Inspection on 26/06/06 for Cherry Trees

This inspection was carried out on 26th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 13/01/09

Cherry Trees 29/01/08

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Cherry Trees Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ Lead Inspector Ms Rosemary Reid Key Unannounced Inspection 26th June 2006 07:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Trees Address Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ 01709 550025 01709 556308 NONE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cherry Health Care Limited Post Vacant Care Home 66 Category(ies) of Dementia (66), Old age, not falling within any registration, with number other category (66), Physical disability (66) of places Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th February 2006 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. 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 for Residential Dementia Care are £370, Nursing Dementia Care £344, Residential £329 and Nursing £344 plus banding for example high £558. dependent on needs assessment as at 1st April 2005 and additional charges are made for hairdressing from £5:00, Chiropody from £15:00, Optical, Dental services, specialised toiletries and magazines etc. The registered person makes information about the service available to residents and their families via the home’s Statement of Purpose and the Service User Guide. A copy of the inspection report is made available at the home. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 26th June 2006 from 7:30am to 17:00pm. The deputy manager had been the acting manager until the present manager was appointed at the beginning of June. The appointed manager had only been in post for a matter of two weeks. Seven staff, six residents were observed, two relatives were spoken with along with observation of the interaction between residents and staff. Ten questionnaires survey cards were left at the home one had been given to the inspector on the day of inspection. No further questionnaires had been received at the Commission’s office. There were no requirements form the previous inspection and the inspection focused on the key standards, two residents’ files from each of the units a total of eight) were case tracked along with medication, staffing rota, the environment and Adult Protection. Each file examined had assessments, pressure care, and care plan, daily recording and monthly review of care plan. Supporting documents were also seen for example home’s desk diaries, medication records, staff files and Health & Safety records. Four staff files were also assessed. The home has an activities organisers and an activities programme, which includes in house activities along with trips out for example shopping and day trips to the seaside. All residents in both levels of the home were observed and many were spoken with. However, the residents in the dementia unit, due to their diagnosis of dementia they could not always give their personal views of the delivery of service. One visitor to the home was interviewed who spoke about the home in positive terms although was concerned that another manager was in post. The inspector spoke with seven staff members, and the manager. A tour of the premises/environment/front and rear gardens showed that on going maintenance work has been undertaken. The home was clean and without mal odours. Feedback was given at the conclusion of the inspection to the manager and at a meeting to the Operations Director. Ten questionnaire survey forms were left at the home and four were returned. Of the four that were returned three were satisfied with the delivery of care the fourth one was generally pleased with the overall care however did have some negative comments. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good, and this judgement has been made using the evidence available. Service users and prospective service users have up to date information regarding the registered provider. An assessment of need is undertaken and all service users have a contract/statement of terms and conditions of residency, which safeguards their legal rights. Intermediate care is not provided in Cherry Trees however, the service offers short stays and respite care if there is a bed available. EVIDENCE: The service has developed a Statement of Purpose and the Service User Guide; both which have been updated due to the recent change to of manager. There was evidence from previous inspections when families and staff confirm that the Service User Guide had been given to prospective service users and/or relatives. There was a Statement of Purpose in the entrance of the home and Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 9 Service User Guide is in each bedroom. Each resident had a contract/terms and conditions of residency with a copy on file. The eight service users’ files that were case tracked had copies of contract/statement of terms and conditions of their residency and delivery of care. Records show that Pre-admission assessment is undertaken and this was recorded within the individual service user’s care file to ensure that the home can meet their needs. Records show and in discussions with service users and families confirmed that the home welcome visits before admission to assess the quality, facilities and suitability of the home. The home does not offer intermediate care. There was evidence that respite care provision is used when a bedroom is available. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good, and this judgement has been made using the evidence available. Arrangements for dealing with resident’s health issues are met by staff at the home, with support from health professionals, and care planning systems are sufficiently detailed to enable staff to deliver the care to residents who have specific identified needs and promoting good health. Staff are working to the organisations policies and procedures for administration of medication. EVIDENCE: Medication policies and procedures are in place, which promotes safe handling and administration of medication. Each resident has a medication review there was evidence that seven residents were to have a medication review and this continues throughout the year. Medication records were examined and found to be correct. There are policies and procedures dealing with care of the dying and where known residents’ wishes for their funeral arrangements are recorded within the file. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 11 A total of eight care files were examined on four of the units, all of which had been updated to reflect residents changing needs. Staff are reviewing care plans monthly to ensure that residents assessed and changing needs are in the care plan and the goals are met. The assessment and the care plan cover all aspects of care. Where possible relatives are involved in the development of the care plan. For example, two relatives spoken with confirmed that they were involved with their relative’s care. One relative stated, “I can only say what I said the last time” “Now that the deputy manager is back on the unit standards of care will be back to normal. Standards are good and I wouldn’t have my wife go to another home.” “I have been concerned that there is another manager “and I have been kept informed of what is happening”. The activities coordinator is new and there have been activities in house and out of the home. There was evidence that there are assessments for tissue viability and action is taken for the care for the prevention of pressure sores. There were five residents who had pressure sores, all of which were acquired in hospital. The tissue viability nurse had been involved and equipment has been obtained to assist in the care and treatment of pressure care. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good, and this judgement has been made using the evidence available. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. Social interaction and the activities programme provided stimulation and interest for residents. EVIDENCE: There were no complaints about food from the residents or relatives spoken with. They said that they enjoyed their meals times and they liked the choices offered. A four weekly menu is offered, which provides a balanced and varied diet. Arrangements have been made for one resident who requires halal meat in their diet. The meal is prepared by a local restaurant and brought to the resident at an arranged time. Records show that all residents have nutritional assessment completed and dietician is used when needed. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 13 The home has a newly appointed activities co-ordinator. There is a range of activities had been undertaken for example shopping trips, day trip to the coast and in-house entertainment. There is a room available for activities and for relatives. Visitors are welcomed at all reasonable times and residents can choose to entertain their visitors in the lounges or their bedrooms. Records show that there is the availability of having communion in the individual resident’s bedroom and for another resident the care plan records that time must be given to the resident for their prayers. Service users and or relatives are asked with regard to the resident’s religious/spiritual needs as part of the admission process so that the staff can contact the local religious representative to visit if required. The inspector spoke with one visitor to the home they confirmed they could visit at any time, and could see their relative in the resident’s own bedroom. They said that they were generally satisfied with the delivery of service. There had been issues however these had been resolved. Where possible families are involved in care planning and have been asked about the residents interests and likes and dislikes. Records show that residents/relatives meetings have taken place in the past with minutes taken and meetings had been arranged later in the month to introduce the new manager Staff were openly and indirectly observed throughout the inspection, good interactions between staff and residents the staff members encouraged residents to make choices whenever possible, for example options at meal times. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16.17,18 Quality in this outcome area is good, and this judgement has been made using the evidence available. Residents and relatives are provided with information to enable them to raise concerns or complaints about the home and their care within the Service User Guide and the complaints procedure. Staff had knowledge and understanding of adult protection issues, which promotes protection of residents from abuse and training, has taken place at the induction programme. EVIDENCE: The home’s complaints policy and procedure is clear and accessible to all residents and visitors. Records show that five complaints had been since the previous inspection. Action had been taken to resolve the matter by the manager. One of the four questionnaire survey forms that had been returned showed that the relatives (who completed the questionnaire on behalf of the resident) were generally satisfied with the service and knew how to use the complaints procedure. There were issues highlighted such as “standards had dipped following the departure of the home’s manage. The changes in management structure will hopefully correct these.” Three other questionnaires were satisfied with the delivery of care at Cherry Trees. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 15 The home has policies and procedures for adult protection staff spoken with confirm they are aware of these polices and procedures and training sessions have taken place. Staff induction records show that residents’ welfare/rights are discussed, which includes Adult Protection matters. It is the company’s policy for staff to have the company induction programme which includes Adult Protection matters. The company have adult protection procedures and the home had a copy of Rotherham Metropolitan Borough Council Social Service Adult Protection Procedures all of which promotes the residents rights to complain and uphold their protection while at Cherry Trees Care Home. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good, and this judgement has been made using the evidence available. Service users live in a safe well-maintained environment, which was clean and tidy. The manager and her staff are working to ensure an environment free from offensive odours. EVIDENCE: Cherry Trees is a purpose built nursing home. From the beginning of 2005 the home has had a refurbishment programme, which greatly improved the environment throughout the home. Tour of bedrooms found that most had been made very homely and residents had some personal possessions in their rooms. All bedrooms one single occupancy and there was evidence that many of the residents had personalised their bedrooms. The corridors and six bedrooms had new carpets fitted; new beds have been purchased during the past eight months. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 17 There is a selection of communal areas in the different units, which include the lounge, dining room and snack kitchen within the home. There is a redecorating programme in place for all areas of the home The domestic staff were observed working hard to ensure a clean and hygienic environment and no mal odours within the home. Gardens are at the rear of the home with seating, which is used for service users. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good, and this judgement has been made using the evidence available. The organisation has recruitment policies and procedures, which include equality and diversity for residents who live and for staff who work at Cherry Trees Care Home. Staff files show that these policies and procedures were completed in a correct manner for example two references are obtained and CRB/POVA checks are undertaken. EVIDENCE: Rotas were examined which showed that there was sufficient staff on duty. Records show that staff had induction and training courses had taken place, which includes, Food Hygiene, First Aid. Moving and Handling training had taken place ensuring that service users are in safe hands at all times. The company have mandatory training programme too ensure that all staff have training according to their needs. Thirteen care staff members have NVQ level 2 with ten working towards the award and six working towards NVQ level 3 award. The manager said that the next focus was to ensure that all madatory training was up to date. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 19 The organisation has recruitment policies and procedures, which include equality and diversity for residents who live and for staff who work at Cherry Trees Care Home. Staff files show that these policies and procedures were completed in a correct manner for example two references are obtained and CRB/POVA checks are undertaken. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is good, and this judgement has been made using the evidence available. The company and the appointed manager are working to ensure leadership; guidance and direction to staff to ensure residents receive consistent quality care. This results in the health, safety and welfare of residents and staff being promoted and protected. There is a plan for formal supervision sessions, which support or develop staff and that does not benefit the care given to residents or the development of the staff group EVIDENCE: The appointed manager has been in post for a very short period of time, a matter of two weeks at the time of the inspection. He is experienced in working in a nursing/residential social care setting and had enrolled on the Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 21 Registered Managers Award. He is aware of his responsibilities and aims to run the home in the best interest of service users. Residents/Relatives and staff meetings are due to take place later in the month. The organisation has sound policies on all areas of care and employment matters and is aware of current legislation. The manager and his team undertake audits to ensure adherence to policies and procedures in their dayto-day practice. The appointed manager has taken action to ensure health & safety measures are undertaken and are up to date. The service has a Health & Safety Committee and the parent company has a good record of meeting relevant health and safety requirements. The home has a handyman who is responsible for fire prevention testing measures and testing of water temperature. For example, the home has a fire risk assessment and fire prevention procedures have taken place. Hoists have been serviced and water temperatures are recorded. Accident records were examined and records show that staff complete appropriate documentation. Records show that some residents take responsibility for their own financial matter while for other residents their families deal with all monetary issues. The service provides receipts and receipts are obtained for any financial transactions. All necessary insurance cover is in place to enable it to fulfil any loss or legal liability. Monitoring visits are undertaken on a monthly basis from a representative of the parent company. Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 X 3 Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cherry Trees DS0000003076.V296419.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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