Inspection on 12/04/07 for Little Orchard

This inspection was carried out on 12th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Little Orchard 28/01/09

Little Orchard 04/01/06

Little Orchard 25/07/05

Little Orchard 29/11/04

Little Orchard 01/07/04

Little Orchard 18/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Little Orchard 17 Lavender Road Hordle Lymington Hampshire SO41 0GF Lead Inspector Nick Morrison Unannounced Inspection 12th April 2007 11:00 Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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 Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Orchard Address 17 Lavender Road Hordle Lymington Hampshire SO41 0GF 01425 617 217 01425 617 217 info@glyn-residential.co.uk 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) Glyn Residential Limited Mrs Mandy Jane Henry Care Home 6 Category(ies) of Learning disability (2), Physical disability (6) registration, with number of places Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Little Orchard, 17 Lavender Road is one of three homes owned by Mr & Mrs Hayward and now provides personal care and accommodation for up to six service users with a physical disability including two service users in the learning disability category. There are two bedrooms upstairs for ambulant residents with a learning disability. The home can also provide day care. The home is situated in Hordle, where there are a small number of shops and facilities. Lymington is the nearest town, and the city of Southampton can be accessed by car. The home comprises of a chalet-style bungalow. All service users have single bedrooms. Communal facilities include a kitchen/diner, lounge, activities room, which contains a kitchen, craft facilities [where service users can cook, create craft projects and have physiotherapy]. Little Orchard is a non-smoking home. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 12th April 2007 and lasted six hours. During this time the Inspector toured the premises, looked at all six service users’ files and met with three of those people. All records and relevant documentation referred to in the report was seen on the day of inspection. The Inspector spoke with a Director of the organisation and the senior member of the care team as well as other staff. The current range of fees in the home is between £600 and £1600 per week, depending on individual needs. What the service does well: What has improved since the last inspection? What they could do better: Issues identified as necessary for development during the inspection were reviewing the medication procedures, implementing the quality assurance system, training staff in person centered planning and implementing the person centered planning system in the home. The home has a positive history and has always complied with issues highlighted through inspections. The identified issues are also things that the organisation is aware of and planning to address. As a result, no requirements have been made but the Commission expects that the home will deal with these issues in a timely manner. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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 Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: Service users’ files showed that they had assessments that had been completed prior to them moving into the home. The assessments were thorough and covered a full range of need areas. There was evidence on file that Care Managers, health professionals and families of service users had been involved in the assessment process. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having clear individual plans in place and from support to take decisions and risks appropriate to their development. EVIDENCE: Service users and their families had been involved in the care planning process and the care plans related to the needs identified in the initial assessment. There were different care plans for each different area of need. The plans detailed exactly what support each person required and how the support needed to be delivered. Staff spoken with were clear about the care plans for each service user. Care plans were reviewed twice a year and were updated in between those times where the needs of service users had changed. The home is currently in the process of introducing a Person Centered Planning system and need to train staff in the process as well as introduce service users to it. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 10 The care planning process emphasised the rights of service users and the importance of them being involved in decisions about their own care and their own lives. Care plans contained information on how individual service users made and expressed decisions for themselves. Staff had good training in the various communication systems used by service users in the home and were able to communicate effectively with them. On the day of the inspection visit staff were observed communicating with service users over decisions about activities. The right of service users to make their own decisions was covered in staff induction training and was emphasised throughout the service including staff meetings, support and supervision and policies. Risk assessments were well written. They contained clear information about the identified risks and had appropriate control measures put in place to ensure that all risks were minimised as far as possible. Not all risk assessments were dated and this made it difficult for the service to demonstrate that they were regularly reviewed and updated. The home has undertaken to review the way care plans are written and ensure they are all dated and kept under regular review. The home’s approach to risk taking was positive and ensured that risks were planned and that the identification of risks did not mean that service users were not able to do particularly activities, but they were supported to do them safely. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being part of the community and involved in varied activities. They also benefit from regular contact with their families and a healthy diet. EVIDENCE: Each service user had an activity plan in place and staffing was organised to ensure support was available when service users needed support with activities. Transport was available in the home for service users to get to different activities. Some service users had activities arranged through local colleges as well as by staff in the home. Activities were based around the individual interests of service users and suited to their individual needs and preferences. All service users spoken with said they felt they had enough Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 12 activities throughout the week and that they were able to do things they enjoyed. Service users were supported and encouraged to maintain contact with their families and friends. One service user was supported to compile a family tree as a visual representation of their family. Service users spoken with said that staff were always supportive in helping them to keep in contact with families and friends and this was confirmed by support in this area being recorded on service users’ care plans. The staff in the home had supported one service user to reunite with members of her family and this proved a positive experience for her. The rights of service users were emphasised throughout the home. Care plans placed emphasis on this, as did the home’s policies. Staff observed during the visit were clearly aware of service users’ rights and of their own role in ensuring that rights were respected. All service users spoken with said they thought the food in the home was very good. There were set menus in the home and service users were able to contribute ideas for the menus. Menus were pinned up in the kitchen so that everyone knew what meals they were having on each day. Staff also contributed to menu planning to encourage service users to try new and different foods. Records were kept of what food was consumed and these demonstrated that meals in the home were varied and nutritious. Support was available at mealtimes for people who needed it and, from observation, it was clear that service users enjoyed mealtimes. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s medication policy and practices and benefit from having their health and support needs met appropriately. EVIDENCE: The home’s medication policy was suitable and was reviewed regularly. Staff spoken with were clear about the policy and had received appropriate training through the local college in administering medication. Staff had also been training in administering particular types of medication that required specialist training. Medication was stored safely and good records were kept of all medication administered. There had been no errors in administering medication but the home was reviewing it’s medication procedures to make more use of pre-dispensed medicines and to cut down on the potential for mistakes happening as a result of medication being taken out of the bottle and out into another bottle before being administered. The healthcare needs of service users were regularly monitored and records were kept. They were supported to attend medical appointments as necessary Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 14 and clear, ongoing records were kept to show what appointments had been attended, the reason for the appointment and the outcome. Care plans were reviewed and updated in response to the outcomes of healthcare appointments. There was evidence of regular input from the Community Learning Disability Team, particularly physiotherapy and speech therapy. As well as seeing service users regularly, these practitioners also provided training and guidance for staff so that they were able to support service users with those needs on a daily basis. Staff were alert to the health needs of service users and had highlighted concerns regarding changes in one service user’s epilepsy. This was then responded to quickly, healthcare professionals were involved and the situation stabilised over a short period of time. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clear complaints policy and were protected by the home’s Safeguarding Adults policies and practices EVIDENCE: All staff in the home had received training in adult protection and were aware of their responsibilities within this. The home had relevant policies and procedures in place regarding the protection of vulnerable adults. Good procedures were in place to ensure that service users’ finances were dealt with appropriately and clear records were kept of all transactions where staff supported service users to manage their money. These procedures were currently being reviewed with the aim of increasing individual service users’ independence in managing their own money where they were able to do so. There was a clear complaints procedure in place that was given to each service user when they moved into the home and was available throughout the home in an accessible format. Service users spoken knew how to complain if they needed to and knew where to direct complaints. There had been no complaints made since the previous inspection. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a comfortable, safe and clean home. EVIDENCE: The home consists of a large house with an extension to the rear, which has been added in the last few years. All bedrooms in the extension have en-suite facilities and further en-suite facilities are being added to the older part of the building. These facilities include hoists and tracking where necessary to improve comfort for service users. Due to physical restraints, there are two rooms in the older part of the building that will not have en-suite facilities, but the occupants of these rooms will have their own, individual bathrooms. The communal parts of the building consist of a large kitchen/dining area, a lounge and an activities room. The kitchen/dining area is in the central part of the house and acts as a focal point of the home and helps to create a sociable atmosphere. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 17 The home was comfortable and planned around the physical needs of service users. The amount of living space within the home was adequate for the number of people living there and the home benefited from good natural lighting and ventilation. All parts of the home were accessible to service users. Furniture provided in the home was comfortable and of good quality. Records showed that maintenance was monitored regularly and issues were responded to in good time. The home was clean throughout, although retained a homely and comfortable atmosphere. Infection control procedures were in place and followed by all staff. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by competent, trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Rotas showed that sufficient numbers of staff were on duty at all times in the home. Service users spoken with felt that were sufficient staff and spoke very highly of the staff that supported them. During the inspection visit the Inspector observed staff interacting with service users in a very relaxed and supportive manner. The approach of staff observed on the day was wholly positive. They demonstrated that they understood the needs of service users and were skilled in communicating effectively with service users and supporting their personal development. Staff were particularly skilled in using sign language with service users. Staff training records were good and showed that staff are able to access a wide range of training opportunities. Good, clear records were kept of all staff training, including induction training. Staff spoken with said that the quality of training within the home was very good and that it was quite freely available. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 19 They felt that the organisation supported them well in having the skills to do their job. Support and supervision sessions in the home were regular and clearly concentrated on the needs and wishes of service users. Staffing in the home was organised around the needs of service users, with staff being required to be flexible in their hours according to those needs. The home does not employ agency workers, but has it’s own bank of staff to cover absences. Staff interaction with service users in the home was extremely good and demonstrated that staff receive very good training in communication and supporting service users to be in control of their own lives and encouraging personal development. Staff records showed that all necessary pre-employment checks were carried out on each member of staff prior to them beginning work in the home. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well run home and they are protected by the home’s Health and Safety policies and practices. Services users’ views are included in the planning and monitoring of the service. EVIDENCE: The manager is registered and has demonstrated that she has the skills, knowledge and qualifications to manage the service. The home is clearly run in the interests of service users and this was emphasised by outcomes of service user group meetings and individual meetings with keyworkers as well as by staff training and the approach of staff to supporting service users. The home is developing a quality assurance system with the aim of regularly monitoring how well the service is performing and what developments are necessary. This Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 21 process will be focussed on input from people who use the service, as well as other stakeholders. In discussion, the Director of the company identified the need to simplify some parts of the quality assurance system and to fully implement it as soon as possible. All staff had received health and safety training and workplace risk assessments were in place and regularly reviewed. Staff spoken with said they knew about and understood these assessments. Records were kept to show that all equipment was regularly serviced. All accident and incident records were clear and the manager regularly monitored and reviewed these in order to look for patterns and plan to decrease future occurrence of these. Regular health and safety checks were made as part of the provider’s monthly assessment of the home. Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Little Orchard DS0000012281.V334374.R01.S.doc Version 5.2 Page 25 - 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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