Inspection on 06/06/07 for Cherry Tree Manor

This inspection was carried out on 6th June 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 Manor 14/06/06

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 6th June 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 Manor DS0000019313.V342573.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.V342573.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.V342573.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2006 Brief Description of the Service: Cherry Tree Manor is a care home, which provides personal care and accommodation for 47 older people. 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. Information about the service is available in the Statement of Purpose and Service User Guide, these and a copy of the latest CSCI inspection report are freely available from the manager. Fees for the services are £480.00-£490.00 per week. Additional charges are made for newspapers, toiletries etc. (this was correct as at 06/06/07). Cherry Tree Manor DS0000019313.V342573.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 16:30. The aim of the inspection was to look at the key standards. The majority of the time was spent talking and observing those who use the service, talking with relatives and staff on shift. Care and administrative records were examined. Where information has remained the same this has been brought forward from previous reports. What the service does well: What has improved since the last inspection? A robust recruitment procedure that protects the people that use the service is in place so that all staff had the relevant information obtained prior to them commencing employment. A training and supervision matrix has been introduced to ensure that gaps can be quickly identified with ease and action taken as necessary. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 6 The activities co-ordinator has started to take photographs to provide information on activities and menus in a pictorial format to empower all residents to access the information. Staff were seen to be seated when assisting those who needed support whilst eating, which protects peoples dignity. 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 Manor DS0000019313.V342573.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.V342573.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Standard 6 is not applicable to Cherry Tree Manor. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to residents and their representatives to enable them to make an informed choice about using the service. Assessments are carried out on all residents prior to a place being offered or taken up. EVIDENCE: A comprehensive Statement of Purpose and Service User Guide is available to all prospective residents and their representatives; this includes the care of residents who suffer from dementia. Pre-admission assessments are carried out to ensure that Cherry Tree Manor is a suitable placement and is able to meet prospective residents needs and this forms the basis of their care plan. Each resident is provided with the terms and conditions of admission etc. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 9 Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 10 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 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people who use the service have their health, personal and social care needs met. Information could be more informative to ensure all needs are met safely. EVIDENCE: Four care plans were examined and through this it was evident that work had taken place to make them more person centred although the pre-populated version is still used on admission. These are reviewed following the first review and written based on the individual’s needs, with the pre-populated version used as guidelines. One had not yet been written for the individual although they had been residing at the home for over 2 months. Again it is recommended that the monthly review should be more detailed to state how care needs are being met and any necessary changes are made to the care plans. Risks have been identified but do not contain details of how they are being managed to minimise or eliminate them. Previous regulatory history has found that the manager has complied with requirements made and therefore Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 11 whilst this would be made requirement it is felt that the manager will action this appropriately and therefore a requirement has not been made. Weights are being recorded, although when there is a loss or gain no comments were being recorded to why this might be or if additional support has being sought e.g. from the GP or dietician. Care plans need to contain consistent information throughout to be able to provide meaningful information for staff however, one plan stated that the person was in a wheelchair all the time but in another area of the plan it said they were placed in a dip chair. Descriptions of moody/aggressive behaviour should be written to provide staff with what this means and details of how staff are to manage the behaviour should also be included within the care plan. There have been no concerns with the handling of medication and therefore this area was not inspected at this time, as discussion took place with the manager who stated that they were still monitoring and recording the temperature of the medication storage, and medication was being returned after two months to the pharmacy for disposal to ensure it remains in good condition and continues to be effective. Good interaction was generally observed during the inspection between staff and the people who use the service. However, whilst the inspector sat in the upper floor lounge observing and talking with people, a number staff entered assisting individuals but failed to acknowledge those already sat within the lounge. One member of staff came to offer an individual a manicure, which they appeared to enjoy; they were also offered the choice of colour to have their nails painted. