Inspection on 20/09/05 for Cherry Trees

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cherry Trees 01/07/09

Cherry Trees 29/06/07

Cherry Trees 02/02/06

Cherry Trees 14/02/05

Cherry Trees 24/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Cherry Trees 28 Berrow Road Burnham-on-Sea Somerset TA8 2EX Lead Inspector David Kidner Announced 20 September 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) National Autistic Society Mrs Christine Morgan Care Home 9 Category(ies) of 1. People aged 18 - 65 with learning disabilities. registration, with number of places Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 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 home is owned by the National Autistic Society. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and was undertaken by two inspectors and lasted one day (6.75hrs). The inspectors viewed all parts of the home, and talked to the manager and four staff. The inspectors viewed records in relation to care and support plans, health and safety and medicines. Four comment cards were received from residents and one from a healthcare professional. The poster, giving details of the planned inspection, including one with signs and symbols was on display in the entrance hall. The residents find it difficult to express their views and opinions, but the inspectors were able to observe care practices and interaction between staff and residents. There were no requirements made following this inspection. What the service does well: What has improved since the last inspection? The home has recently built an extension, which provides improved staff and visitor facilities and laundry facilities to the residents. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 6 Lockers have been provided to give staff a safe place to store their personal belongings. A trampoline has been purchased for residents use. 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 D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 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 standard(s) 1 The statement of purpose and service user guide gave clear information about the services provided at Cherrytrees and the terms of residency. EVIDENCE: The home had revised, the statement of purpose, and it contained all the required information in a clear, easy to understand manner. This had been identified as a requirement at the previous inspection. A service user guide tailored to each individual residents needs had been produced, it included details of the services offered by the home and the terms and conditions of residency. Both documents were written in plain English. The documents enabled prospective residents, relatives and funding authorities to make an informed decision about services offered at the home. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 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 standard(s) 6,7,8,9 Residents are encouraged to make decisions about their life and are supported to be involved in the running of the home. The home uses alternative methods of communication to offer choice and aid decision-making. The staff team and culture within the home supports residents to take risks while promoting an independent lifestyle. The care and support plans are user led, well-organised and regularly reviewed. Risk assessments are conducted and reviewed when needed. EVIDENCE: The inspectors viewed two care and support plans, both of which were detailed and comprehensive and gave clear information to staff. Each resident has a nominated key worker. Relatives and other people important to residents had been involved in the residents’ plan of care and consulted on a regular basis. Risk assessments were in place, detailed and up-to-date and were reviewed as necessary to ensure the safety of residents. Residents were supported by staff to access all necessary medical and health care. Copies of medical and health care assessments were on file. Records relating to individual residents were Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 10 kept in several files. Consideration should be given to keeping information in one care file for ease of access for staff. Residents have the opportunity to attend a church of their choosing if they wanted to. Residents were seen making choices in how they participated in the running of the home. Signs and symbols are used to aid communication, where needed. Weekly house meetings take place, with one resident, taking minutes and distributing these to their peers. The residents are responsible for doing their own laundry and instructions on how to use the facilities were available in pictures and symbols. The home had recently purchased a trampoline, as residents had enjoyed using one elsewhere. Risk assessments were in place and staff had been given clear guidelines on how to support residents in its use. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 11 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 standard(s) 11,12,13,14,15,16,17 The home encourages and supports residents to access the local community and partake in a variety of leisure, recreational and social activities. The home encourages family and friends to visit the home and residents rights are respected and promoted. The home has a planned menu, that is healthy, and with choices available. EVIDENCE: Residents are given the opportunity for personal and social development in a number of ways, including becoming involved in the running of the home, attending college, day services, and through leisure activities. Service users are offered choices in leisure, social and recreational activities. Activities are based on individual choice and need and records kept of all activities undertaken. Some service users have recently begun bell ringing as a group on a regular basis, with support from a volunteer. Two residents were using computers during the inspection. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 12 Residents have access to all areas of the home. Each bedroom has a suitable lock to promote privacy and residents are offered their own key. The home encourages residents’ contact with family members and friends. Records are kept of all visits, letters sent and received, and telephone contact. Residents go home to see their families on a regular basis. Residents are involved in menu planning, whenever possible, and alternatives are always available. A resident was preparing vegetables for the evening meal during the inspection. Residents are able to make individual choices for their meals on a Saturday. Residents prepare their own breakfast and packed lunches. Residents go shopping with staff and are able to assist with buying weekly groceries for the home. