Inspection on 18/05/06 for Cherrytrees @ Abbotsbury

This inspection was carried out on 18th 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cherrytrees @ Abbotsbury 11/01/08

Cherrytrees @ Abbotsbury 17/12/05

Cherrytrees @ Abbotsbury 23/09/05

Cherrytrees @ Abbotsbury 05/10/04

Cherrytrees @ Abbotsbury 16/04/04

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Maple Lodge

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Inspirations

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Hopwood Court

Coton Hill House

Doddington Lodge

Innage Grange

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

CARE HOMES FOR OLDER PEOPLE Cherrytrees @ Abbotsbury Pettiver Crescent Hillmorton Rugby CV21 4JD Lead Inspector Martin Brown Key Unannounced Inspection 18th May 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 Cherrytrees @ Abbotsbury DS0000029373.V290096.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. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cherrytrees @ Abbotsbury Address Pettiver Crescent Hillmorton Rugby CV21 4JD 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) 01788 540163 01788 540163 Pinnacle Care Ltd Mrs Patricia Hanlon Care Home 2 Category(ies) of Dementia - over 65 years of age (2) registration, with number of places Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mrs P Hanlon is to achieve the NVQ award in Health and Social Care at Level 4 by 1st September 2006. 17th December 2005 Date of last inspection Brief Description of the Service: Cherrytrees at Abbotsbury provides respite care and day care facilities and services for people over the age of 65 years who have been diagnosed as having dementia. The service is provided on the ground floor, at the rear of an existing local authority residential care home, with its own entrance and reception area. The home provides two single bedrooms with en-suite facilities; there is additional space, which includes a communal lounge, dining area and kitchenette, and a small laundry. The home also offers up to eight places each day for older people assessed as requiring day care services, the day care provision is not subject to regulation procedures and therefore not registered with the Commission. The accommodation is light and airy, and has a range of equipment and adaptations for service users who have physical disabilities. Access is available to a landscaped enclosed garden at the rear of the building. Cherrytrees @ Abbotsbury DS0000029373.V290096.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 on a Thursday, between 10am and 2pm. The two current service users were spoken with, as well as staff and the manager. Care plans and other records were examined, and activities and interactions were observed. Staff, management, and users of the service were helpful and positive, and a relaxed and pleasant atmosphere was evident throughout. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 6 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 @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 7 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): 3 The judgement for this outcome group is good. Assessments ensure that the needs of new admissions to the home can be met. EVIDENCE: Assessments were seen to be in place for the two current users of the service, showing that they had been assessed by the home to ensure that it could provide a suitable service for them. Care plans were seen to be regularly updated to ensure that changing needs are met. One of the people seen during the inspection said that she used the day service and consequently felt very much at ease stopping there overnight and at the weekend as well. Both people using the respite service on the day of the inspection were very complimentary about it. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 8 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): 7,8,9,10 The judgement for this outcome group is good. Good care practices are now better supported by up-to-date recording that shows that care needs are known and met. Service users are treated with dignity and respect. Service can be confident that, where required, medication is stored, administered, and recorded appropriately. EVIDENCE: The care plans of the two users of the service on the day of the inspection were examined. These were dated, and regularly reviewed. There were some free-standing parts of the care plan, for example, a record of food preferences, that were not dated or signed. The manager agreed that these would all be dated and signed in future, to facilitate regular review and updating where necessary. The manager also agreed that the inclusion of a ‘frontsheet’ with basic information for use in the event of, say, an emergency hospital admission, Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 9 would be useful. Evidence of visits by such as the district nurse were recorded. Medications for those currently using the service are now stored securely in the office. Administration of this was recorded accurately, and the procedure satisfactorily explained. Observations showed staff treating all users of the service with dignity, offering support of whatever sort, whenever needed, and ensuring that a relaxed, therapeutic atmosphere prevailed at all times. The two people using the respite service were able to go, either by themselves, or with help if needed, to their own room for privacy, although most of the time they preferred the company of staff and the people in the day service. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 10 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): 12, 13, 14, 15 The judgement for this outcome group is good. The activities and lifestyle met the needs and wishes of those there at the time. EVIDENCE: Activities were taking place for two hours of this inspection. Staff at the home had everyone happily involved in a word game for an hour. After this, a regular music activities visitor ran a musical singalong, which again appeared to be enjoyed by all. Staff were observed throughout to be attentive to needs and wishes. Life histories, some still in the process of being more fully developed, assist staff in developing activities and fulfilling interests. Midday mealtime was a relaxed, unhurried affair, and those spoken to were very complimentary about the food, which is cooked fresh at the day centre next door and brought through in a hot trolley. Menus were clearly displayed and explained by staff where necessary. Care plans included details of food preferences. Facilities are available at other times of the day for snacks and drinks. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 11 Family contact was evident in records, discussion with users of the service, and in one instance, by a photograph and a laminated sheet reassuring one lady that her dog was safe and well while she was in respite care. Many complimentary letters and notes showed the appreciation of relatives for the service provided. Cherrytrees @ Abbotsbury DS0000029373.V290096.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): 16,18 The judgement for this outcome group is good. The home continues to protect service users from abuse, has satisfactory procedures for managing complaints, and a staff team committed to upholding and promoting the rights and dignities of the people using the service. EVIDENCE: There is a complaints procedure, but currently no complaints. There were a large number of complimentary comments from relatives of those using the service. Staff were aware of adult protection issues. One member of staff had ‘whistleblown’ on abusive practices at another home, immediately prior to working at this service. Details of this were seen and discussed, and she was able to demonstrate her conviction in standing up against poor and abusive practice. Cherrytrees @ Abbotsbury DS0000029373.V290096.