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 12 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Contact with family and friends are encouraged. Autonomy and choice is promoted within the home. Residents receive a wholesome and appealing well balanced diet. EVIDENCE: Activities are provide six days a week, the activities co-ordinator has been working with the national association for providers of activities on a course and has two units left to complete. It was evident from discussions with her that she is keen to provide activities in consultation with those who use the service. There is an allocated budget for providing equipment. She provides some one to one activities for those who choose or have difficulty in joining in the activities on offer. She keeps records of all activities and these can be used when carrying out the monthly reviews and for planning forth-coming activities. She is going to look at producing a programme in a pictorial format and states they have already started taking photos of various activities and is also looking at producing the menu in the same format to empower people who have some difficulty in communicating to make a more informed choice. A game of bingo took place during the inspection and appeared to be enjoyed by Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 13 most, with one of the residents helping in the calling out of the numbers as they chose not to join in the game. All staff are encouraged to take part in supporting those less able. We discussed the possibility of producing a quarterly newsletter to inform relatives and those using the service of events that have happened or that are coming up in the future. Those who use the service could contribute to articles being placed in the newsletter for example favourite poems/recipes etc. Lunch was served in an unhurried and pleasant atmosphere and staff were seated when assisting those who required additional support. Those spoken with were complimentary about the food that was served and confirmed that alternatives are offered if they do not like what is on the menu. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 14 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to protect the residents from abuse and ensure complaints are dealt with appropriately. EVIDENCE: The visitor spoken to during the inspection was complimentary about the care that is provided at Cherry Tree Manor. They felt that any issues that have been raised have been dealt with appropriately. They feel they are kept well informed about their relative and are a regular visitor to the home. The home has received no formal complaints since the last inspection. A number of compliments have been received thanking the manager and her team for the care provided. There is a wide range of information on advocacy, legal and financial service available in the main entrance to the home. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 15 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 & 26 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 well maintained. Regular checks are carried out on services and equipment. EVIDENCE: There is work being carried out to put a shower in one of the bathrooms to provide those using the service an alternatives means of bathing. There is a regular redecoration plan and a monthly visit is conducted where any issues can be addressed quickly and a plan put in place. Although some unpleasant odours were obvious the manager and her team are constantly trying to address these and look at ways to eliminate them. Policies and procedures are in place for dealing with the control of infection. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 16 Those using the service looked well kempt on the day of the inspection and were happy with the laundry service provided. A pavilion and some raised beds are being built in the garden and a memory path, which will have scented bushes and plants to provide stimulation when people are out in the garden. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure that the people who use the service are protected at all times. The numbers and deployment of staff appear to meet the needs of those who live at the home. EVIDENCE: The four files examined evidenced that all the required information had been obtained prior to the care staff starting their employment at Cherry Tree Manor. The rotas demonstrated that a minimum of 7 staff are on shift, plus the manager, Monday to Friday. A chef and a housekeeper also compliment the staff in meeting the needs of the home. The manager and proprietor are looking at changes in the pattern of the housekeeper’s hours to better meet the needs of the service and support the care staff by working later in day to cover the teatime period. There is a rolling programme of training in place and a matrix has been introduced to easily identify any gaps in training. Cherry Tree Manor DS0000019313.V342573.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health welfare and safety of residents, staff and visitors to the home is protected most of the time. EVIDENCE: The proprietor carries out regular visits to the home to ensure the manager and her staff meet the National Minimum Standards and the Care Home Regulations 2002. As part of the visit she produces a Regulation 26 report, where issues are raised and an action plan is put in place to address these. The manager has now put a matrix in place to ensure that staff receive supervision a minimum of six times a year. Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 19 Oak Care Limited does not take any responsibility for the financial matters of those who use the service; the next of kin, appointee-ship, and solicitor or guardianship office deal with any financial matters. Policies and procedures are in place to ensure the welfare, health and safety of all who enter Cherry Tree Manor is maintained. As already discussed risk assessments that have been identified need to have information on how these risks are to be managed etc. Fire records, accident and incident records were examined and were all well kept. The Commission For Social Care Inspection have been informed appropriately under Regulation 37 of any adverse incidents etc. Cherry Tree Manor DS0000019313.V342573.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 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. 2. OP12 A pictorial programme should be introduced to aid residents in choosing the activities they like to take part in. Risk assessments should contain more information on how to manage any identified risks. 3. OP38 Cherry Tree Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Manor DS0000019313.V342573.R01.S.doc Version 5.2 Page 23 - 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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