CARE HOMES FOR OLDER PEOPLE
Cherry Trees Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ Lead Inspector
Ms Rosemary Reid Unannounced Inspection 11th February 2006 09:00 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 Trees DS0000003076.V263948.R01.S.doc Version 5.1 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 Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cherry Trees Address Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ 01709 550025 01709 556308 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) Cherry Health Care Limited Post Vacant Care Home 66 Category(ies) of Dementia (66), Old age, not falling within any registration, with number other category (66), Physical disability (66) of places Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th July 2005 Brief Description of the Service: Cherry Trees Care Home is situated in the Kimberworth Park area to the north west of Rotherham. It is on the fringe of a large housing estate. The home was purpose built and facilities are provided on ground and first floor level; access to the first is by a shaft lift. Cherry Trees is registered as a care home that provides personal and nursing care for 66 older people. There are four units within the home. Two of the units provide nursing and residential care: - 32 beds in total. The remaining two units offer care for service users who suffer from dementia: - 34 beds in total. There is a level garden area to the rear of the home suitable for access by pedestrian and wheelchair users, and access to the garden is gained through the conservatories. Car parking is provided for several cars to the front of the home. Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 11th February from 9:00am to 12:45pm and on the 13th February from 8:00 to 11:30am. A manager had been appointed April 2005 and the Commission was processing the application. However, that manager left in February 2006 and the deputy manager Anita Mace was made acting manager until a general manager is appointed. Although she had worked at the home as deputy manager she had been in post as the acting manager for a week and was coming to terms with her new role. Six staff, six residents, three relatives were spoken with along with observation of the interaction between residents and staff. A poster was placed in the entrance of the home to inform residents, staff and visitors to the home that an unannounced inspection was taking place. At previous inspections comment cards had been received at the Commission’s office, all of which were satisfied with the delivery of service provided at Cherry Trees. All of the relatives spoken with had positive comments about the care their relative received and were impressed with the changes in the home for example the improvements within the home to decoration, renewal of some furniture and cleanliness of the home The comments from staff indicated that they felt supported by the acting manager. Records show that staff meetings and residents/relatives meetings had taken place. The three relatives all indicated that they were highly satisfied with the care given by staff at Cherry Trees. The inspection focused on the one requirement and one recommendation from the previous inspection, two residents’ files from each of the units (a total of eight) were case tracked along with medication, staffing rota, the environment and Adult Protection. Feedback was given at the conclusion of the inspection to the manager and at a meeting to the Operations Director. What the service does well:
The parent company took immediate action to ensure continued management of the home. Staff on the four units of the home were observed to have good rapport with residents. The home has had improvements to the environment in that new curtains had been fitted to some bedrooms and communal areas. Six bedroom and corridor carpets had been replaced and many areas decorated. New carpet had been fitted to corridor areas. Rotas for the domestic staff had changed and there has been audit system introduced for bedroom cleaning and all other areas, which has improved the cleanliness of the home. All areas of the home were clean with no offensive odours. All of the service users and the relatives spoken with were highly satisfied with the delivery of care and had no complaints were received on either day of the
Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 6 inspection. Records show that complaints were made and action was taken. During 2005 induction and training for all staff had been a main focus of the parent company. The company have robust Adult Protection procedures, which have been put into practice where and when a concern or an issue needs to be referred to the Adult Protection Team. 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 Trees DS0000003076.V263948.R01.S.doc Version 5.1 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 Trees DS0000003076.V263948.R01.S.doc Version 5.1 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): This standard was not assessed. EVIDENCE: Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 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 - 11 The care plan system is clear and provides staff with direction that they need to meet service users needs. Staff on four units are working to the policies for the administration of medication, which promotes the wellbeing of residents. EVIDENCE: A total of eight care files were examined on four of the units, all of which had been updated to reflect residents changing needs. Staff are reviewing care plans monthly to ensure that residents assessed and changing needs are in the care plan and the goals are met. Where possible relatives are involved in the development of the care plan. For example, three relatives spoken with confirmed that they were involved with their relative’s care. One relative stated “I can only reiterate what I said the last time” “Staff are wonderful to my father” another relative said, “I am made welcome and I know about any changes staff keep me informed.” The past activities room has now been changed to a smoking area. Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 10 Medication policies and procedures are in place, which promotes safe handling and administration of medication. Each resident has a medication review. Medication records were examined and found to be correct. There are policies and procedures dealing with care of the dying and where known residents’ wishes for their funeral arrangements are recorded within the file. Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 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, 13,15 These standards were assessed in April 2005, which demonstrated that the company promotes activities for the stimulation and enjoyment, which will benefit service users. Residents and relatives are informed of advocacy services, which promote and advance residents’ rights EVIDENCE: These standards were not fully assessed at this inspection. However records show that concerts and day trips have taken place. There have been changes in that the activities room has been altered to a smoking area and residents/relatives lounge where service users can be with their relatives and drinks can be made. Each unit has a selection of activity material available. The home are promoting advocacy services by placing posters advertising telephone numbers on notice board along with the information in the Service Users Guide. The residents who could make their views known said that meals are varied and they thought that meals although good had improved in recent months and said they enjoy their meals. Arrangements had been made to have talks on nutrition by the dietician for the staff group. Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 12 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 home has policies and procedures to protect service users from abuse. The home has a clear complaints system, which service users and relatives have used to register their grievances and/or concerns EVIDENCE: All staff had received training on Adult Protection matters and this is on going to ensure all new staff have the same training. At the three inspections during 2005 staff that were interviewed gave a good account of what their responsibility was regarding allegations of abuse and were aware of the adult protection policy. Complaints are recorded and the company have taken action to resolve complaints and issues. No complaints were given to the inspector. Relatives and residents had only constructive comments to make about the new manager and the staff group. Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 13 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 Service users lived in a safe well-maintained environment, which was clean pleasant and hygienic EVIDENCE: Cherry Trees is a purpose built nursing home. From the beginning of 2005 the home has had a refurbishment programme, which greatly improved the environment throughout the home. All bedrooms and single occupancy and there was evidence that many of the residents had personalised their bedrooms. It is company policy that bedrooms are redecorated when they become vacant. The corridors and six bedrooms had new carpets fitted, new beds have been purchased. All areas used by service users were clean without offensive odours Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 14 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 These standards are not fully assessed. The number and skill mix of the staff met residents’ needs, staff are have had induction and trained to do their jobs. EVIDENCE: Rotas were examined which showed that there was sufficient staff on duty. Staff had staff induction, which includes Health and Safety training ensuring that service users are in safe hands at all times. At the next inspection all these standards are to be fully assessed. Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 15 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): 31.38 The health, safety and welfare of service users and staff are promoted and protected EVIDENCE: Mrs Anita Mace is the deputy manager who is working as the acting manager until a general manager is appointed. Staff said that they felt supported and valued by her. Mrs Mace had only been in post as acting manager and was in the early stage of her induction to the role. Staff had received training in health and safety, moving and handling, fire instruction and infection control. They were able to verbalise the steps they took to promote the health and welfare of service users, and maintain a safe environment for them to work in, therefore reducing the risk of harm Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 16 Health & Safety certificates were checked at previous inspection January and April this year. The Operations Director undertakes monthly monitoring visits give and available to give support and guidance to the acting manager during this time. Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Cherry Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 18 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 Trees DS0000003076.V263948.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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