CARE HOME ADULTS 18-65
Cherry Trees 28 Berrow Road Burnham-on-sea Somerset TA8 2EX Lead Inspector
Ms Sue Hale Unannounced Inspection 2nd February 2006 12:15p Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 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 DS0000015981.V282123.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 Adults 18-65. 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 DS0000015981.V282123.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cherry Trees Address 28 Berrow Road Burnham-on-sea Somerset TA8 2EX 01278 792962 01278 795961 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) Vanessahalfacre@nas.org.uk National Autistic Society Mrs Christine Morgan Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Cherry trees is registered to provide personal care for up to nine people who have a learning difficulty. The home is located in Burnham on Sea, within walking distance of the town centre and the seafront. Residents’ accommodation is arranged on two floors, with two rooms on the ground floor and the remaining seven on the first. The registered manager is Christine Morgan, and the National Autistic Society owns the home. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place in February 2006. The inspector spoke to the registered manager. There were no staff on duty during the inspection as the residents were away from the home at college and participating in activities in the community. The inspector checked one resident’s care and support plan, viewed parts of the home and checked other records relevant to the running of the home. What the service does well:
Robust admission policies ensure that prospective residents assessed needs would be met at the home. Prospective residents are able to meet the staff and existing residents and spend time in the home before making a decision on residency. Care plans and risk assessments were very well maintained, up to date and contain detailed information to enable staff to meet residents, health, social and care needs. The home has not received any complaints or allegations of abuse. The staff team work very effectively to make sure that the residents’ needs are met in a person centred way. Residents are fully involved as afar as they are able in the running of the home. Effective quality assurance that includes the views of residents and their relatives are in place to ensure that the standards in the home are monitored. The policies and procedures, including protecting vulnerable adults, ensure that the home is run in a way that safeguards residents’ best interests. Records were well kept and stored securely. The home is well run by a suitably qualified and experienced registered manager. The home continues to provide a very high standard of care and very good environment for residents. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 4. Robust admission procedures are in place and all prospective residents would be able to spend time in the home and meet staff and existing residents before making a decision on residency. EVIDENCE: There have been no new admissions to the home for some time. However, the National Autistic Society have detailed and robust procedures for any new admissions to the home. The home would undertake a pre admission assessment and would obtain information from the funding authority from the care management assessment and proposed care plan. An individual care and support plan would be developed with the resident and discussion with their families and/or representatives would take place. Prospective residents would be invited to meet the staff and current residents informally and to spend time within the home including an overnight stay to assess their suitability and ascertain the view existing residents. All admissions would be on a trial basis and be reviewed formally after a settling in period. The home does not accept emergency admissions. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10. Records were stored securely and staff and residents aware of confidentially issues. EVIDENCE: The home has a robust confidentiality policy and the manager spoken to was familiar with it and confident in how it worked in day to day practice. Residents are made aware of which confidences are kept and which cannot be kept and the reasons for this. Residents have the policy available to them in an accessible format and are aware that they are able to access information held about them. Records are stored securely in the office. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All standards were assessed and met at the previous inspection on the 20th September 2005. EVIDENCE: Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 & 21. Residents now benefit from an increased number of male staff. Arrangements for recording the receipt and administration of medicines were satisfactory. Information for residents about bereavement was available in accessible formats. EVIDENCE: A new male member of staff has started work and this offers residents, who are all male, increased choice of working with staff of the same gender. The manager stated that the home now uses the medical administration forms supplied by the community pharmacist to record the receipt and administration of medicines, which is good practice. The manager stated that the home had access to information in accessible formats to support residents who may experience the serious illness or death of a close friend or relative.
Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Robust systems are in place to protect residents from abuse. EVIDENCE: The home has not received any allegations of abuse. The home has robust policies and procedures including whistle blowing, to protect residents from abuse and all staff are aware of the policies and their responsibility in relation to protecting vulnerable adults. Polices and procedures are in place to inform staff that they must not accept gifts from residents or assist or benefit from their wills, this is also included in the induction programme. Staff do not work at the home until a check has been returned from the Criminal Records Bureau. Physical intervention is not used at the home. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24. The home is decorated and furnished to a high standard that will be maintained once the planned redecoration takes place. The hall carpet is worn and presents a possible hazard. EVIDENCE: The home was clean, tidy and free from odours on the day of the inspection. The manager stated that plans are in place to redecorate the communal space and the inspector saw evidence that this had been discussed with the residents at the weekly meetings and that they had been involved in choosing colour schemes and wallpaper. The carpet in the hallway by the office and laundry was worn and frayed presenting a possible trip hazard. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 & 36. On the day of the inspection the home appeared appropriately staffed to meet the needs of the residents. Staff had the knowledge and skills to provide a good quality service for residents. The staff team work effectively to meet residents’ needs and provide a high standard of care. The home provides formal and informal supervision and appraisal of staffs care practice. EVIDENCE: The inspector noted that there were 12 members of staff, including the manager in the staff team. Four members of staff have achieved NVQ three qualifications and a further three are currently registered on a course to ensure the staff have the appropriate skills and knowledge to meet the needs of the residents. The staff have access to an detailed induction and foundation training programme and also to training in how to communicate with residents appropriately, the gender balance of the team has improved since the employment of another male member of staff with four members of staff now male. All staff are aged 18 and all senior staff are aged over 21.
Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 15 Records showed that staff received regular supervision with records kept of discussions and outcomes. All staff had access to appropriate training courses and received encouragement and support from the manager to do so. Regular staff meetings took place with all members of the staff team being able to contribute to the agenda. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40 & 41. Effective quality assurance processes that include residents are in place. Residents’ rights and best interests were safeguarded by the homes policies and procedures. Records were kept and stored appropriately. EVIDENCE: The home was inspected by a member of the National Autistic Society Trust Board as part of the organisations quality assurance process. As part of the process residents and relatives views were canvassed and taken into account in the report. The report was very positive about the service provided at the home. Residents meetings are held regularly and minutes kept for all to refer to. All residents have a yearly review of their care and support plan that identifies development and future opportunities.
Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 17 The manager stated that new changes since the previous inspection included the introduction of two meal choices at weekends and a record of individual residents likes and dislikes in relation to food and drink. The home has comprehensive policies and procedures that are accessible to staff. Relevant policies are available to residents in accessible formats. Policies and procedures are reviewed and updated regularly by the National Autistic Society. Records were stored securely and kept in a manner that meets the requirements of the Data Protection Act 1998. Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 3 X X 3 3 3 X X Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 19 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. 1 Standard 24 Regulation 16(2)(c) Requirement The hall carpet must be replaced to maintain a safe and comfortable environment. Timescale for action 01/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cherry Trees DS0000015981.V282123.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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