Inspection on 08/05/06 for Cherrymead

This inspection was carried out on 8th May 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cherrymead 29/11/07

Cherrymead 23/11/05

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Cherrymead Station Road Angmering West Sussex BN16 4HY Lead Inspector Mrs S Rodgers Key Unannounced Inspection 8th May 2006 15:00 Cherrymead DS0000064747.V291933.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 Cherrymead DS0000064747.V291933.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. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cherrymead Address Station Road Angmering West Sussex BN16 4HY 01903 783791 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) Outreach 3 Way Mr Mark Daniel Peirce Care Home 7 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1), Physical disability (1) of places Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to seven (7) male and/or female service users in the category Learning disability age 18 to 65 years may be admitted/accommodated. one (1) person with Learning and Physical Disability may be admitted/Accommodated. One (1) Service user over the age of 65 years may be accommodated. The total number of service users that may be accommodated must not exceed seven (7). 23rd November 2005 Date of last inspection Brief Description of the Service: Cherrymead is a care home registered to provide accommodation for up to seven adults with a learning disability. The property is a large detached property. Accommodation is provided on ground and first floor level, a vertical lift is in situ enabling residents to access all areas of the home. There is an enclosed garden to the rear of the property and parking facilities to the front. The establishment is near to Angmering train station and local amenities. The weekly fees are £917.18 per week. Extras include hairdressing, trips out and personal items. The inspection reports are displayed in the hallway of the home. Outreach 3 Way owns the services. The registered manager responsible for the day-to-day running of the home is Mr Mark Peirce. The responsible individual on behalf of the providers is Mrs Vanessa Keen. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours. Planning for this inspection centred on reviewing the Statement of Purpose and Service User Guide, the previous inspection report, the action plan sent in following the last inspection and general correspondence. During the course of the inspection the inspector toured the home and reviewed records and spoke with residents and informally with the staff on duty. Not all residents were able to talk with the inspector due to communication difficulties however the inspector took time to sit in the lounge and observe the interaction between residents and staff. The manger is requested to advise the commission of action being taken with regards the two requirements identified at the inspection by 25th June 2006 What the service does well: What has improved since the last inspection? What they could do better: The management must ensure that all staff receive fire safety instruction at the regular intervals of 6 monthly day staff and 3 monthly night staff. A review of staffing levels should be undertaken in light of the changing needs of some residents. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 6 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. Cherrymead DS0000064747.V291933.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 Cherrymead DS0000064747.V291933.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, 2 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide informs prospective service users of services provided. The pre admission assessment enables the prospective residents, their relatives or representatives and the carer to make an informed decision as to whether the service care meet their care needs. EVIDENCE: The homes Statement of Purpose and Service User Guide are displayed in the entrance hall of the home. The document is in both written and pictorial format. The document clearly shows services provided and how they will be delivered. The have been no admissions to the home since the last inspection. Care plans seen at this visit contained Social Service assessment documentation, The Statement of Need and the Implementation plan and of the care homes own pre admission assessment. Cherrymead DS0000064747.V291933.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): 6, 7, 9 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans clearly record how care to individual should be delivered. Residents are supported to make decisions about how they maintain and develop an individual lifestyle. Residents are support to maintain their personal allowance. Risk assessments are undertaken on activities undertaken by residents. EVIDENCE: The care plans of two residents were reviewed. Each contained a full assessment of need, care plan, reviews of care plans, daily records, risk assessments, activities programme and evidence of contact with health professionals. The care plans also contained a ‘passport’ i.e. a detailed account of the person’s history and likes and dislikes. This document enables staff to gain an insight to the needs of individuals at a glance. Care plans are reviewed 6 monthly. The service demonstrates that residents are enable to take part in the decision making process. Due to the complex needs of residents it is not always easy Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 10 for them to express their wishes. The service uses ‘an observation sheet’ to record spontaneous comments or reactions of residents; their reactions to situations and comments are monitored adjusted accordingly. An example of this would be if a resident undertakes a new activity i.e. one resident likes car racing, so staff took the resident to a local racing circuit, he enjoyed it so much that the was asked if he wanted to again. Staff identified that the next time they go they will take a seat and a picnic lunch. Staff do not maintain residents finances. The local authorities receivership unit deal with resident personal finances should there be no relatives to do so. The home does hold resident’s money in safekeeping. Each resident’s money is kept in an individual lockable safe box. Records of transaction and receipts are kept. Staff check the money tins 3 times a day i.e. at the end of every shift. Risk assessments are undertaken on activities undertaken by residents. Those seen clearly indicate that residents are supported to take risks as part of an individual lifestyle as well as what action to take to minimise any identified risks. Cherrymead DS0000064747.V291933.