CARE HOME ADULTS 18-65
Cherry Trees (Woking) Cherry Trees 15/17 Claremont Avenue Woking Surrey GU22 7SF Lead Inspector
Damian Griffiths Unannounced Inspection 25th January 2006 10:00 Cherry Trees (Woking) DS0000013599.V283012.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 (Woking) DS0000013599.V283012.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 (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cherry Trees (Woking) Address Cherry Trees 15/17 Claremont Avenue Woking Surrey GU22 7SF 01483 829463 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) Mr Samy Kadoovel Gengasamy Mr Samy Kadoovel Gengasamy Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Age Range The age range to be accommodated is 18 - 65 in respect of those service users within category MD. Category MD (E) Of the 11 (eleven) service users accommodated at the home 2 (two) may fall within the category MD (E) - over 65 years of age 15th August 2005 Date of last inspection Brief Description of the Service: Cherry Trees consists of two Victorian houses that have recently had a corridor built linking both premises. The development also includes a pleasant entrance lounge, office and additional rooms. Cherry Trees is registered to accommodate eleven service users with mental health needs. The Home aims to assist service users to work towards independent living. Both parts of the home have adequate communal areas but the main kitchen and dining area is situated on the left side of the main entrance. Bedrooms are of various sizes and some bedrooms have been fitted with ensuit shower and toilet. The new building provides additional storage, a newly converted reception room and a newly converted computer/resource area. There is a small workshop to be found at the rear of a spacious garden where practical skills and workshops can be obtained. The home is situated on a busy one-way road system close to Woking Town Centre. There is limited parking space to be found on the entry driveway and metered parking is available on the road outside the premises. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection of two, to be undertaken by the Commission for Social Care Inspection (CSCI) year beginning April 2005. It was an unannounced inspection and took place over a period of 6hrs. Mr Samy Gengasamy Registered Manager representing the establishment and Ms Beata Mikoda Senior support worker assisted Regulation Inspector Damian Griffiths throughout the inspection. A tour of the premises took place and the inspector was able to meet five service users and three members of staff who were happy to contribute to the inspection process. A selection of documents and reports were sampled relating to service user information, including contracts, care needs and service user involvement with the running of the home. Staff files were inspected for information about the staff skills and training. The Inspector would like to extend thanks to the services users, management and staff at Cherry Trees for their time and hospitality. What the service does well:
The home continues to provide a secure base for independence training, assessment and reintegration into the community with the support of a client focused care plan. The multi-disciplinary nature of the ‘care-plan-approach’ required by the mental health practitioners provides a good model of focused service user care that ensured the health and social care needs were regularly reviewed. Service users were encouraged and supported to take part with decisionmaking that was in evidence at this inspection. Service users commented about the practical skills being attained at Cherry Trees at a level that was acceptable to them and without pressure. Staff Training and support was in evidenced and the home provided an equitable environment for support workers to gain interpersonal skills and knowledge of mental health issues. The home is to be congratulated for receiving the ‘Investors in People Award’ in March of last year. The manager works in conjunction with the Local Community Mental Health Team and does not admit service users without careful planning and preparation. Service users at the home were happy with the service they received and felt they were well cared for and treated well by the staff. They were also happy
Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 6 with the level of involvement at the home that included attendance at staff meetings and service users meetings whenever they felt the need. 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 (Woking) DS0000013599.V283012.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 (Woking) DS0000013599.V283012.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): 1 and 5. The Statement of Purpose was helpful and informative and would assist any new or prospective resident. Written service user care plans and contracts inspected were all in order. EVIDENCE: The home had a detailed Statement of Purpose, which accurately described the services the home had to offer. The Manager commented on the need to review the statement of purpose with the help of the service users who will contribute to its rewriting. Five care plans were inspected and showed that all aspects of daily living had been assessed and implemented. Information was comprehensive detailing health plans, risk assessment and contracts. Cherry Trees (Woking) DS0000013599.V283012.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. Information of a confidential nature was stored well and handled sensitively by staff members. EVIDENCE: Confidential information contained on service users files was stored securely and policies and procedures in place Service users care plans, were stored in a locked cabinet and accessible when required. Staff were seen to be discrete and sensitive towards the services users throughout the inspection and exhibited awareness of the ‘no secrets guidelines’ as promoted in the adult protection training that staff had attended. Service users and staff were encouraged to respect boundaries relating to confidentiality. This was evidenced by a sign that was placed on the door of the office during the inspection requesting service users not to enter the office as their maybe confidential papers on show. Service users consulted confirmed that that their privacy was respected. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 10 Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 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 the following standard(s): Not inspected. EVIDENCE: Not inspected Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 12 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 and 19. Staff were available to assist service users with personal care if needed, however, service users were encouraged and supported to participate with the management of their own care needs. EVIDENCE: Service users at Cherry Trees were not in need of help with personal care unless identified in the assessment care planning process i.e. brushing teeth or showering. This was generally handled in a sensitive way, commented one service user. Care plans were reviewed monthly by staff at Cherry Trees and jointly every three months with the local Community Mental Health team (CPA). Care plans inspected, evidenced the involvement of a range of Social and health care practitioners such as: GP, Social Worker and family who were involved to ensure that needs were identified and met in agreement with the service user. The multidisciplinary way of working, evident at Cherry Trees guaranteed the health care needs of the service users were being met. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 13 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): 22 and 23. Complaints procedures were in place and service users were regularly consulted. Staff were aware of the Protection of Vulnerable Adults procedures and were receiving regular training and support. EVIDENCE: The complaints procedure was available in policy form and in the service users guide. Service users commented on being able to approach the manager if they wished to make a complaint however no complaints had been recorded or reported at the time if the inspection. Staff work closely with Police, Social care teams and the Probation service and have attended Surrey’s vulnerable adult protection training. Staff are updated at every shift change, with the issues of the day and have access to the Surrey Multi-agency Procedures located in the office. Service users consulted said they felt safe and well cared for and were able to talk to staff if they were concerned about anything. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 14 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 and 28 The home was found to meet service users’ individual and collective needs in a comfortable and homely way. Investment in the home has enabled radical changes to be made that will benefit the service users. EVIDENCE: Service user consultation and discussion had brought about the radical redesign of two communal areas in the new extension. The smoking room overlooking the garden area has been designated as a new reception room for meeting family and friends in private. A service user commented that the change had reduced the number of sleepless nights caused by other service users walking about at night on their way to the smoking room and quieter calmer atmosphere now prevails. The second kitchen in the new wing destined for the training and general use of practical cooking skills was being converted into a new computer-resource room. The adjoining lounge wall had been removed and new furniture added has helped to create an airy and comfortable room that provides space for teaching, leisure or study. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 15 Alterations to the area next to the main kitchen were in progress to provide additional space. All the changes had been thoroughly discussed with the service users who thought it was a good idea and were enthusiastic about accessing computers and the potential for training. This provided an excellent example of focused service user care provision. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 16 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 and 33. All interactions observed between staff and service users evidenced a high degree of respect and skill in working with individual service users at the home. The staff team provided a good range of skills and showed that they were receiving appropriate training to meet the needs of the service users and to ensure their safety. EVIDENCE: Staff were observed to respond to the service users when in need of help and were sensitive to their needs responding to their queries with patience and respect. Four staff files were inspected to establish that the skill mix of those on duty were satisfactory and met the needs of the service users at home on the day of the inspection. Evidence of training and experience was available in the following areas: First aid, food hygiene, behavioural management and vulnerable adult awareness training. Training for the year was available on the staff notice board and provided a good example of forward planning. NVQ level two, geared towards mental health had been attained by some of the staff and was ongoing. The manager is a strong supporter of continued professional development and encouraged his staff team to discuss their
Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 17 training needs. Staff consulted confirmed that they were well supported this was further endorsed by the Award of ‘Investing in People’ bestowed upon the Home. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 18 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): 38, 39 and 42. The home was run in an open and inclusive way that was seen to encourage service user involvement and fostered good health and safety practices. The home had progressed with changes in a safe manner and with regard to the needs of the service users. EVIDENCE: The manager was available to supervise most days from 8am to 8pm and an open door policy was maintained. Two service users are encouraged to attend staff meetings and to hold their own meetings, last meeting minuted January 6th (2006). Recent changes at the home confirmed the style of management and service user participation was inclusive and open. Staff support service users to present their own care needs at an annual care plan review meeting, linked with the Care Plan Approach (CPA) and staff present a progress report. Service users confirmed that they were able to put Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 19 their side of things to be discussed and were satisfied with this aspect of the procedures. Health and Safety was observed and practised during the inspection. Policies and procedures, including COSHH, legionella, water temperatures, electrical appliance checks and gas certificate were in place. Fire drills were held regularly and recorded appropriately as were fire extinguishes checked by fire officer. Areas of the home undergoing refurbishment were clean and tidy and risk assessed. Staff and service users consulted confirmed that this was a winning combination and proved a satisfactory friendly environment to live and work in. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 20 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 3 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 4 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 X 36 X 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 4 4 X X X 3 4 X X 3 X Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 21 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 00 Regulation 00 Requirement None arising from this Inspection. Timescale for action 25/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 00 Good Practice Recommendations None arising from this Inspection. Cherry Trees (Woking) DS0000013599.V283012.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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