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 13 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 standard(s) 18,19,20,21 The home ensures that residents have access to all appropriate health care professionals. Residents would benefit from a higher male gender balance in the staff team. Current arrangements for recording the administration of medicines for the majority of residents would benefit from review. The home offered good support for residents who had experienced bereavement. EVIDENCE: Residents at the home need minimal support with personal care, any particular need is detailed in individual care plans. For one resident staff have developed a flip chart book with pictures and symbols to prompt the resident with personal care which had worked better for the person concerned than verbal prompts. All residents living at home are currently male, the staff team of 12 includes two males. To allow the residents a choice of a member of staff of the same Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 14 gender for personal care and leisure activities, consideration should be given to this when recruiting staff. The care and support plans view contained records of visits made to health care professionals. These included visits to the GP, dentist, chiropodist, optician and to speech and language therapists. The inspectors viewed the arrangements in relation to the storage and administration of medicines. This was in general, satisfactory. However, the home had developed their own system of recording the administration of medicines. This system worked well to provide a larger space for a resident who self medicates to sign that he had received his medication. However, for all other residents, serious consideration should be given to using the medical administration record supplied by the community pharmacist. Two residents had experienced bereavement, since the last inspection. Residents had received considerable and appropriate support from staff and the manager. The inspectors discussed with the manager how to support residents in relation to bereavement. Consideration should be given to obtaining suitable information in appropriate formats for residents on the terminal illness or death of a close relative or friend. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 15 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 standard(s) 22,23 The home has a detailed complaints procedure that is available in appropriate formats to residents. Robust systems are in place to protect residents from abuse. EVIDENCE: The home has a clear complaints policy and procedure, which is also available in symbol and picture form. No complaints have been received by the home or the Commission for Social Care Inspection since the last inspection. The manager should ensure the complaints log is kept on the premises and accessible to all staff immediately, should they receive a complaint. A resident spoken to was clear about who he would speak to, if he had a any problems or wanted to complain. 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 D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 16 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 standard(s) 24,25,26,27,28, The home is well maintained and provides a homely, comfortable and safe environment. The home is fully accessible and meets the needs of residents. Residents’ private rooms reflected their individual needs and choices. The home was clean and tidy. The shared space would benefit from updating and redecoration. EVIDENCE: Cherrytrees is furnished and decorated in a homely, comfortable style and provides a well maintained home for the residents. There is a lounge area which had been divided to make two smaller rooms, a separate dining area and the spacious conservatory. The kitchen is located off the dining room. It was proposed that the dining-room and 2/3 bedrooms would be redecorated and refurbished in the coming year. The shared space would benefit from updating. The home was clean and tidy on the day of inspection. All bedrooms are of a single occupancy and had been furnished and personalised by the residents. Residents art work has been framed and displayed and furniture made by a resident was in use. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 17 The home has good laundry facilities located in a recently built extension. Instructions for the residents on how to use the laundry equipment were displayed in signs and symbols. The recently built extension provides improved facilities for the staff who sleep in and is also used as a room available for visitors to use. Locker facilities are also now available for staff to store their personal belongings. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,35,36 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 home provides formal and informal supervision and appraisal of staffs care practice. EVIDENCE: The inspectors were provided with a copy of the homes duty rota. There were 12 members of staff, including the manager in the staff team. Three 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. Staff have access to training in how to communicate with residents and were observed to communicate effectively with residents. Reference to the need to consider the gender balance of the staff team has been made in standard 18. Staff spoken to confirmed that they received regular supervision with records kept of discussions and outcomes. A member of staff spoken to said that Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 19 advice and support was always available and that an ‘open door policy’ was in place by the manager. All staff spoken to confirmed that they had access to appropriate training courses and received encouragement and support from the manager to do so. Fortnightly staff meetings took place with all members of the staff team being able to contribute to the agenda. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41,42 The manager is qualified, competent and experienced to run the home and shows direction and leadership. The home has a clear management structure and comprehensive policies and procedures available for staff. The home met all its requirements in relation to health and safety. EVIDENCE: The manager of the home has many years experience working in the care sector and has achieved a certificate in management studies and NVQ level 4 in care. Regular staff meetings take place. Staff spoken to were generally very positive about the support offered by the manager, who was described as a’ good listener’, and as someone who communicates well with staff. The inspectors viewed documents and records relating to health and safety. All appropriate checks are undertaken, including the fire alarm system, and fire Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 21 equipment. Record showed that all equipment was in good condition, and regularly serviced. Records were up to date and well maintained. Staff had all undertaken fire training and fire drills took place regularly. Environmental risk assessments are conducted and reviewed as necessary. Records were kept of any accidents that had occurred. The home has comprehensive policies and procedures that are accessible to staff. The inspectors noted that day-to-day information about the residents was recorded in a manner contrary to the requirements of the Data Protection Act 1998. The manager should address this as soon as practicable. Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cherry Trees Score 2 3 2 2 Standard No 37 38 39 40 41 42 43 Score 3 3 x x 2 3 3 D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 23 no 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA6 YA18 YA20 YA21 Good Practice Recommendations It is recommended that consideration should be given to keeping information about each resident in one individual file. It is recommended that consideration should be given to increasing the number of male members of the staff team. It is recommended that the medicine administration records supplied by the community pharmacist are used in the home. It is recommended that consideration should be given to obtaining information in appropriate formats for residents about death and dying, particularly in relation to parents or relatives. It is recommended that redecoration and updating the shared space is undertaken. It is recommended that all records are kept in a manner that complies with the Data Protection Act 1998. 5. 6. 7. 8. YA24 YA41 Cherry Trees D53_D02 S15981 Cherry Trees V233712 200905 Stage4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier, Taunton TA1 4AL 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. 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