Inspection on 13/01/09 for Cherry Trees

This inspection was carried out on 13th January 2009.

CSCI found this care home to be providing an Good service.

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 Trees 29/01/08

Cherry Trees 26/06/06

Cherry Trees 11/02/06

Cherry Trees 18/04/05

Cherry Trees 06/01/05

Cherry Trees 15/07/04

Cherry Trees 08/07/03

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cherry Trees Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephanie Kenning     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Cherry Trees Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ 01709550025 01709556308 cherrytree@exempalhrc.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cherry Health Care Limited Name of registered manager (if applicable) David Ardern Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 66 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP; Dementia - Code DE and Physical disability - Code PD Date of last inspection Brief description of the care home 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 lift. Care Homes for Older People Page 4 of 26 care home 66 Over 65 0 66 0 66 0 66 Brief description of the care home 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 people who have 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. Cherry Trees Care Home is located in the residential area of Kimberworth Park, a suburb of Rotherham. The home is on a bus route, bus numbers 39,41,42,43 and within a short walking distance of bus stops. Car parking is provided for several cars to the front of the home along with street parking Fees range from £343 to £597 at time of visit 13/01/09, dependent on needs assessment. Additional charges are made for hairdressing, Chiropody, Optical, Dental services, specialised toiletries and magazines etc. The registered person makes information about the service available to residents and their families via the homes Statement of Purpose and the Service User Guide. A copy of the inspection report is made available at the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection carried out by Stephanie Kenning, regulation Inspector. The site visit took place between 09:30 and 16:30. The Manager Shelagh Sweeney was present during the visit and was given feedback on the findings at the end of the visit, along with a representative of the provider, Guy Cunningham. Prior to the visit the manager had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the home was doing well, and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of this report. Surveys were sent out to people living in the home, staff and health care professionals, Care Homes for Older People Page 6 of 26 about the care and support provided, and comments from these have been included in the report. On the day of the site visit opportunity was taken to make a tour of the premises, inspect a sample of care records, check records relating to the running of the home, and check some of the policies and procedures. Time was spent observing and interacting with people. People living at the home, staff and visitors contributed to these findings. The inspector checked all the key standards and some additional standards. The inspector wishes to thank the people at the home for their time, friendliness and co-operation. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service have information about the home and opportunities to visit before making a decision. The personalised needs assessment means that their needs are identified and planned for before they move into the home. Intermediate care is not provided at this home. Evidence: We wanted to understand peoples experiences when they decide whether to choose this care home, and what it is like for people if they did decide to move there. We spoke to people living in the home, relatives, visitors and staff working in the home. We also used information from surveys that we sent to people before the visit. We looked at information the home give to people and how they assess whether they can meet peoples needs. One person said that they had received sufficient information about the home before Care Homes for Older People Page 10 of 26 Evidence: deciding and the home was recommended to me and my family by a number of friends. Another person said that they had received a little book about the home and this gave them enough information to make a choice. A relative said, this was the right choice for all of us as I feel happy that she gets the right care. Information for people living in the home and for potential residents was being revised at the time of the visit. The manager confirmed that the revised version would be available to everyone when it was available. People were assessed by a nurse or senior member of staff before being admitted to the home. The records showed that these were carried out well, covering all the areas required, and that peoples needs were identified from them, enabling the home to decide if they were able to care for them. Sometimes people visited the home before deciding to move there, but often families visited on their behalf. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have their health and personal care needs met. Evidence: We wanted to understand how people had their health and personal care needs met. We spoke to people in the home, observed practices in communal areas such as at mealtimes, and looked at records and medication systems. People living in the home were well presented and appeared well and generally calm, which showed an improvement from the previous visit. Personal care tasks were carried out in the privacy of their rooms or bathrooms. Some people preferred to stay in their rooms for all or parts of the day and this was supported by staff who took drinks and meals to them, including some people who had stayed in bed later in the morning. This showed that people have choices about where and when they do things. People made the following comments about the service: We have to fit in to staff routines and shift patterns, not flexible to our needs and individual care, but they are Care Homes for Older People Page 12 of 26 Evidence: good enough to me. They phone the doctor when I ask them to. I can decide if a bath is wanted and staff help me. There is always somebody there to help. The care here is very good, the staff treat me well. A staff member said, I do not have the time to give the nice care that I would like, we just do the basics. Another said, We always meet peoples personal and health care needs. The comments show a variety of opinions that probably mean that care is sometimes affected by the numbers of staff on duty. It