Inspection on 26/05/05 for Home Orchard

This inspection was carried out on 26th May 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 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

Home Orchard 09/11/06

Home Orchard 03/11/05

Home Orchard 16/11/04

Home Orchard 06/05/04

Home Orchard 09/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Home Orchard Palace Farm Rock Road Chudleigh TQ13 0JJ Lead Inspector Fiona Cartlidge Announced 26 May 2005 th 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. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Home Orchard Address Palace Farm, Rock Road, Chudleigh, Newton Abbot, Devon, TQ13 OJJ 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) 01626 852254 01626 854787 Mr David John Martin and Mrs Annette Martin Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/11/04 Brief Description of the Service: Home Orchard is a care home registered for five younger adults of either gender who have learning difficulties. The Home is owned and managed by David and Annette Martin who also live at the home. The home is divided into two properties. Three residents live on the original premises named Palace Farm. Another property, Sunset Cottage next door to Palace Farm, accommodates two further residents. The home is registered as one Care Home. Both properties are situated in Chudleigh, which has a variety of shops, medical and dental practices, a library, community centre and public swimming pool. (Open in the Summer months). Chudleigh is just off the A 38, approximately eight miles from Exeter City Centre. The town is on the main line bus routes to Exeter and Newton Abbott, which have main line railway stations. Palace Farm site is a spacious well presented farmhouse, situated on a small holding in the small historical town of Chudleigh. Residents share the accommodation with the Providers and their family. Each Resident has free access to the entire property and have their own bedroom with either ensuite or designated bathroom. The house has a large farmhouse kitchen where all residents cared for at Home Orchard, eat meals with family, staff and Providers. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 and a half hours and was announced. Information was received from the registered provider before the inspection as was written feedback from 2 residents and 3 relatives/visitors. A full tour of the home took place and personal records of 2 residents and 2 staff were inspected. The inspector spoke to 2 members of staff on duty and 3 of the residents as well the registered owners. What the service does well: What has improved since the last inspection? What they could do better: Ensure that relatives of residents and other interested parties are aware of the complaints procedure. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 6 Ensure that at least 2 written references are obtained for all individuals applying to work at the home before making a decision about their employment. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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 Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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) 1,2,3,4 The level of information the home provides to service users is good. The needs of service users are fully assessed before a decision is made about if/how those needs can be met within this home. EVIDENCE: The inspector looked at the homes Statement of Purpose and Service User Guide/brochure. The Guide is attractively presented with photographs and pictures for those who cannot read. Records and discussion with the Provider confirmed that residents visit the home for an assessment period when their needs are identified. Records confirmed that information from Social workers and care managers is obtained prior to their admission to be sure that Home Orchard is an appropriate setting. Discussion with the provider confirmed that trial visits are preferred and mostly used in the decision to live at Home Orchard. Discussions confirmed that the admission process is gradual and the number of visits made before a decision to stay on a long- term basis is led by the resident. During this period the Provider obtains information from health care professionals and social workers to ensure the placement is suitable. The Provider stated that Home Orchard do not accept short term or respite placements due to the impact on the welfare of existing residents. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 9 Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 10 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,&9 The residents are aware and agree their planned care within a risk- assessed framework. EVIDENCE: Inspection of records confirmed that each resident has an A4 lever arch file, a life plan and daily diary. These documents contained a photograph, assessment, care plan, personal information, review sheet by the multi disciplinary team, health care information, prescriptions, risk assessments and contract. Evidence was provided of reviews involving health care teams, home staff, Service Users and Representatives. Residents seen on the inspection were observed to join in as much or as little as they chose. The inspector noted that was mutual respect shown between residents and staff members. Activities provided and encouraged by the home have been supported following specific risk assessment. The risks at Home Orchard, which are unusual, include: Use of an incinerator and bee keeping. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 11 Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 12 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) 11,12,13,14,15,16,17 The home offers a broad range of activities to meet the needs of those living in the home individually and on a group basis. People can make choices about all aspects of their lives and are supported to do so. The food in the home is of good quality with plenty of choice. EVIDENCE: Throughout the inspection residents were seen to be guided and respected in a sensitive and supported manner. Small prompts were given and residents were seen to respond. The use of affection, humour, appropriate touch and reassuring conversation was shared between staff and residents. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 13 Discussion with residents, staff and observation of records confirmed that residents are encouraged and supported to continue education, take up pursuits and find appropriate employment. One Service User was working at a riding stable on the day of this inspection and other Service Users have been encouraged to set up business selling compost. . The inspector was also shown a worm farm. Residents had also been recently showing sheep and cattle at a county show. Photographs and discussions confirmed that residents are fully involved in the local community. Examples include: entries at the local Devon county show, attendance at the local Lions club and apiary organisations. Home activities include: Farm animal care, horse riding, woodwork and construction, bee keeping and horticulture. Other activities include attendance at the local cinema, funfairs, arcades, swimming pool, horse racing, rock climbing, ten pin bowling, local night club and shopping trips. In addition to this residents have equipment within their private rooms this includes: TV’s, videos/DVD players and computer games. Records confirm that Service Users maintain links with their families and that this process is supported by staff at Home Orchard. Three Visitor/Relative feedback cards were received regarding Home Orchard. One stated “the level of care is excellent.” Menus seen displayed within the home confirm that residents at Home Orchard have a wide variety of home cooked balanced meals. Residents spoken to said they enjoyed the food at the home. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 14 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) 18,19,20 The home has robust arrangements to ensure the health care needs of residents are identified and met. EVIDENCE: Observation and discussion confirmed that the majority of residents are independent in performing personal care. The inspector witnessed that prompts are given to ensure Service Users achieve a satisfactory standard of personal care. Records confirmed that health care is provided through a General Practitioner and specialist community and hospital services as well as trips to the dentist being enabled. All of the three feedback cards received stated Representatives were satisfied with the level of care provided and were always kept informed about important matters. The registered Provider confirmed that he is solely responsible for the medicines and authorises selected staff to administer medicines. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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 standard(s) 22,23 Residents are listened to and feel safe in the home. EVIDENCE: The Provider gave information in the pre-inspection questionnaire that Home Orchard has not received any complaints in the last year. The Commission for Social Care Inspection have not received any complaints either in that time. The complaints procedure has been reviewed and updated to include detail and timescales and methods of how residents and Representatives should contact the Commission for Social Care Inspection. Of the three feedback cards all stated that it has not been necessary to make a complaint but only one was aware of the homes complaints procedure. Observation confirmed that the home have a Devon County Council Alerter Guide. Discussion with 3 residents and written feedback from 2 confirmed that they felt safe living at the home and that staff were kind and caring. The policy and procedure file contained policies about the protection of residents, public disclosure, complaints, personal contact, physical restraint, the management of problem behaviours, reporting and recording accidents and racial harassment. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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 standard(s) 24,25,26,27,29,30 The environment is safe, comfortable and homely. EVIDENCE: Home Orchard is divided into two sites: Palace Farm and the next-door property -Sunset Cottage. Both Properties appeared safe, comfortable, bright, airy, clean and free from offensive odours. Planned and routine renewal and redecoration were discussed with the provider and include a new kitchen arrangement in the cottage and alterations to the office and laundry area in Orchard farm. All rooms inspected contained personalised equipment and were individually decorated to reflect the choice of the individual resident. All residents have either en suite or access to a private designated bathroom. All equipment seen within the home appeared to be in a good state of repair. Resident’s records confirmed that they are supported and encouraged to clean and tidy their individual rooms. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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 The staff team are effective and competent. EVIDENCE: Records, observation and discussion with staff confirmed that Staff collectively have a wide range of experience and knowledge to meet the needs of Service Users. Gaps in knowledge are accessed through training. Examples given were training for deaf awareness. Existing staff have experience in Care and education of Service Users with learning difficulties, animal care, horticulture and agriculture, primary school education, nursing, administration and outward pursuit training. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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) 39,42 The management of this home is effective, clear and transparent. EVIDENCE: Staff spoken to during this inspection said they felt happy working at the home. Five feedback cards received in respect of Home Orchard were complimentary about the service provided. Residents stated that if they do not like something and report that to the providers it is changed. Reviews are used as an opportunity to formally seek opinions of residents, Care Managers and Representatives regarding the service provided. Care Plans confirmed this process is recorded. All records seen were secure up to date and in good order. Confidential written information is securely stored in a locked office. Pre inspection information confirmed that gas, legionella checks and central heating was checked in September 2004. Health and Safety Executive posters and safety notices were displayed within the home. Insurance certificates were displayed. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 4 x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 x 3 3 Standard No 11 Home Orchard 3 Standard No 31 32 33 Score 3 3 4 Version 1.20 Page 20 D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc 12 13 14 15 16 17 4 4 3 3 3 3 34 35 36 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 21 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. 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. 2. Refer to Standard 22 34 Good Practice Recommendations The complaints procedure should be communicated to residents representatives. Ensure that at least 2 written references are obtained for all individuals applying to work at the home before making a decision about employment. Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Home Orchard D54-D07 S3724 Home Orchard V214525 260505 Stage 4.doc Version 1.20 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. 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!