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): 19,20,21,23,24,26 The overall judgement for this outcome group is adequate. The home continues to be a pleasant, safe and well-maintained environment. However, the use of washable, rather than disposable, towels compromises otherwise good hygiene. Bedrooms would be more homely if lockable spaces were more discrete. More storage space would enable better storage of items. The current bathroom taps may be a little confusing for people to operate independently. EVIDENCE: The home was clean, airy, well-maintained, and free of unpleasant odours. Both users of the service said they found it a very pleasant place to be, and both appeared at home throughout, enjoying, rather than resenting, the fact that some areas are shared with the people using the day service. One person commented to the effect that it was nice to have plenty of people around in the day, and then have plenty of space in the evening. There is a pleasant accessible outdoor area. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 14 Both bedrooms have en-suite facilities; lockable facilities are provided by padlocked drawers; neither person spoken to on this occasion said they felt the need or wish to use them. A clock in one bedroom was not working. The manager replaced this during the inspection. There were incontinence pads in one of the bathrooms, the manager advised that there was no cupboard space in which to put them. The taps in the communal toilets and bathrooms are of a push button variety, and it was not immediately apparent to an inspector, let alone an elderly person with dementia, how they worked. Cherrytrees @ Abbotsbury DS0000029373.V290096.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): 27,28,29,30 The judgement for this outcome group is good. Users of the respite service benefit from the care and support offered by a sufficient number of trained and motivated staff. EVIDENCE: There were three staff, as well as the manager, on duty during the inspection, for a total of eight users of the service. Staff were always on hand and available to offer support when needed for either of the users of the respite service. One lady commented that she was particularly gratified that the staff in the evenings always had time to talk to and listen to her, and that this was something she found especially comforting. Rotas showed an adequate spread of staff to cover all times of day, with an obvious concentration of staff for the times when people were attending the day centre. One member of staff is not yet twenty one, and was fully aware that she could not work on her own or administer medication until she had at least reached this age. A sample of staff files showed that recruitment procedures included the required elements, with appropriate references and Criminal Record Bureau checks being prominent. The most recent file examined showed the induction process had been modified and made more comprehensive. Both staff spoken Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 16 to showed a good awareness of their roles, and a good understanding of and commitment to the well-being of the people in their care. Staff training records, certificates and discussion showed that staff received appropriate training, and are able to benefit from on-going quality dementia training. The manager advised that the service had not yet achieved the required target of 50 of staff having achieved NVQ level 2 training, principally because of turnover recently, but that staff were now on course to achieve this. Staff spoken to showed a knowledge, understanding, and evidence of training that suggested that this was readily achievable. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 17 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): 31,33,35,36,38 The judgement for this outcome area is adequate. The home is a safe one for all, and run effectively by a competent person. A suitable Quality Assurance would shed further light on this. More regular recorded staff supervision would further aid staff development. EVIDENCE: The manager stated that she has one unit to complete on her registered manager’s award, which she anticipates will be completed well in advance of the required deadline. The manager advised that a pre-inspection questionnaire had not been received by the home; another will be sent out, on which the manager advised that she will confirm that all gas, electric and safety checks are up-to-date. Safety checks for equipment such as bath chairs had been done recently. All users of the service spoken to were complimentary about the care received, and the impression gained was that they appreciated the service and were Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 18 very happy with the flexibility, familiarity and convenience offered by the day and respite service operating from under one roof. There were a large number of complimentary cards and messages from relatives. As the manager advised, there were no complaints, only compliments. The respite service was fully booked up until October. There is no formal Quality Assurance system at present in place, the manager advised that she was looking to adapt the organisation’s feedback system, designed primarily for residential care, to reflect the respite service. Formal staff supervision does not take place as regularly as six times a year, discussion and records showed that at present it occurs irregularly, at approximately three monthly intervals. Supervision records demonstrated a positive dialogue between manager and staff, supporting their development. Staff commented that the manager was readily available for informal discussion of issues when this was needed. Users have a secure facility for any valuables they may have. Both people seen during this inspection chose not to use this facility. The manager advised that respite residents may or may not have small amounts of money, which they look after themselves. There is a visitor’s book available; this is not left out, the manager advised, as it frequently disappears. Access to and departure from the premises is secure and can only be with staff knowledge. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 19 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 x 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 20 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 OP26 Regulation 13(3)(4) Requirement Paper towels must be available in a suitable dispenser in identified communal areas where staff would be expected to wash their hands to maintain standards of hygiene. (Outstanding from inspection dated 23/09/05) The registered provider must confirm to the Commission the plans for ensuring that a minimum of 50 of care staff are qualified to NVQ level 2. (Outstanding from inspection dated 23/09/05) Recorded supervision of staff must take place at least six times a year. The home is required to have a formal Quality Assurance system in place. Timescale for action 25/07/06 2. OP28 18(1)(a) 25/06/06 3. 4. OP36 OP33 18(2) 24 25/07/06 25/08/06 Cherrytrees @ Abbotsbury DS0000029373.V290096.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. 2. 3. 4. 5. Refer to Standard OP24 OP13 OP7 OP21 OP7 Good Practice Recommendations It is recommended that lockable facilities for those using the respite service are more ‘homely’ and discrete than a locked padlock on one of the cupboard drawers. It is recommended that the visitor’s book is more readily available. It is recommended that all sections of care plans are signed and dated, to facilitate review and updating. It is recommended that taps more suited to use by older people are in place in toilets. A ‘frontsheet’, giving basic medical etc. details of a person in individual care plans is recommended, in the event of, for example, emergency hospital admissions. Cherrytrees @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 @ Abbotsbury DS0000029373.V290096.R01.S.doc Version 5.1 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. 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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