was identified that there were some times, including night time when there were less staff around. There was evidence that additional staff are accessed to ensure there are sufficient staff, but this sometimes takes a little time to organise. The care records gave detailed instructions for staff to follow in most cases, showing an understanding of the needs of individuals and a respect for their preferences. There was also detailed information about health care and records of treatment from other health professionals. However there was an example of some information not being recorded, such as how best to improve someones diet when they were losing weight. Staff present described how they were helping that person, but other staff or new staff may not be aware without written instructions to follow. The daily records were not always specific enough, saying things like diet and fluids taken, when it would have been useful to have known exactly what that person was managing to eat. It was explained that this information was recorded elsewhere. People living at the home received medication through safe procedures. The storage and administration of medicines was managed well, with clear records and staff trained appropriately. Medication was monitored by management and identified areas for improvement. The monitoring also highlighted some useful areas, such as use of laxatives, sedatives and anti-depressants. This information could be used to further improve peoples lives, for example, by reviewing the use of laxatives and considering changes to peoples diet. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home experience some choices in their daily lives and activities. Evidence: We wanted to understand peoples daily experiences and opportunities for social activities and outings. We observed the routines, meals, and the activities taking place and spoke to people living in the home, relatives, staff and the managers of the home. We looked at the records of activities, routines and meals. The people living in the home are assisted with activities by a member of staff who mainly does activities. She was very skillful at providing suitable activities and assisting both individuals and groups, and people obviously enjoyed doing the activities. During the visit there was a coffee morning, a quiz, some reminiscence discussion, discussing and showing art work done previously, crafts, and work with some individuals. As it was such a large home she was unable to meet everyones needs, and so some people watched television, listened to music or slept. Other staff did not have time to spend socialising with people living in the home and so their experience was very different, compared to those attending the organised activities, which were excellent. Care Homes for Older People Page 14 of 26 Evidence: One person was sat in front of a sensory unit that offers different things to stimulate or to relax, and was a useful new resource. The home were also in the process of developing a dementia strategy for use on the dementia units, to improve the lives of the people living there. People living at the home made the following comments: There are coffee mornings on a Tuesday for residents, Bingo on a Thursday and occasional trips out to Meadowhall. Sometimes I get bored. There is a bus trip each week. There is a summer house in the garden for use during the summer. The meals are usually good. There are lots of sandwiches for main meals, at tea time/ evening meal. I can pick if I want a cooked breakfast. I sometimes like the meals at the home. People living at the home seemed to enjoy the meals and chose from a menu what they wanted to eat. Records of the meals served showed a good variety of foods, including home cooked dishes and some healthy options. Specific requirements and preferences are usually recorded and catered for, including diets for medical needs. People were assisted sensitively and staff were aware of specific needs. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home are protected by the homes policies and procedures, and the service is improving, sometimes as a result of a complaint. Evidence: We wanted to understand how people were protected from abuse or neglect and how the service responds to complaints. We looked at records, policies and procedures and spoke to people living and working at the home. Written procedures for making complaints were available within the home. There were about 18 complaints recorded with information including the actions taken. The complaints were varied across many areas of the home including care, and staffing levels. Most were easily rectified and appeared to have been resolved. Sometimes the lack of detail in care plans and daily records, did not evidence that changes to care following complaints had happened. Through observation of staff it was noted that changes had been implemented, showing that people were getting the right care. Management do a review of complaints as part of their quality assurance, and encourage people to share their concerns. The management team have a pro-active approach to reporting safeguarding and other issues within the home. There have been a number of referrals for investigation under safeguarding procedures, some of which have been found to be unproven, and Care Homes for Older People Page 16 of 26 Evidence: two were ongoing. Correct reporting procedures have been followed and changes to practice have resulted following the investigations. Staff have training in awareness of abuse, whistle blowing and safeguarding people during induction and there is annual training undertaken to ensure that this proactive approach is encouraged. Recruitment checks are carried out prior to employment to protect people from unsuitable staff. People at the home made the following comments: Staff do listen and act on what I say, but it could be better if we had meetings to discuss things that are important to us. There were meetings when I first came here. I dont know who the manager is by name, but I speak with another member of staff if a problem arises. People living at the home demonstrated the ease they felt with staff members, and staff demonstrated their understanding of individuals behaviors, showing that there was a good level of communication. