Inspection on 12/07/05 for Cherrytrees

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cherrytrees 16/05/07

Cherrytrees 27/02/06

Cherrytrees 01/12/04

Cherrytrees 20/05/04

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

CARE HOME ADULTS 18-65 Cherrytrees Cherrygrove Road Frome Somerset BA11 Lead Inspector Justine Button Unannounced 12th July 2005 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 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 Stationary 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 D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cherrytrees Address Cherrygrove Road Frome Somerset BA11 01373 452965 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Somerset County Council (LD Services) Mrs Shirley Anne Perry Personal Care Home Only 6 Category(ies) of Learning Disability (6) registration, with number of places Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be admitted who have concurrent physical disabilities and/or sensory impairment. 2. Service users will be admitted for a maximum of 3 months between each admission and dishcharge. Date of last inspection 1st December 2004 Brief Description of the Service: Cherrytrees has been registered as a care home for up to 6 younger adults (aged 18 – 65) with learning disabilities for respite care since September 2003. The home is run by Somerset County Council. A registered manager is in charge of the day-to-day running of the home. Staff are employed at the home for care provision. Also run from the same site is a community care outreach service for adults with learning disabilities. The home benefits from being sited adjacent to a day service facility for adults with learning disabilities also run by the Council.Cherrytrees is a single storey purpose built home in the town of Frome. This has the local facilities of shops, banks, pubs and leisure amenities. Cherrytrees is adapted to be able to support highly dependent service users whilst maintaining a homely atmosphere. All accommodation is in single rooms. Outdoor space includes pleasing gardens as well as shared use of an allweather outdoor sports court. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day between the hours of 09.30 am – 3.30 pm. Six people were residing at the home on the day of the inspection. The inspector was able to speak to a number of the residents as well as staff on duty. The manager, Mrs Perry, was available for the inspection. The inspector would like to thank the residents and staff for their time and hospitality shown to the inspector during her visit. This is the first inspection using the new CSCI reporting format, which focuses on outcome statements for National Minimum Standards. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff. Records examined included care plans, duty rota’s, staff training and some health and safety records. Other records will be examined at subsequent inspection visits. A tour of the building was carried out on this visit. What the service does well: What has improved since the last inspection? There were no requirements made at the last inspection. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 standard(s) 1,3. People who access the service have the information they require prior to their first stay. EVIDENCE: The statement of purpose and the service user guide were on display in the home. Both of these documents are available in Somerset Total Communication. This would allow the majority of people who are considering having their short breaks at Cherrytrees to make an informed choice about the services that are provided Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 standard(s) 6,7 8,9,10 All people who live at the service have a plan which informs staff of their individual care and support needs. It could not be assessed if the people who visit the service are involved in the development or review of their plan. People who visit the service are involved in the day-to-day running of the home. Information is stored in a secure manner. EVIDENCE: Three plans were viewed on the day of inspection. The majority of the plans gave clear guidance and instruction to staff. The people who live at service have a range of care and support needs and these were reflected in the plans. None of the plans or aspects of the plans are in an accessible format to the people whom they relate to. It is therefore difficult to clarify if people are involved in the development and review of their plans. The manager stated that the plans were reviewed with the person or their main carer prior to each admission to ascertain if there had been any changes to care needs. Staff confirmed that they were made aware of any changes and stated that they felt that the care notes were adequate and informed them of the needs of individuals. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 10 Service users are supported by staff to make choices and decisions. Communication systems are widely used through out the service. Pictures and symbols are used to inform service users of such things as the menu for the day or activities that will be available on that day. Staff were observed reinforcing verbal communication with signs. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 standard(s) 11,12, 13,14, 16, 17 People who access the service are supported by staff to continue their “normal” routine and life style EVIDENCE: People who live at the service stated that they found the staff supportive and helpful. A number of people were out on the day of inspection. These people were accessing their “normal” routine for that day which for most included attending day services. Activities and opportunities are available to the two people who have been living at the service for a period of time. It has to been recognised however that life at Cherrytrees is not suitable for people on a long terms basis. Staff confirmed that they were anxious that the two individuals were developing strong relationships with staff at the service and that this would mean that a move to another service might become problematic considering both people had already had one move to cherrytrees. Due to this it is important that the two individuals are supported to find alternative long-term placements. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 12 Lunch was observed during the inspection. Staff were seen supporting people to choose what they wanted for lunch. On discussion with staff it was evident that they were clear about the dietary needs of the individual people who access the service. On the day of the inspection the kitchen was clean and tidy and in a good state of repair. During the inspection it was noted that the fridge was running at the incorrect temperature. The manager stated that she would investigate this and rectify the situation. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 standard(s) 18, 19, People’s healthcare needs are met. EVIDENCE: People visit the GP if and when required, staff give support when needed. People are supported by staff to attend any pre-arranged healthcare visits. All visits to all services are well documented in the service user plan. Staff confirmed that all personal care is conducted in privacy. Staff were observed dealing with issues of personal hygiene in a sensitive manner using appropriate communication methods. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22,23 People who live at the service are protected by a clear complaints procedure. The procedures to protect people from potential abuse are not robust. EVIDENCE: The home’s complaints procedure was included in all service users’ care plans and management confirmed that parents or guardians were issued a copy of the Council’s complaints procedure. The information on how to complain is also available in pictorial form, or a video is available. This is commendable. Service users spoken to, where able, confirmed that they felt comfortable raising issues of concern to staff and management. One complaint has been received since the last inspection. This complaint had been dealt with appropriately by the management team. Staff are aware of the vulnerable adults and whistle blowing policies. In addition to this training there is in place a policy for the two areas. The policies complied with the Public Disclosure Act and the DOH Guidance No Secrets. One new staff member had been recruited to the service and was due to commence employment the following week. This staff member had been employed to cover the waking night shift. The manager had not seen the necessary documentation, including CRB and POVA checks for this staff member. It could not be confirmed on the day of inspection if these checks had been completed. The manger was advised that this staff member could not commence employment particularly lone night working until these checks had been obtained. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24, 25,26,27,28,29,30 The service is suitable for it’s stated purpose. The area was clean and tidy EVIDENCE: Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 16 The home is a purpose built unit that opened on the 05/09/03. The home is adapted to a high standard to meet the range of disabilities that service users may have. A tour of the building was conducted during the inspection. All areas are homely and comfortable. All the bedrooms are for single occupancy with en-suite facilities. People who visit the service are able to bring in personal possessions to personalise their rooms. There are 9 toilets in this small home with adequate space for wheelchair users. There is one very large shared bathroom with a bath suitable for service users with severe mobility impairment to access via a patient hoist. The water temperature of the bath is displayed on a digital readout. There is also a shower trolley available, where adequate space is provided for its use in the bathroom. All washing and bathing facilities inspected were cleaned to a high standard All service users’ bedrooms are lockable and at the time of the inspection one service user was choosing to carry her room key. All service users, where able to express an opinion said that they were pleased with their bedrooms. Shared space at the home includes a large lounge and a separate dining area. The kitchen is roomy and provides good storage and cooking facilities. Evidence was seen of daily fridge/freezer temperature recordings. The laundry provides good equipment for washing of clothes and machines enable programmes to heat to a degree to manage infection control measures. All chemicals are stored in a locked cupboard. A private room is available for visitors and service users to meet people in private. Staff on sleep in duties have a bedroom and rest area provided with an ensuite facility. The home has shared use of an all weather outside sports ground. The surrounding gardens are pleasant and well kept. The home also has outside hours access to the adjacent day unit if required. Smokers do so outside of the home, within its grounds. During the inspection it was noted that some of the hoists used to support people in moving and handling had not been serviced. The manager agreed to rectify this. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32, 33, 34, 35, 36 There is a dedicated staff team in sufficient numbers to meet the needs of the people who access the service. It could not be confirmed if all staff had received all necessary training. EVIDENCE: The duty rota’s were viewed on the day of inspection. These demonstrated that there are sufficient staff employed. The staff team are supportive of each other and obviously work well as a team. All staff spoken to during the inspection expressed how happy they were working at Cherry trees. The recruitment procedures are not robust (see standard 23). All staff stated that they feel well supported by the management structure. Staff’s training records were viewed during the inspection. It could not be confirmed if al staff had received all mandatory training including moving and handling, first aid and basic food hygiene. It was suggested to the manager that she develop a training matrix in order to demonstrate staff training and this could also be used as a reminder to herself as to who requires training at any one time. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 42 The service is well managed and run. EVIDENCE: The manager has the City and Guilds Advanced Care Management qualification. The manager is also a registered nurse. The manager is an experienced, confident and competent person. All staff felt that the management team were supportive and open. All stated that they felt that they could discuss issues with the management team. Staff meet on a regular basis. These meetings are minuted. Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x x Standard No 22 23 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 2 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 1 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cherrytrees Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 20 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. 2. Standard YA23 YA 35 Regulation Schedule two 18 (1) Requirement It is required that CRB and POVA checks are seen for all new staff employed. It is required that all staff recieves all mandatory training to include Moving and handling, basic food hygiene and first aid Timescale for action immediate Action plan to be submitted to the CSCI by 30/09/05 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 YA11 Good Practice Recommendations It is recommended that the management ensure that all efforts are being made to secure a permanent home for the indentifed indivduals in order that they can regain their expected lifestyle and can be accommodated in a suitabe long term placement. It is recommended that a system is developed which will ensure that people who access the service have input into the development and review of plan of care and support It is recommended that the management review the servicing schedule for the hoists and take any remedial action. It is recommended that the temperatures of the fridge are D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 21 2. 3. 4. YA6 YA29 YA17 Cherrytrees kept under review and any remedial action is taken Cherrytrees D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 D53 - D02 S54215 Cherrytrees V235847 120705 Stage 4.doc Version 1.40 Page 23 - 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. 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