Inspection on 03/11/05 for Home Orchard

This inspection was carried out on 3rd November 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 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

Home Orchard 09/11/06

Home Orchard 26/05/05

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 Newton Abbot Devon TQ13 OJJ Lead Inspector Fiona Cartlidge Unannounced Inspection 3rd November 2005 11:10 Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 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 Home Orchard DS0000003724.V253105.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Home Orchard Address 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) Palace Farm Rock Road Chudleigh Newton Abbot Devon TQ13 OJJ 01626 852254 01626 854787 Mr David John Martin Mrs Annette Martin Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26/05/2005 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. Sunset Cottage is a separate detached house next door to Palace Farm. It has three bedrooms. Each Service User has free access to the entire property and an ensuite bedroom. Staff employed by Home Orchard also live within the home and provide 24 hour staff cover. In the event of holidays/sickness cover is provided by existing staff. Home Orchard is a home which has a working farm and has a variety of animals including: cows, horses, sheep, pigs and bees. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4hours and 20 minutes and was unannounced. A partial tour of the home took place when some bedrooms and all communal living rooms were viewed. Personal records of care of 2 residents and personnel records of 3 members of staff were inspected. The inspector spoke with 3 residents, 2 staff members and both of the registered providers. Readers may wish to consider the contents of the last inspection report with this one to gain a full picture of the homes progress in meeting the National Minimum Standards in Inspection year April 2005 to 2006. What the service does well: What has improved since the last inspection? To greater enhance the broad knowledge and skills of the staff team, both Providers are working towards a National Vocational Qualification in Management (Level 4) this will underpin their existing knowledge and skills and ensure the management of all resources in the home is based on current best practise. In addition to this the providers are also working towards a certificate in the safe management of medication and two staff have attended a four - day course in the management of potential and actual aggression and violence incorporating appropriate physical interventions. Planned and routine renewal and redecoration were evident; the kitchen in sunset cottage has had a double sink fitted, additional shelving in the larder and new work surfaces. Plans are in place and work has commenced to alter the office and laundry area in palace farm and a residents bathroom has also been redecorated. Home Orchard DS0000003724.V253105.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. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The admissions process is safe. The needs of prospective residents are fully assessed before a decision is made about if/how those needs will be met within this home. EVIDENCE: 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 DS0000003724.V253105.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 The residents are aware and agree their planned care within a risk- assessed framework. EVIDENCE: Each resident has an A4 lever arch file, a life plan and daily diary. The inspector looked at all of the records held on behalf of 2 residents, 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 there was mutual respect shown between residents and staff members. Activities provided and encouraged by the home have been supported following specific risk assessment. Both residents who were spoken to by the inspector about the care plans, were aware of the documentation held in the home about them and agreed that they had been involved in discussions and agreement about the plans. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17. A broad range of activities is on offer 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: During 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. 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 resident is being assisted to gain employment within the community in a local shop and others have been encouraged and supported to set up a business selling compost another told the inspector of their bottling and selling of honey produced by bees in their own hives. Another resident is an avid horse rider and is employed at a local stables Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 11 unfortunately not able to attend on the day of the inspection as was feeling a little under the weather. Photographs and discussions confirmed that residents are fully involved in the local community. Examples include: entries at the local county shows, attendance at the local Lions club and apiary organisations. Home activities include: Farm animal care, horse riding, woodwork and construction, bee keeping, art, and horticulture. Other activities include attendance at the local cinema, funfairs, arcades, and swimming, horse racing, rock climbing, ten- pin bowling, local night clubbing and shopping trips. The residents spoke about their activity holiday to France earlier in the year when some of the activities had included, rock climbing, abseiling and kayaking. A tour of the buildings showed that residents have their own entertainment equipment within their private rooms. This includes: TV’s, videos/DVD players and computer games. Care Plans and daily diaries confirm that residents maintain links with their families and that this process is supported by staff at Home Orchard. Menus seen displayed within the home confirm that Residents at Home Orchard have a wide variety of home cooked balanced meals. Those residents spoken to about food, said they enjoyed what was served to them. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Residents receive support in the way they prefer; their physical and emotional needs are 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 residents 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. The registered Provider confirmed that he is solely responsible for the medicines and authorises selected staff to administer medicines, when administration takes place the medication chart is signed and dated after giving and ensuring the resident has taken it. Both registered providers are working towards gaining a certificate in safe handling of medicines. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Residents views are listened to and they feel safe in the home. EVIDENCE: The residents told the inspector that they feel confident discussing personal issues with staff members one told me that they were often asked by the providers if there was anything they would like changed that might make them happier. The Commission has not received any complaints about the service, but has been involved in a protection issue, which has been dealt with in a safe and collaborative manner. The complaints procedure, which includes detail and timescales and methods of how residents and Representatives should contact the Commission for Social Care Inspection have been sent to all of the residents representatives and social and health care teams. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27,30, 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 evident the kitchen in sunset cottage has had a double sink fitted, additional shelving in the larder and new work surfaces. Plans are in place and work has commenced to alter 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, one bathroom had been redecorated since the last inspection. 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 DS0000003724.V253105.R01.S.doc Version 5.0 Page 15 Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The staff team are effective and competent. The procedures for the recruitment of staff do not always provide all the safeguards that are recommended to offer protection for people living in the home. EVIDENCE: Records, observation and discussion with staff confirmed that the Staff collectively have a wide range of experience and knowledge to meet the needs of residents. Gaps in knowledge are accessed through training. Examples seen were that 2 staff have recently attended a 4 day training course on the management of potential and actual aggression and violence incorporating appropriate physical interventions. An NVQ assessor was in attendance at the home during the inspection assessing both providers on elements of their management course. 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. Interestingly one resident was observed teaching a carer sign language and was confident enough to teach the inspector as well. The inspector examined the personnel files of 3 recently employed members of staff 2 of these contained all of the information and evidence required to ensure their suitability for the post, one file lacked written references, although the providers explained that they have known the individual for a number of Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 17 years and would ordinarily act as referee on their behalf, the inspector explained that the providers would still be expected to obtain 2 written references on this individuals behalf, despite all other checks being satisfactory. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,41,42 Resident’s benefit from the open and clear management approach taken in this home. The health, safety and welfare of residents are promoted and protected. EVIDENCE: Staff spoken to during this inspection said they felt happy working at the home personnel files showed that staff undergo an annual appraisal as well as regular and ongoing supervision and support. Residents said they feel comfortable discussing any issues or concerns with the staff and providers, formal 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. Some records seen did not contain signatories or dates and therefore it was at times difficult for the inspector to track through the documentation and identify who had made or when information had been documented. The records are stored securely and residents were aware of the information held about them. Health and Safety Executive posters and safety notices were displayed within the home as was a current employers liability insurance certificate. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 19 All activities involving residents, identified as a possible risk have been assessed with a documented plan to minimise the risk, which has been communicated to the carers/enablers. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 20 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 X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Home Orchard Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X 2 3 X DS0000003724.V253105.R01.S.doc Version 5.0 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 YA34 Regulation 19 Requirement The registered person must not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1-7 of schedule 2 Timescale for action 01/12/05 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 YA41 Good Practice Recommendations All entries in documentation relating to residents should be dated and signed. Home Orchard DS0000003724.V253105.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Ashburton Office 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 DS0000003724.V253105.R01.S.doc Version 5.0 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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