CARE HOMES FOR OLDER PEOPLE
CHERRY TREES Simmonite Road Kimberworth Rotherham S61 3EQ
Lead Inspector Rosemary Reid Unannounced 18 April 2005 09:30. 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 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 Version 1.10 Page 3 SERVICE INFORMATION
Name of service Cherry Trees Address Simmonite Road, Kimberworth, Rotherham, South Yorkshire. S61 3EQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01709 550025 01709 556308 None Cherry Health Care Limited Manager Michael Sykes has been appointed but not registered CRH 66 Category(ies) of DE 66; OP 66; PD 66 registration, with number of places CHERRY TREES Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 06 January 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 Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7 hours from 9:30am to 16:30. The previous unannounced inspection in January 2005 highlighted many issues and it was agreed at a meeting at the CSCI office with the Operations Director that further inspection would take place during this cycle of inspection. A new manager had been appointed and the day of the unannounced inspection was his first day in post. He had started his induction programme with a meeting with the Operations Director who made himself available during the inspection. Seven of the twelve staff on duty, three residents and two relatives were spoken with and the residents on Keppels and Greasborough were observed for the majority of the inspection. Notices were placed around the home to inform residents, staff and visitors to the home that an unannounced inspection was taking place. Forty comment cards and prepaid envelopes were left at the home so that service users or their representatives can contact the CSCI with their views about the home, seven of which were returned immediately. The inspection focused on the requirements from the previous inspection, four residents files were case tracked along with medication, staffing rota, training, and Adult Protection. What the service does well:
Staff were observed to have good rapport with residents. There has been audit system introduced for bedroom cleaning, which has improved the cleanliness of the home. A new activities organiser started on the day of inspection and is looking to develop a varied activities programme in and outside the home to provide stimulation for residents. All of the service users and the relative spoken with were highly satisfied with the delivery of care and had no complaints. One family sent the staff a floral tribute and a card of appreciation for the “wonderful care” of their relative who had died and for the reception after the funeral. The parent organisation has given the CSCI every co-operation to up-grade the home and to comply with regulations and the National Minimum Standards for Older People thereby improving the service offered to residents. CHERRY TREES Version 1.10 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. CHERRY TREES Version 1.10 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 Standards Statutory Requirements Identified During the Inspection CHERRY TREES Version 1.10 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 standard(s) 1, 2 & 3 Vast improvements in the environment and care practices have taken place since 6th January 2005 for the well-being and comfort of service users. Prospective service users receive information they need, to make an informed choice about where to live. New documentation in assessment and contracts are in place to ensure the home meets residents’ needs. EVIDENCE: Statement of Purpose and Service User Guide has been updated and both documents are in the entrance of the home for all visitors to read. Two relatives confirmed that that they had received on behalf of their relative, the Service User Guide and the terms and conditions of the contract. A new preadmission assessment format is in use and contains the required information outlined in Standard 3 of the NMS. Four files were examined and found to have assessment documents. CHERRY TREES Version 1.10 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 standard(s) 7 & 9 The care plan system is clear and provides staff with direction that they need to meet service users needs. Staff on two units are not working to the policies for the administration of medication, which promotes the wellbeing of residents. EVIDENCE: Four care files were examined (in the Keppels and Greasborough units) all of which had been re-written to reflect residents changing needs. Staff have rewritten the care plans to include information to direct the staff in the action to be taken. 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, two relatives spoken with confirmed that they read care plans and were involved with their relative’s care. One relative made the comment “Staff treat my wife with care fully respecting her and her rights”. “They treat her well.” “We are more involved in her care than we were in hospital.” Medication policies and procedures are in place, which promotes safe handling and administration of medication. Staff are inconsistent in two units (Keppels and Greasborough inspected) in working to the home’s medication policies by failing to record the administrations of drugs.
CHERRY TREES Version 1.10 Page 10 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 standard(s) 12 & 14 The home is promoting 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: Previously the home had an activities organiser who had resigned. The new activities organiser had been employed and had started on the day of inspection. A concert took place in the afternoon and some residents from all units attended. When asked they said, “Yes I have enjoyed the music.” Another resident said “ I don’t like music, so I don’t go”. There have been changes in that the activities room has been altered to a 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. All of the three residents who could make their views know said that meals are varied and said they enjoy their meals CHERRY TREES Version 1.10 Page 11 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 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 has received training on Adult Protection matters and this is on going to ensure all new staff have the same training. All the bolts on bathroom/toilet and office doors have been removed for the safety of service user, relatives and staff. The training record was examined stating how many staff had training on abuse. Staff interviewed gave a good account of what their responsibility was regarding allegations of abuse and were aware of the adult protection policy. The homes policies state that staff are prohibited from involvement in, or benefiting from service users wills or loyalty cards. One of the comment cards stated “Complaint re agency nurse was dealt with immediately.” Complaints are recorded and the company have taken action to resolve complaints and issues. Three residents and two relatives who were visiting the home confirmed that staff were caring “you couldn’t find better”. CHERRY TREES Version 1.10 Page 12 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 standard(s) These standards were not assessed. EVIDENCE: CHERRY TREES Version 1.10 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The company is working towards ensuring there are sufficient and suitably qualified experienced staff that are trained in providing care for residents’ assessed needs. EVIDENCE: The staffing levels have increased to ensure that service users have their care needs met although there are times that agency staff are still used. The company is working to fill vacancies to have a consistent staff group to ensure that they can meet resident need. Staff morale is much higher than of January 2005. Staff rotas were examined and there are three members of staff on each unit ensuring sufficiency to meet resident’s needs. Through discussions with staff members they stated that the atmosphere within the home had improved and that they felt listen to and have been supported by senior staff members. The manager was short-listing application forms for new staff to have interviews in the near future to fill vacancies to reduce the need for agency staff. All staff have been given a copy of Codes of Practice issued by the General Social Care Council and is part of the recruitment/new employee procedures. Each employee has a file with all information, which includes training and development assessment and profile, enabling the management to review staff development. CHERRY TREES Version 1.10 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 The home has been in the direct supervision of senior management of the company to change the ethos of the home and for the home to be managed for the best interests of the service users until a new manager was in post. EVIDENCE: The company advertised and appointed a new manager who started on the 18th April 2005 who has experience of social and nursing care of older people, they will be expected to carry on the improvements in the home, following senior managers guidance. The home does not comply with the Health & Safety (First Aid) Regulations 1981. At the previous inspection health and safety certificates were up to date and were not assessed at this inspection. All new staff have basic first aid on their induction programme. However, there are no members of staff who have an up to date certificate in first aid. There are no “nominated person” on each shift or on each level of the home failing to meet the health and safety standards required.
CHERRY TREES Version 1.10 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x x x x 2 CHERRY TREES Version 1.10 Page 16 yes 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. 2. Standard NMS OP 31 NMS OP 38 Regulation Reg 8 Reg 13 Timescale for action The company must put forward a 1st July candidate to be the registered 2005 manager of the home. Sufficient staff must be trained 1st in first aid to comply with the September Health and Safety(First Aid) 2005 Regulations 1981 to have a nonimated or certified on each shift on each level of the home. Requirement 3. 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 NMS 28 Good Practice Recommendations A minimum of 50 of trainined members of care staff to have achieved NVQ level 2 or equivalent by the end of 2005. CHERRY TREES Version 1.10 Page 17 Commission for Social Care Inspection First Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ 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. Extracts may not be used or reproduced without the express permission of CSCI CHERRY TREES Version 1.10 Page 18 - 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!
