Inspection on 12/07/05 for Little Orchard

This inspection was carried out on 12th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Little Orchard 19/11/07

Little Orchard 20/03/07

Little Orchard 20/02/06

Little Orchard 18/01/05

Little Orchard 22/06/04

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

CARE HOMES FOR OLDER PEOPLE Little Orchard 75 Woodlands Avenue Woodley Nr Reading RG5 3HQ Lead Inspector Yvonne Souden Unannounced 12 July 2005 11:40 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 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. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Little Orchard Address 75 Woodlands Avenue Woodley Nr Reading Berkshire RG5 3HQ 0118 9696847 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) Mr Frazer John Noel Dennison RNMS Mr Frazer John Noel Dennison RNMS Care Home 5 Private care Category(ies) of Learning Disability over 65 years of age LD(E) registration, with number of places Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18th January 2005 Brief Description of the Service: Little Orchard is a care home providing twenty-four hour care and accomodation for up to five older people who have a learning disability. The service aims to provide service users with a secure, relaxed and homely environment in which their care, well being and comfort is of prime importance. The Proprietor believes that personal development should continue throughout the whole of life Little Orchard is an extended bungalow with 5 single bedrooms. The home is situated in a residential road within walking distance to the Woodley shopping precinct, sports centre and doctors’ surgery; amenities within Reading town are within a ten minute drive, and public transport is available. Car parking spaces are available at the front of the property. There is a secluded garden to the rear of the buiding with mature plants a patio area and seating. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a positive inspection that observed good care practice and systems in place to improve environmental standards. Three requirements have been made one was a previous requirement, and the other two is to ensure staff have an awareness of the procedure to protect vulnerable adults and ensure the safe containment of substances hazardous to health. The inspector had opportunity to speak to four service users, two of whom had non-verbal or limited verbal communication skills, and also spoke to staff and the manager of the home. What the service does well: What has improved since the last inspection? What they could do better: The home could improve the monitoring of maintenance, repair and décor by implementing a maintenance and repair programme, this would help within the quality control monitoring. Staff need to be aware of the multi agency policy and procedure on the protection of vulnerable adults from abuse, and need to ensure substances that could be harmful to the resident is locked away. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 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. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 8 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 standard(s) 1 & 3 Information is available, but not in an appropriate format to enable prospective service user to make an informed choice. Service users do not move into the home without assurance that their needs can be met by the home. EVIDENCE: The home has a Statement of Purpose and Service Users Guide (SUG) but the SUG is not in a format that would be suitable to those service users who cannot read. The manager is in the process of developing a pictorial SUG following a requirement made at the previous inspection, and aims to have the SUG completed by 1st October 2005. The current service users have lived in the home for a number of years, and the last admission was in 2001. The manager has formatted a needs assessment document to ensure thorough assessment of prospective service users needs, and to ascertain whither the home can meet those needs. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8, 9 & 10 Health and social care professionals are informed and involved in meeting the care needs of the service user as set within the individual service user plan, and are protected by the homes policy and procedure for dealing with medicines. Service users are treated with dignity and respect. EVIDENCE: There are detailed care plans in place that address the individual health and personal care needs of the service user. The care plans have an action plan to meet the need and a risk assessment to minimise associated risk. Records show that the service users attend health care appointments. A review of the individual service user is undertaken annually by social services and monthly by the keyworker of the service user; changing needs identified within the review process are added to the service user’s plan of care. Staff administer service users medication as dispensed by the pharmacist; all staff have received in-house medication training in line with the homes medication policy and 50 of staff have received external medication training with plans in place to ensure all staff have external medication training. Positive interaction between staff and service users was observed that demonstrated staff awareness of the service users right to be treated with dignity and respect, and have their privacy assured. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 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 standard(s) Standards 12 –15 were not assessed at this inspection. EVIDENCE: Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 11 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 standard(s) 16 & 18 The home has a complaint procedure that demonstrates complaints would be listened to and taken seriously, but staff are not aware of procedures in place to protect service users from abuse. EVIDENCE: The home has a complaint procedure and a record book to record informal or formal complaints; there have been no complaints registered within the home or with CSCI about the service provided within this inspection year. The home has policies and procedures in place for the protection of vulnerable adults against abuse. Staff demonstrated awareness of what constitutes abuse and of what they would do to protect vulnerable adults, but staff are not aware of the policies and procedures in place, and have not received abuse awareness training. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 12 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 standard(s) 19, 20, 22,23,24,25,26, The home has systems in place to provide a clean, comfortable, homely and safe environment for the service users, but do not strictly follow COSHH procedures. EVIDENCE: The home has an ongoing programme of maintenance, décor and repair; some of the service users bedrooms have been redecorated and have aids in place as assessed by occupational therapy. All bedrooms are comfortably furnished and personalised and have a wash hand basin. The communal areas are comfortably furnished and have natural light and ventilation; plans are in place to refurbish the hall in 2006. Fire safety measures are in place and staff receive mandatory training to ensure a safe environment, but COSHH procedure was not strictly followed. Service users are protected from burns and scalds as radiators are covered and water temperatures are monitored. The home has a laundry and appropriate hand washing facilities throughout to ensure infection control. Patio doors from the lounge and dining room open on to a pleasant garden with a patio, flowerbeds and seating for all to enjoy. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards 27 – 30 were not assessed at this inspection. EVIDENCE: Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards 31 to 38 were not assessed at this inspection. EVIDENCE: Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 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 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 2 Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 16 yes 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 1 Regulation 5 Requirement Timescale for action 01/10/05 2. 18 13(6) 3. 38 13(4c) The manager must produce an appropriate Service Users Guide within a format that is suitable to the service users. (timescale 31/03/05 not met) The manager must ensure staff 12/08/05 are aware of the procedures in place to protect vulnerable adults and arrange training for staff on abuse awareness. The manager must ensure staff 12/08/05 follow the Containment of Substances Hazardous to Health procedure (COSHH), and ensure the COSHH cupboard is locked when the area is unsupervised. 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 19 Good Practice Recommendations The manager should implement a maintence and repair record to identify areas within the home that requires attention. This would aid the manager within his quality assurance monitoring of the home. v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 17 Little Orchard 2. 19 The manager should refurbish the hall as planned for January 2006. Little Orchard v226570 h52-h01 s11396 little orchard v226570 120705 stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 2nd Floor Arlington Business Park Theale RG7 4SA 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. 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