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): 12,13,15,16,17 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered and take part in appropriate work, educational and leisure activities and access the local community. Residents are supported to maintain appropriate relationships. The rights of residents are respected. Residents are offered a well-balanced and varied diet. EVIDENCE: Residents individual activity plans demonstrate that residents are able at take part in age, peer and culturally appropriate activities. Activities include, shopping, day services, bowling, Sussex Seals activities, badminton, structured music and nature trails. One resident also has a work placement with the local coastal Enterprise workshop. Personal time activities are ad hoc and are limited due to their being only 2 staff on duty. This means it is sometimes difficult for staff to take residents out if only 1 person wants to go, as there would only be one staff member for the remaining 6 residents. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 12 Resident’s are enabled to maintain contact with family and friends, the Statement of Purpose and Service User Guide informs of the visiting arrangements. Care plans clearly record important links with family and friends. Visits and contact with family and friends are recorded in care notes. Records indicate that resident rights are responsibilities are recognised, i.e. resident’s are able to decide if they want to access local amenities and activities. Resident’s were also observed to be able to access all communal areas of the home freely. Records of meals provided indicate that a well balanced diet is being offered. Residents who were asked confirmed that they like the meals provided. Fresh fruit is readily available, fruit is stored in one cupboard which all residents have access to. A four weekly rotating menu is offered, menus show that there is a choice to the main meal. Residents participate in planning the menus and some also go to the local supermarket with a staff member to purchase the weekly shopping. Meals are generally taken in the dining room. Monday to Saturday the main cooked meal is taken in the evenings due to residents attending day centres and undertaking general activities. Sunday lunch is at midday. During the week resident’s who go to work or day centres take packed lunches. Residents help to lay and clear the tables. The mealtime observed at this inspection appeared relaxed and unhurried. Residents told the inspector that the ‘food was good and they got enough to eat’. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 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 the following standard(s): 18, 21 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s receive personal support in a manner most suited to their individually assessed needs. The health and emotional needs of resident’s are met. Appropriate systems are in place for dealing with medicines. EVIDENCE: Care plans indicate how care for individual residents is maintained. One resident likes to shower in the morning and in the evening prior to going to bed this is recorded in their care plan along with what support is required i.e. encourage person to do as much as they can for themselves. Care plans identify that resident’s choose their own clothes to wear each day. Resident’s are enabled to get up and go to bed when they like however, guidelines are in place for those who have to get up to go out to day centres and activities in the morning. All residents are registered with a GP. Records of visits of health professionals are recorded in individual care plans. Records also indicate that resident’s have access to other paramedical services such as opticians, chiropodists and Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 14 dentists. Resident’s also have access to the Community Team for People with Learning Disabilities. The home has an agreement with a local pharmacy. Medication is pre dispensed by the pharmacist. Appropriate systems are in place for the receipt, recording, administration and disposal of medication. Resident’s photographs are attached to individual Medication Administration Record sheets. Staff take medication to residents and sign the medication administration sheet at the time the medication is dispensed. All staff have received training in the safe handling of medication on the 9 December 2005. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 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 the following standard(s): 22,23 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place. Systems are in place to protect residents form abuse, neglect and self–harm. EVIDENCE: The homes complaints procedure clearly advises residents and/or their relatives of their right to complain. The procedure states each state of the complaint process and timescales by which the complaint will be dealt with. Resident’s spoken with told the inspector that they felt able to talk with all staff about any concerns that they may have. Since the last visit staff have received training in the procedures to follow should they suspect abuse of a resident. Training identified different types of abuse, how one abuses, how to recognise abuse and the reporting process. The two staff members on duty at the time of this visit were on duty at the previous inspection. They were asked at that time what they would do should they suspect abuse of a resident, both gave a good account of action to be taken. