: Comment cards were received from families, a number felt that activities should be increased and felt there were no opportunities for residents to go out. There is also a part time activities co-ordinator and the full time one has been on long term sick. The manager has recently recruited a full time daily activity co-ordinator (DAC), and this should increase the activities on offer. Discussion with the DAC showed they were extremely keen to work with the residents and provide them with a full and varied programme, they are also planning to work two Saturdays in a month. Information was provide to the DAC on NAPA (National Association for Providers of Activities for Older People) and accessing the Alzheimer’s Society website for further information in meeting the social needs of those who suffer from dementia. One to one sessions are provided to those residents who choose to stay in their rooms. Examination of the records showed that information should be more detailed and include how individuals Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 12 responded to each activity. This would enable staff to build up a picture of what that individual prefers especially if they have communication difficulties. A quiz took place during the inspection to which those residents who took part enjoyed it very much. Relatives spoken to during the inspection were very happy with the care and felt they are kept informed about the relative. They support the home whenever they can and attend meetings, fundraising events. The inspector joined the residents for lunch, which was an enjoyable and pleasant experience. Music was played quietly in the background and there was gentle chatter between the residents. With the exception of one new member of staff who stood to assist a resident with their lunch, staff were seen to sit, support and encourage residents with eating their lunch as appropriate. The main meal of the day was Shepherds Pie & vegetables or cheese salad followed by ice cream, yoghurt, or strawberry flan. Residents spoken to had really enjoyed their meal and stated that the food is very nice. As part of the auditing process food is an area that is kept under review. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality outcome in this area is good. This judgement has been made using the available evidence, including a visit to the home. Relatives are confident that their views are listened and acted upon. Staff are aware of the need to protect residents from abuse. EVIDENCE: The home’s quality assurance system includes feed back from the residents and relatives. Relatives spoken to felt they were kept informed about the care of individuals and any changes that are to be made in the home. Residents felt that if they were unhappy about the care they received they would be able to discuss this with the manager and her team to have it put right. The proprietors have updated their complaints procedure in line with new guidance received from the Commission For Social Care Inspection stating that CSCI no longer investigate the complaint but ensure that standards have been maintained. There is also information contained of other bodies to contact should they remain dissatisfied. A wide range of information is available on advocacy, legal and financial services in the front reception area on entering the home. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The quality outcome in this area is good. This judgement has been made using the available evidence, including a visit to the home. Cherry Tree Manor is safe, well maintained and clean. Residents are provided with a good laundry service. EVIDENCE: The main lounge on the ground floor was in the process of being cleaned on the day of this inspection. The residents were able to use the smaller lounge until after lunch. From the questionnaires received by the Commission, one stated that it felt the home sometimes smells and another stated they feel an effort is made to prevent smells. A tour of the home found that all areas were fresh and clean. There are good systems in place to maintain any repairs and redecoration is carried out as required. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 15 The residents were dressed appropriately in freshly laundered clothing and were very satisfied with the laundry service provided. Resident’s rooms have been personalised with photographs, pictures and small ornaments. Those residents spoken to were happy with their rooms, and stated they were kept clean and tidy. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 The quality outcome in this area is adequate. This judgement has been made using the available evidence, including a visit to the home. Recruitment of staff are not as robust as they should be, due to the failure of ensuring a clear criminal records check has been obtained for a new member of staff prior to commencing employment. Staff receive an induction in line with the Sector Skills induction programme although this had not yet been commenced with the recently recruited members of staff. A rolling training programme is in place. EVIDENCE: Staff numbers appeared adequate to meet the needs of the residents at the time of this inspection. On the day of the inspection the staffing on shift included the deputy, a team leader, a senior carer and 5 carers. The manager was also in the home. A random check of newly recruited staff records showed that one had not had a clear criminal records check received prior to commencing employment and an immediate requirement was issued to ensure this does not happen in the future. All other relevant checks had been carried out as stated in the Care Home Regulations 2001. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 17 There is a rolling training programme in place it is recommended that a training matrix is produced to give a full overview of what training staff have completed and what needs to be refreshed and when, this ensures that staff remain up to date in their skills. A plan has been put in place to ensure that 50 of care staff attain an NVQ award in care. It is recommended that this is included in the regulation 26 visits report. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 The quality outcome in this area is adequate. This judgement has been made using the available evidence, including a visit to the home. Cherry Tree Manor was found to be well managed with formal and informal systems in place to respond to the views of residents and relatives. The homes policies safeguard the financial interests of the residents. Staff receive formal supervision although this has not been happening a minimum of six times a year. There are well-organised systems in place for protecting and promoting the safety of residents, relatives and staff. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 19 EVIDENCE: A quality assurance system is in place, and this asks the views of the residents, relatives and visiting professionals. Feedback is made available to residents and relatives. Mrs Reekhaye, (Director) is available to speak to residents and relatives on her regular visits to the home. Mrs Reekhaye carries out regular visits and compiles regulation 26 reports, which have been received by the Commission For Social Care Inspection on a monthly basis over the last year. This provides an action plan and timescales for the manager and staff of any issues raised during the visit. A number of questionnaires were sent to a sample of relatives who have relatives residing at Cherry Tree Manor. The majority of those received were very positive about the care received at the home, and stated that “staff are very helpful” “the manager is always willing to speak to me during my visits”. All the questionnaires received by the commission stated they had received a contract. A sample of resident’s files showed a copy of these to be available. Supervision has been taking place, but staff have not been receiving this at least 6 times a year, it is recommended that a matrix is put in place to demonstrate this is happening and identify any shortfalls etc. Policies and procedures are in place to ensure the welfare, health & safety of all residents, staff and visitors is maintained. Procedures do not allow staff to be involved in the financial matters of residents. Information on financial and legal matters is available in the main entrance to the home. All accidents and incidents were well documented and the Commission For Social Care Inspection had been informed as appropriate. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 20 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 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 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 21 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. 1 Standard OP29 Regulation 17 (2) sch 4 &19 (1) sch 2 Requirement The manager/proprietor must ensure all the relevant paperwork and checks have been obtained prior to a member of staff commencing employment at the home. An immediate requirement notice was served at the inspection. Timescale for action 14/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Detailed information should be given describing the action required by staff to meet the care needs of individuals within there care plan. Monthly reviews of the care plans should provide information on how the needs are being met and note any changes required. A pictorial programme should be introduced to aid residents in choosing the activities they like to take part in. The manger should remind staff to be seated when DS0000019313.V299388.R01.S.doc Version 5.2 Page 22 2 3 OP12 OP15 Cherry Tree Manor 4 OP36 assisting residents to eat so as not to appear they are being hurried. Staff should receive formal supervision at least six times a year. A matrix should be put in place to ensure this happens. Cherry Tree Manor DS0000019313.V299388.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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