Inspection on 24/01/06 for Cherryfield House

This inspection was carried out on 24th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cherryfield House 14/01/09

Cherryfield House 16/01/07

Cherryfield House 13/09/05

Cherryfield House 15/11/04

Cherryfield House 22/06/04

Cherryfield House 10/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Cherryfield House Petersburg Road Edgeley Stockport Cheshire SK3 8UF Lead Inspector Sylvia Brown Unannounced Inspection 24th January 2006 10:00 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 Cherryfield House DS0000008602.V274966.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 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. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cherryfield House Address Petersburg Road Edgeley Stockport Cheshire SK3 8UF 0161-474 1787 NO FAX 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) Cherryfield Homes Limited Samantha McCoy Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (29) Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Cherryfield House is owned by Cherryfield Homes Limited. The home is a two storey detached property set within the community of Edgeley. The care home is close to the town centre of Stockport, situated in a residential area and is within walking distance of a local park. Cherryfield House offers 21 single rooms, of which 18 have an en-suite facilities, and four double rooms. The home is equipped with a passenger lift. Service users have access to a large lounge and dining room on the ground floor and a lounge and dining room on the first floor. There is a small garden for use during fine weather and a roof garden on the first floor provides service users with additional outdoor seating. Cherryfield House is registered to accommodate service users over the age of 65 who may or may not have mental health frailty. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Cherryfield House was unannounced and took place over 4.5 hours. The inspector had the opportunity of talking to residents and observe staff practice as they went about their duties to support residents. The inspection focused on poor medication practices that were identified during the visit and time was spent discussing progress on meeting requirements made at the previous inspection visit. All the core standards were evaluated at the inspection of 13th September 2005, and a full picture of the service will be gained by reading that inspection report as well as the report of this visit. What the service does well: What has improved since the last inspection? What they could do better: The home’s statement of purpose and service user guide failed to detail required information and were out of date, which meant that residents did not have accurate information about the home provided to them. Serious concerns were identified with the home’s management, administration, record keeping, storage and disposal of medicines. These systems will be monitored closely to ensure improvements are made . Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 6 There continue to be odours present in the home and action had not been taken to ensure the laundry area met environmental health standards, as identified at the previous inspection. The home has an inappropriate locking device on the entrance door. The fire service has informed the provider of the home of this matter, however no action has been taken to replace the lock. The registered manager has spent time away from the home assisting in improving another care home which has had a detrimental effect on the standards at Cherryfield. 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. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 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 Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 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): 1 Prospective residents do not receive up to date written information to enable them to make informed decisions about their future. EVIDENCE: The home’s statement of purpose and service user guide fail to meet required standards. Basic information about the services provided by the home are not included. The documents to do not include information about the terms and conditions of residency, the home’s complaint procedure nor is reference made to the most recent inspection report. Furthermore, information regarding staffing arrangements is incorrect. Prospective residents should receive accurate information when making initial enquiries at the home and prior to making any decisions about their future placement. Requirements have been repeatedly issued regarding this matter. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Residents’ health and safety were compromised by inadequate medication procedures. EVIDENCE: Following direct observation of medication administration practices, evaluation of records and inspection of medication storage areas, serious concerns were identified regarding many of the home’s practices in relation to medication administration, record keeping, storage, safekeeping and disposal of medicines. Medication was observed to be handled throughout administration, the medication administration trolley was overloaded, culminating in quantities of blister packs being placed on the floor. Some staff who administered medication had not received correct training. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 10 Staff were routinely undertaking secondary dispensing of medication, administration records did not correspond with medication stock, medication was not administered as prescribed and administration records were not signed when medication had been administered. Prescribed controlled medication records indicated stock was held on the premises when it wasn’t, medication was not stored at the appropriate temperature, or as detailed on the packaging. Medication waiting for collection from the pharmacist was incorrectly managed, preventing identification for whom is was prescribed. There was no evidence that medication was received into the home correctly or that management systems were in place to monitor practice, ensure competence of staff, evaluate records or audit stocks. At the conclusion of the inspection an immediate requirement was issued to ensure that action was taken to rectify practice. Following that process, a serious concerns letter was issued to the registered provider and registered manager which identified the home’s failing and action required. The CSCI will continue to monitor the home to ensure that it meets and maintains the required standard. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 11 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): 15 Residents receive an enjoyable, varied and nutritious diet. EVIDENCE: During the course of the inspection one mealtime was observed. Residents appeared to have enjoyed the meal, informing the inspector that it was hot and tasty. In general, residents were positive about the meals served at the home and were able to explain how other meals can be requested should the main meal not be desired. Though residents stated their overall satisfaction, it was noted that all residents received only one sausage with their lunchtime meal, two residents informed the inspector, that they would have liked more than one sausage. Meals are served ready plated so residents are not offered individual choice about quantities served. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 12 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): These standards were not assessed at this inspection. The core standards were evaluated at the previous inspection and met the required standard. EVIDENCE: Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 13 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, 21 & 26 Residents live in a fairly well maintained home. However, odours were present in the main lounge and environmental standards within the laundry area were below that required. EVIDENCE: The inspection identified that the home was maintained to a fairly good standard, being clean and homely. Residents have ample access to bathing and toileting areas, the inspection of which identified they were maintained to a good standard. The entrance door to the home has an inappropriate locking device which may, in the event of a fire emergency, compromise residents’ safety. The Fire Authority has brought this matter to the attention of the provider on a number of occasions. The home has not taken any action to replace the lock with an appropriate locking system. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 14 Although many of the carpets have been replaced, the home has failed to prioritise the lounge carpet, where strong odours are present. After the re-siting of the new and improved laundry area, the home has not completed outstanding tasks to ensure it meets with environment health standards regarding wall and floor finishes. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 15 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 & 30 Residents are supported by staff in appropriate numbers; however, their health and safety maybe compromised due to a lack of staff training in the safe management of medication. EVIDENCE: The inspector identified that sufficient care staff are on duty each day and that action is taken to increase staffing levels when the dependency of residents increase. The staffing rota identified staff positions and detailed the nominated first aider and activities co-ordinator for each day. Though new staff complete an induction/orientation programme the registered manager informed the inspector that induction and foundation training had not commenced to the levels set by Skills for Care. Not all staff with the responsibility to administer, record and manage medication have received appropriate training. Such failings place residents at an increased risk of harm. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 16 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 The home is managed by a competent manager and staff team, however residents’ safety has been compromised by the lack of effective management monitoring systems and the use of the manager to troubleshoot problems in another home. EVIDENCE: The registered manager continues to be committed to the home and ensures that routines are, in the main, around the needs and preferences of residents. The registered manager has been assisting another care home to develop and has had to divide her time between both homes. This has affected the smooth running of the home and has contributed to the falling of standards in some areas, including medicines control. Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 17 The home could not evidence that monitoring systems were in place to directly observe staff practice or evaluate competency. Furthermore, administration systems were not routinely evaluated. Cherryfield House DS0000008602.V274966.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 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 1 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X 3 X X X X 2 STAFFING Standard No Score 27 3 28 X 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X X Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4&5 Requirement Timescale for action 01/04/06 2 OP9 13 3 OP26 16 (2)(k) 4 OP26 16(2)(j) The registered person must produce and make available to service users an up-to-date statement of purpose and service user guide which meet required standards. (Previous timescale of 15/10/04 not met). The registered person must 24/01/06 ensure that arrangements are in place for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person must 01/03/06 ensure that odours within the home are eradicated, through professional cleaning or replacement of carpets and chairs where odours are detected. (Timescale of 01/11/05 not met). The registered person must 01/03/06 ensure that walls and flooring in the laundry have impermeable finishes which are readily cleanable. (Timescale of 01/01/06 not met). Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 20 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. 5 Standard OP19 Regulation 13(4)(a & c) Requirement The registered person must provide a suitable locking device to the front entrance which conforms to fire safety regulations and is suitable for safe and easy use by visitors, staff and residents. (Timescale of 01/01/06 not met). The registered person must ensure the registered manager is not designated to support another establishment and that management procedures are implemented to monitor staff practice and competences. Timescale for action 15/02/06 6 OP31 10, 13(1)(a) (b) 26/01/06 Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 21 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 OP9 Good Practice Recommendations The registered person should ensure that the home retains a list of staff members authorised to administer medicines, which includes a record of their signature and approved initials. The registered person should ensure that the medication trolley is not excessively overloaded, culminating in medication being placed on the floor when administration takes place. The registered person should ensure that medication is administered in sequence from monitored dosage systems. The registered person should ensure that residents are consulted regarding portion sizes and quantities of food at meal times. The registered person should confirm that the homes induction and foundation training complies with NTO standards and details which staff are currently undertaking such training. 2 OP9 3 4 5 OP9 OP15 OP30 Cherryfield House DS0000008602.V274966.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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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