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 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 the following standard(s): 24, 30 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Accommodation is appropriate to the needs of the residents. The home is clean and hygienic. EVIDENCE: The property has recently been renovated and refurbished. The home is comfortable, bright and cheerful. When the property was being renovated last year residents were able to choose the colour schemes of their own bedrooms. All rooms appeared homely and welcoming. Bedrooms are all individually furnished with resident’s own belongings. Fire safety systems are in place. From touring the home the inspector was able to see that the standard of cleanliness was of a high standard. The home has a contract with a clinical waste company. Protective clothing and hand washing facilities are available for staff and systems are in place to ensure that dirty laundry is appropriately handled. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 17 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): 33, 32, 34,35 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are being offered National Vocational Training. Staffing levels need to be reviewed in light of changes to resident needs. Appropriate recruitment procedures are in place. A training and development programme is in place. EVIDENCE: Six care staff are employed by the registered providers. One holds National Vocational Qualification level 4 and one other holds National Vocational Qualification level 2. The inspector was advised that two staff were going to be registered on a National Vocational Qualification course in the near future. Duty rotas seen at this inspection demonstrated that there are two care staff on during the day and one member of staff awake, on duty during the night. The existing staffing levels were based on the assessed needs of resident’s when they were first placed at the home. During the last 8 months the needs of resident’s have changed. More resident’s want and are facilitated to stay at home during the day. This has meant that if there are only two staff on duty and one has to take a resident to an appointment/or out the one remaining staff member is restricted in what they can do with the other resident’s if only one of them wishes to go out. The staffing levels also have the potential to restrict activities at the weekends. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 18 Recruitment records of two new staff employed at the home were reviewed. They demonstrated that appropriate recruitment checks i.e. references, Enhanced Criminal Records Bureau Checks are undertaken on all new staff prior to them commencing duties. Since the last inspection a review of staff training has taken place. A programme for mandatory training such as manual handling, food hygiene, first aid and infection control is being implemented. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 19 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): 37,39.42 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is experienced and holds the relevant qualifications. The quality assurance and monitoring system has been implemented. Health and safety of residents is promoted, however fire training in not up to date. EVIDENCE: Mr Peirce is an experienced manager who has gained his National Vocational Qualification level 4 and Registered Managers Award. Copies of certification were seen during the registration process. Mr Peirce has 2 shifts allocated for administrative duties and 3 shifts working on the floor. Although basic care plans are in place not all are in the detail required by the homes care planning process. Due to the lack of opportunity to take resident’s out during the day (as indicated in standard 33) and the length of time being taken to fully complete care plans it would beneficial to the smooth running of the home to Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 20 allocate more hours to administrative duties. From speaking with residents the inspector gained the impression that residents feel able to go to him should they have any concerns. Systems are in place to gain the views of resident’s and other stakeholders. The system needs to be expanded to encompass the outcomes in a report identifying what they do well, what needs improving and the timescales in which they anticipate action to be taken. Although this standard is not fully met a requirement has not been made as the service is in the process of carrying out their audit. Lifts, boilers, water and electrical systems were installed and checked on completion of refurbishment work. Annual checks have been organised. Risk assessments have been carried out on identified risk and procedures put in place to reduce risk. Training records and the training development programme indicate that staff are receiving training in manual handling, infection control, first aid, and food hygiene. Fire training records indicate that staff have not recovered training at the recommended intervals of 6 monthly day staff and 3 monthly night staff. The organisation has provided staff with a written health and safety policy. Accidents to staff and residents are recorded. The accident file was seen. Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 21 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 3 3 X 4 X 5 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 22 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 YA33 Regulation 18 (1) (a) Requirement Timescale for action 24/06/06 2. YA42 23 (4) (d) The registered person shall, having regard to the size of the care home, the Statement of Purpose and the number of residents ensure that at all times suitably qualified, competent and experienced persons are working in the care home in such numbers are appropriate. All staff must receive fire safety 24/06/06 instruction at the recommended intervals of 6 monthly day staff and 3 monthly night staff. 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 Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. Extracts may not be used or reproduced without the express permission of CSCI Cherrymead DS0000064747.V291933.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!