Inspection on 01/12/05 for Cherrytrees

This inspection was carried out on 1st December 2005.

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

Cherrytrees 31/03/08

Cherrytrees 09/01/07

Cherrytrees 15/07/05

Cherrytrees 02/03/05

Cherrytrees 01/12/04

Cherrytrees 07/01/04

Cherrytrees 10/05/03

Cherrytrees 16/08/02

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

CARE HOMES FOR OLDER PEOPLE Cherrytrees 149 Park Road Cowes Isle Of Wight PO31 7NQ Lead Inspector Mark Sims Unannounced Inspection 1st December 2005 12:30 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 Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 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. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cherrytrees Address 149 Park Road Cowes Isle Of Wight PO31 7NQ 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) 01983 299731 01983 296084 Mrs Dorothy Mary Gustar Mr Laurence Woodford Gustar Shirley Anne Carley Care Home 25 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (6), Old age, of places not falling within any other category (25), Physical disability over 65 years of age (9) Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th July 2005 Brief Description of the Service: Cherrytrees is registered in respect of 25 places and provides care for people falling within the older persons categories. The premises is a converted gentleman’s residence set within its own gardens and is within easy reach of the town and all of its amenities and facilities. For those individuals unable to walk into town or without other means of transport the local bus company operates a scheduled bus service, which runs directly past the home. Transport is provided by the home for appointments. If service users, visitors or representatives have their own transport then car parking is available to the rear of the home or along the roadside. The premises has two floors, although due to the fact that the home is created out of two buildings the first floors are split with transition between the two only possible via a small flight of stairs. This obstacle does not normally cause a problem, however as the lift only services one side of the home anyone living on the opposite side requires a degree of mobility to ensure they can access their bedroom. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was undertaken unannounced and formed the second statutory inspection of the year for Cherrytrees Residential Home. The inspection focused on those core standards not addressed at the 15th July 2005 inspection and various sources of evidence were considered in the formulation of judgements: records, observations and discussions with service users and staff/management. What the service does well: What has improved since the last inspection? Nothing has improved since the last inspection, as nothing has needed to improve. The home continuing, as indicated above, to be well run and well maintained with both the service users and their relatives appreciative of the service provided. On a more practical note the proprietors have recently replaced the home’s cooker, and installed new boilers, which has enabled the manager to plan for the installation or fitting of additional storage units within the kitchen. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 6 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. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 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 Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 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): None The only core standard within this section not reviewed this year is Standard 6, which a standard that is not applicable to this service. No additional standards within this section were reviewed during this inspection. EVIDENCE: Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 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): Standard 8. The health care needs of the service users are well monitored and responded to appropriately by the management and staff teams. EVIDENCE: The health care needs of the service users are addressed and managed on several different levels by the home. Each service user within the home has an individual care plan which, as suggested, is used to plan and monitor the care delivered and the care they need. On reviewing several of these documents it was evident that not only are these documents used to record care planning issues but also to record and document health and social care issues, each file being sub-divided into sections that correspond to different aspects of the care service delivered, i.e. the actual plans of care, running records and medical records, etc. Within each of the sub-sections different information is recorded, although often the information documented cross over between sections and only when considered in total can you build up a picture of what is occurring with the service user, i.e. the running records often document changes within the person’s condition and the actions taken by the staff: called out doctor, etc., Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 10 whilst the visit of the general practitioner or involvement with St Mary’s Hospital is documented within the medical records section, this section identifying the diagnosis and prescribed treatments. In addition to the information maintained by the home within the care planning documents, the manager also maintains a diary of events or visits, which was witnessed being used on the day of the inspection, when in agreement with a service user’s family arrangements were made for a service user’s admission to hospital. What was particularly pleasing to note was the level of involvement and control the family exercised on behalf of their relative and how the management responded accordingly to the decision-making of the relatives, who wished to discuss and agree all of the finer points of the admission, from rising that day and breakfast arrangements to the appointment time at the hospital and travel. In conversations with the service users themselves it was clear that they generally felt well cared for and that they appreciated the efforts of both the staff and management in ensuring their wellbeing was attended. A new practice within the home, which should be acknowledged, is the discreet placement around the home of liquid gel dispensers, which dispense a sanitising lotion for removal of bacteria. This gel is being actively used by staff when dealing with clients or between dealing with residents in an attempt to reduce any cross contamination of infection. The manager is also encouraging health professionals visiting the home to use the gel when seeing or attending to service users, with reasonable success reported on the part of the District Nursing Team but a little less success with the general practitioners. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 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): Standards 14 & 15. The service users are provided with adequate means of exercising control over their day-to-day lives. The meals provided at the home are well liked, well balanced and well presented. EVIDENCE: In discussion with the management it was established that the service users continue to be offered the opportunity to comment on all aspects of the home’s running via: 1. The monthly residents’ meetings which enable people to raise ideas, make comments or challenge practices as they wish, each meeting being minuted with copies of the minutes circulated to those individuals who could not attend and a hard copy retained on file for reference purposes. 2. In face-to-face conversations with the manager or her assistant manager, both of whom are accessible to service users or their relatives/representatives within the home. In conversation with the service users it was noted that this particular means of communication was quite popular, people discussing their Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 12 preference for direct contact with the management as they were perceived to be approachable, kind and considerate listeners. People’s relatives were also supportive of the management and staff, going to great lengths to ensure the inspector understood how well the home was run and how you could approach anyone associated with the service if you had a problem and it would be addressed. Further evidence of these sentiments were seen on the comment cards and letters retained by the home, which were entirely supportive of the staff and management and thanked them on numerous occasions for the service provided, the care delivered and the dignity and respect shown to their relative/friend. People had also made clear and positive choices over how their bedrooms were to be furnished and set out, with people obviously having brought items into the home from their own properties in order to personalise the space and establish a sense of ownership and familiarity. What also was nice to witness was how the home accepted the nuisances of human behaviour without question or judgement, an example being that of a service user whom during the inspector’s time in the home was witnessed wearing several different outfits, all of which they chose for themselves and all of which displayed a preference for contrast instead of compliment. Since the last inspection the proprietors have overseen both the replacement of the home’s heating (boiler) system, opting for combination boilers, which supply hot water and heating and the more recent replacement of the home’s cooker. The kitchen continues to be clean, tidy and well maintained, with the additional room left after the removal of the old boilers allowing for extra storage space to be created and utilised. The menus continue to offer a wide selection of wholesome and appealing meals, that in discussion with the service users were widely praised and complimented. Whilst lunch had already been served prior to the inspectors arrival the teatime meals highlighted how flexible the home are when it comes to offering choice, etc., with half a dozen different options for tea catered for. The home was also in the midst of planning for the home’s Christmas party the next day and were discussing having to set up tables outside to cater for all of the food, etc. to be made available, as not only were the service users and their families expected to attend en masse but also the staff and their families, making for a fun and enjoyable day for everyone. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 13 It was clear in conversation with the service users and their families that the event would be well supported and that they appreciated the efforts made by the home to embrace the Christmas spirit and make the day fun for all. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 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): Standard 18 The protection of vulnerable adults from abuse is promoted within the home. EVIDENCE: The management has undertaken to raise awareness of adult protection issues by developing a useful in house training package, which all care staff are required to complete. The package includes a visual aids element, reading materials and a questionnaire, which staff must complete within a set timescale. The video used to accompany the in house training package was purchased by the manager and includes sections on ‘No Secrets’ a ‘Department of Health’ guidance document and Abuse Awareness, which is the more focused section for staff. In addition to the training programme devised for use with the staff the manager has also completed a training programme arranged by the Local Authority ‘Managing Safely (adult protection in day, residential and domiciliary care services). She is hoping next year to either attend or arrange for her assistant to attend a another Local Authority training course designed at training in house adult protection trainers, which comes with its own learning materials and resource packs and ties into the ‘Islandwide Strategy and Procedure’ a copy of which is available in house. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 15 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): Standard 19. The proprietors continue to provide funds to ensure the property remains well maintained and functional. EVIDENCE: A limited tour of the premise was undertaken at this visit, as a full tour had been completed during the 15th July 2005 inspection. This particular tour only took in the communal areas of the home, the kitchen and corridors, which were all found to be decoratively fine, clean and tidy. In addition to the decorative and cleanliness state of the kitchen it was also noted that the proprietors had arranged for the old boilers to be replaced with new combination boilers and the cooker replaced, following the failure of the old oven to maintain its temperature. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 16 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): Standards 28, 29 & 30. Over 50 of the home’s staff are trained to National Vocational Qualification (NVQ) level 2 or equivalent. The home’s recruitment and selection process is robust and thorough. Staff have access to good levels of training and support. EVIDENCE: The management is committed to staff training and the development of skills within the care team, making a wide range of in house and external courses available. All staff training is recorded using a matrix system, developed in house for monitoring and track training achievements, renewal dates and areas of skills development within the staff team. In addition to the matrix, which is a tool used by the management to monitor staff training, each care staff is provided with an individual training file, which contains certified evidence of the training attended. Three files were randomly selected for inspection, each one containing evidence of a wide range of internal, external and distance learning materials being used in the development of the skills within the staff team. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 17 In addition to specific information on the courses attended by the staff, each file also contained details of the induction programme completed by the care staff on recruitment and NVQ status. In conversation with the manager it was established that 12 staff presently possess as a minimum an NVQ level 2 or equivalent and that 3 further staff were currently enrolled on NVQ courses, which should be completed early next year. As the home presently employs 22 staff, 12 of whom possess an NVQ at the required level this gives the home a ratio of 55 , 5 above the 50 ratio recommended. During the visit the inspector reviewed a number of staffing files and considered the policies and procedures available to the management team when recruiting new staff. It was evident, given the files inspected, that the home’s general approach to the recruitment and selection of new staff is both robust and consistent, with tracking or monitoring forms used by the administrator to ensure each new staff member’s recruitment follows a very similar pattern and that all relevant information is applied for and received. All prospective staff are required to complete an application form as part of the process, the application form designed to obtain details of the person’s employment history, educational history, medical history and references, etc. Once the application has been submitted the manager arranges to meet with the applicant for the purposes of interview and retains information relating to the outcome of the interview on file. Once an applicant has successfully completed the preliminary stages of the recruitment process, they are issued with written confirmation and subject to the successful return of their references and Criminal Records Bureau check and POVA check, are invited to attend for induction. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 18 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): Standards 31, 33, 35. The manager is a skilled and competent leader, who possesses a managerial qualification in care. She has NVQ Level 2 and 3 in care and is an assessor for NVQ 2 and 3 in care. The home’s approach to quality audit is good and allows the views of service users to be gathered and taken into consideration when shaping the future of the home. The home’s approach to the supporting of service users to manage their monies is robust and sound. EVIDENCE: As stated above the manager is a skilled and competent leader, who is well respected by her staff team and is admired and liked by the service users and their relatives, people commenting on how approachable and sympathetic she is and how if they had any problems, etc. they would happily approach her to Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 19 discuss them, as evidenced during the inspection when a family came to speak to the manager about arranging the admission and transportation, etc. of a relative to hospital, the manager listening and responding appropriately to their requests and observations. The manager also possess the ‘Registered Manager’s Award’, a managerial qualification designed specifically for people working within the care sector, however, she does not possess a care qualification at NVQ level 4 or equivalent, as recommended, although arrangements to address this issue are in place and should ensure she attains this qualification relatively early next year. Evidence of how capable the manager is can be seen throughout the home’s managerial systems and tools, which are functional and structured. One such area of the service is the quality auditing or assessment process, which is designed to measure the clients’ satisfaction with the home and the home’s performance year-on-year. To this end the manager employs a number of techniques including a client satisfaction survey, which had only recently been completed (13.05.05) and included information on staff performance, environmental issues, food and entertainment, etc. In addition to the comments sought via this means the manager also maintains a comment card and letter portfolio, which contained numerous letters, etc. thanking the staff and the management for their commitment and support and the care they delivered to loved ones during their stay at Cherrytrees. The manager also employs a number of meetings, staff meetings and service user meetings, at which she encourages people to share their views of the home and any possible or potential improvements they would like made to the home, these meetings are minuted. The proprietors also support the manager throughout this process and regularly undertake their own unannounced visits to the home, in accordance with Regulation 26, copies of the reports produced are sent to the Commission. In discussion with the service users it was evident that they appreciate both the efforts made to ensure the service runs well and the ability to have their feelings heard and listened to. The home is presently involved in the supporting of 17 service users manage their finances, with four accounts randomly inspected during the visit. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 20 Where the home is involved in managing the finances of service users all recommended safeguards and precautions have been adopted. This includes obtaining receipts, double signing all transactions, balancing accounts and storing safely and securely all monies held. For service users wishing to handle their own monies the home provide each room with a lockable cabinet for the use of the occupant, although in conversation with residents, etc. it was noted that most people elect to have personal allowances or monies secured by the home. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 21 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 4 X 3 X X X Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No 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. 1 Refer to Standard OP31 Good Practice Recommendations The manager should ensure she completes her National Vocational Course (level 4 in care) as soon as possible next year. Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Cherrytrees DS0000012475.V250164.R01.S.doc Version 5.0 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. 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