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is suitable for its purpose and is generally well presented and maintained. Evidence: We wanted to understand what it was like to live in the premises and whether they were appropriate for the lifestyles of the individuals living there. We were shown around the premises including the rooms of some people living there. Generally the home was clean and bright, well maintained and decorated, with suitable furnishings and equipment. The home was warm and generally smelled fresh. Records showed that routine checks and maintenance were carried out to ensure equipment was working well and safely. Individual rooms were personalised and people were very happy with their rooms, and some liked to spend a lot of time there. Communal areas were generally good, though the conservatory was showing signs of damage and wear, including the walls, windowsills, flooring and furniture. Management stated that this was to be rectified very soon. There was an ongoing programme of redecoration and refurbishment, with some new furniture planned for communal areas this year. Some of the carpets were problematic despite cleaning, however they were identified on a replacement program, that should see them replaced in the near future. Care Homes for Older People Page 18 of 26 Evidence: A number of items of old furniture were piled up at one side of the garden, awaiting a skip that was quickly organised to remove them during the visit, and suggestions for future outdoor storage were discussed. Bathrooms were not all as well decorated, nor maintained and some were used for storage. They need some work to improve both their function and appearance, so that people living in the home have a pleasant experience when using them. It was identified that these were also due to be decorated in the near future. People living in the home made the following comments: The home is always fresh and clean. I like my room. This is a nice place, very comfortable. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by well recruited and basically trained staff, but there were times when there may not have been enough staff, and more staff should be further developed. Evidence: We wanted to understand how staff were recruited and trained to ensure that they could carry out their jobs well. We talked to people living in the home, relatives, staff and the manager. We looked at the staff rotas and observed how staff were carrying out their duties. We checked the recruitment files and the training records to see if procedures had been followed. We looked at the questionnaires returned from people, and noted the comments they had made. People made the following comments: Sometimes there are not many staff. Staff are usually available when I need them. We need more staff especially at night time. During the visit, which took place during the day, there did seem to be enough staff, with people getting the care they needed and a calm atmosphere. There were busy times and sometimes people did have to wait for a short time, but staff did seem to Care Homes for Older People Page 20 of 26 Evidence: cope with this. The rotas showed that on nights there were sometimes less than 2 staff per unit, often with a shared senior or nurse between 2 units. Whilst the overall numbers of staff for the home may have looked adequate, with 9 or 10 staff, the layout of the home in four very separate units means that they need to be staffed separately for safety. The manager and senior representative of the company agreed that this would be looked at immediately and reported back that they had ensured that there were two people, at least, on each unit at night. The recruitment files demonstrated that all the necessary checks and procedures are followed before someone is recruited in order to safeguard the people at the home. Training records show that the home trained staff in all the required areas though the manager was aware that some individuals were not fully up to date and was working with those people to ensure they would be updated. The home do not currently meet the standard of 50 of care staff trained in NVQ2 or above, but are working towards it. The company is now an accredited training centre and several assessors are being trained at the home showing a committment to increasing the levels of carers trained in NVQs. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the systems are being put in place to ensure people are listened to. Evidence: We wanted to understand how the home was managed and ensuring the quality of service for the people living there. We talked to people in the home, visitors, and staff including the managers. We looked at some records and questionnaires returned to us. The Manager of the home is Shelagh Sweeney, who has several years management experience and The Registered Managers Award. She was promoted from deputy manager after the previous manager left, but has previously managed a home. She is supported by the Clinical Manager Eilis Parkinson who has a nursing qualification in addition to the Registered Managers Award. There was also a new administrator at this home since the previous visit. Care Homes for Older People Page 22 of 26 Evidence: The atmosphere at the home was friendly and welcoming, and whilst there was a lot of activity there was also calm. There were some clear policies and procedures for staff to follow and the home are well supported by the provider, with regular visits by the company representative. The visit identified some areas of concern, such as night staffing, and it was pleasing to note that someone had been appointed as responsible for nights, to look at recruitment, staffing, and communication, so that these areas could improve. People at the home made the following comments: I feel that I can go to my senior with any problem, or my manager, and it will be dealt with appropriately. Sometimes when I take a problem to the management they do not listen to me. Unit meetings, resident meetings and staff supervisions have been implemented, and for day staff these were working well. The manager was aware that she needed to prioritise staff appraisals and to focus on issues that night staff were raising. The home follows clear financial and accounting procedures to safeguard peoples monies. Records are kept well and were up to date, including evidence that maintenance was being done to protect people. There are some quality assurance systems in place that monitor areas such as care plans and medications, that identify issues to be addressed. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 7 27 Continue to improve the recording in care plans and daily records to give more specific information. Keep the staffing levels on each unit under review to ensure that there are sufficient staff for the needs and safety of the people living in the home. Ensure staff working at the home are updated and trained as required, including 50 of care staff with at least NVQ2 in care. 3 28 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!