Inspection on 04/01/06 for Little Orchard

This inspection was carried out on 4th January 2006.

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

The inspector 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 12/04/07

Little Orchard 25/07/05

Little Orchard 29/11/04

Little Orchard 01/07/04

Little Orchard 18/02/04

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Hillview Farm

Dalewood Respite Care

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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 Mr Rodney Martin Unannounced Inspection 4th January 2006 10:00 Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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.V275845.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V275845.R01.S.doc Version 5.1 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.V275845.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25.7.05 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.V275845.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 17 Lavender Road has a house name, ‘Little Orchard’, and so for the purposes of this report the home will be referred to as Little Orchard. There were no requirements in the previous inspection report, dated 25 July 2005, and again none were made following this inspection visit. The unannounced inspection took place between 10am and 1.30pm and the manager was available. There were only three service users in the home at the time of the visit but two staff members took them out, to New Milton, as it was market day. They also had lunch out. The other residents were visiting their respective families. Since the last inspection has Little Orchard increased the number accommodated from five to six on 21 November 2005, following an extension to the building. A new large bedroom with specialist en suite equipment has been created, specifically for an intended prospective service user, making use of the home’s previous activities room. The extension now accommodates the new bedroom, a separate laundry room and a new larger activities room. There were two admissions in August and November 2005, with both residents having attended Little Orchard as day care clients. Little Orchard now has six service users, whose ages ranged from 21 to 43 years old, with four male and two female service users accommodated. It is confirmed that all forty-three standards, including the key standards have been inspected during this inspection year. What the service does well: The home provides a safe environment for residents where they are looked after by dedicated and caring staff, who are suitably trained. There is a commitment to staff training with Little Orchard, with a good training programme. The manager leads by example. The home enables residents to participate in appropriate activities, which are tailored for each service user. Meals are varied, plentiful and well managed to meet residents’ needs and preferences. There is continuity of care with staff having worked in the home a long time. There is a friendly and relaxed atmosphere within the home where residents support needs are met within Little Orchard. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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.V275845.R01.S.doc Version 5.1 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): 1, 2, 3, 4 and 5 The home’s admission procedure ensures that prospective residents needs are assessed and they have adequate information and opportunities to visit the home, prior to making a decision about living at the home. Service users have a relevant terms and conditions of residency. EVIDENCE: Since the last inspection the home has further up dated the statement of purpose to include the increase in the home’s registration from five to six. The home has a relevant statement of purpose and service users guide. The residents have a copy of these documents in their room. In March 2005 Little Orchard increased the registration from three to five by utilising two upstairs bedrooms, for ambulant service users and this was subsequently increased further in November by the building of an extension. The activities room was changed into a large bedroom with specialist en suite facilities and a new activities room created. Since the last inspection on 25 July 2005 two further residents were admitted, in August and November 2005. Both prospective service users had attended as day care clients and so knew the home, the staff and the other four residents well. The home is now full. Since the last inspection the home has changed the residents’ files over to modular ones. All six files were seen. It was confirmed that a full assessment Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 9 had been completed on the two new residents and that the home could meet their needs. Several service users at the home use British Sign Language to communicate, and staff have received training in this. The staff demonstrated a good understanding of service users needs and are skilled at meeting their needs. There is a good rapport between the residents and staff members. This was observed on the day of the visit, in particular when “signing” with residents. Individually and collectively staff have the necessary skills and experience to provide the care service users require. The aims and objectives of Little Orchard are “to provide care support and accommodation to people with various disabilities and problems and to ensure quality of life through freedom of choice”. There was evidence that the home is meeting its stated aims and objectives. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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 the following standard(s): 6 There is a clear care planning system in place, with evidence of consultation with service users about decision making, which ensures that their needs are met. EVIDENCE: Since the last inspection the home has changed individual residents’ files into a ring binder file, in a modular format, indexed for ease of use. All six residents’ files were seen. These were detailed and contained all the key information describing the individual care required. The files were comprehensive and gave a good picture reflecting the needs and aspirations of each service user. The care plan had been reviewed, involving the service user. The use of a care plan outcome sheet was again discussed, as it would enable staff to record when the care plan is reviewed and updated. It was agreed that this would be implemented. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Social activities, family relationships and meals are well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: Each resident has a timetable of activities for the week, which is full and meaningful for their individual choice and preferences. Service users attend various clubs and activity centres, including Leonard Cheshire day centre in New Milton, Fernmount day services, arts and crafts at Hordle village hall and the Hexagon Centre in Chandlers Ford. Service users also attend the Gateway Club at the Nedderman centre in New Milton [part of New Forest Mencap]. One service user is attending Brockenhurst College for 36 weeks on a BSL level 2 course [British Sign Language] and two residents are attending Brockenhurst College for 30 weeks on a world wise course [the course aims to improve skills in literacy, numeracy, communication and I.T.] Service users are supported to develop and maintain their skills, relevant to their age and capabilities. It was evident that each service user has different needs and interests but these are catered for in the home. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 12 One service user has an individual interpreter for communication skills. Residents enjoy a variety of social activities including swimming, wheelchair aerobics, going out for walks, parental visits and cookery. Glyn Residential Ltd has its own transport to provide access to the local community, for service users. There is support for the service users to pursue entertainment, outings and holidays of their choice, as well as eat out and enjoy visits to local pubs. There are joint residents’ meetings with the other two homes. The home has a specially adapted bicycle with a wheelchair on the front to enable residents to go out for a ride. Service users have their own radios, televisions, video, books and hi-fi systems in their rooms. The home has Sky television installed and is connected to each bedroom. Glyn has a beach hut at Milford-on-Sea, where service users can enjoy a break by the seaside in the summer months. Glyn Residential Ltd also has a holiday home in Spain, which is made available for residents’ use. All service users have family and friends involved. The home actively encourages and supports the service users to maintain family links. Service users spend time with their families in the home and also go to stay with their families. Little Orchard, in conjunction with the other two homes, has a newsletter, which includes a diary of forthcoming events, news items about the residents, articles, quizzes, photographs and visits from local events. The home received a recent letter from grateful parents, in which they said thank you for “the lovely presents and cards you gave to [the resident] for Christmas”. Another family had produced a calendar for 2006 with various photographs of the Christmas party including residents, staff and family members. The menu is discussed with service users each week, as well as residents’ meetings. It was reported that they all generally like most food and do not have particular dislikes. The main shopping is done on-line but two residents go out with staff to Tesco’s and another resident enjoys going with their designated carer. On the day of the inspection the cook prepared sausage casserole and rice pudding for the residents. Two residents have their meal liquidised. This was attractively presented with each portion separately liquidised. The residents were out in the morning, visiting the market at New Milton, and were due to go to the arts and crafts session in Hordle village hall in the afternoon. They did not return midday but had a pub lunch out and so the food was kept for the teatime meal. One service user has a PEG feed [a system of direct liquid food into the stomach] for which all staff have received appropriate training. A dietician monitors this. The manager is aware that new food hygiene legislation came into force on 1 January 2006 and is in the process of producing a documented food safety management system. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The residents’ physical and emotional health needs are being met, with evidence of good support from health care professionals. The home has clear arrangements in place ensuring the medication needs of residents are met. EVIDENCE: There are risk assessments and manual handling assessments on file for each service user. Service users can choose what time they get up, or go to bed et cetera. Health professionals such as occupational therapists, physiotherapists, speech therapists and dieticians are involved with service users, as appropriate. Service users have a multitude of aids and adaptations in place to meet their individual needs, including an electric hoist fitted to the downstairs walk-in shower room and a specialist bath and toilet for a resident, which were funded by the registered persons. The home has appropriate policies and procedures for receipt, administration and disposal of medicines. Service users are supported and encouraged in all aspects of individual health care and personal care needs. Medication procedures are appropriately undertaken. All, bar one, residents are on some form of medication, although two residents are to be referred to their GP for a medication review. The medication administration sheets were appropriately Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 14 completed, without any gaps. The GP gave the residents the ‘flu jab this winter. This is also a time when the GP is able to see each individual resident. Staff have received external training on medication at Brockenhurst College, which was a ten to twelve course to National Vocational Qualification [NVQ] standard level 2. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were not inspected on this occasion, although the home previously met both standards on the last inspection. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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 the following standard(s): 24, 25, 26, 27, 28, 29 and 30 A very good standard of accommodation is provided ensuring residents live in a homely, comfortable and safe environment with appropriate facilities and equipment to meet their needs. EVIDENCE: The home obtained planning permission to further extend Little Orchard and on 21 November 2005 the home’s conditions of registration was varied from five to six service users. The existing activities room was converted into a large single bedroom with specialist en suite bath and toilet facilities. A new laundry room was built into the planned extension as well as a new improved and larger activities room. Little Orchard is a large chalet bungalow, which is now double glazed throughout. Little Orchard Road provides sufficient communal space for the permanent service users and is a non-smoking home. Staff are provided with adequate facilities, including a safe place to store personal belongings. All the bedrooms are a comfortable size and service users have personalised their bedrooms, with hi-fi equipment, televisions et cetera. One service user has a fish tank and another a fax machine, to enable them to communicate with a parent. All residents have their own single bedroom, which is provided Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 17 with electric beds, hoists et cetera. Bedroom radiators have been covered. Service users are able to choose their own colour scheme. The home has a very attractive garden, Mediterranean in style. The home has a large greenhouse, with a grapevine growing. Since the last inspection the garden has been pruned and trees trimmed. The home was found to be clean and free from unpleasant odours. The new laundry room is situated away from the kitchen and food preparation and has sufficient machines for the number of service users accommodated. Control of Substances Hazardous to Health assessments [COSHH] policies and procedures are in place, to ensure that staff and residents’ health and safety is promoted. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Residents are well supported by a sufficient, well-trained and consistent supervised staff team, who offer continuity of care. EVIDENCE: Little Orchard employs twenty-one staff members and two bank staff members, and employs staff in sufficient numbers with the complementary skills to support service users’ assessed needs. The home does not use agency staff, but fills last minute gaps in the rota with existing staff. Little Orchard is one of three homes, in the vicinity, owned by Mr & Mrs Hayward. The majority of staff have worked in Little Orchard for some time, providing continuity of care. There is a large pool of staff that work interchangeably at all the homes. On the day of the inspection there were three carers on duty. The manager was seeing the administrator at 6 Dudley Avenue and came over to assist in the inspection process. The cook, who works three-days a week as two days the residents are out at lunchtime, also came on duty. Since the last inspection two staff members left but the home has recruited five new carers, included a staff member who is deaf. Little Orchard has a full compliment apart from requiring a weekend cook. The home had taken the necessary recruitment checks, including CRB [Criminal Records Bureau] and PoVA first checks [protection of vulnerable adults]. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 19 Staff receive adequate training for caring for the current residents. This includes deaf awareness and aspects of physical disability as well learning disability. The manager is researching for specific training in autism as a relevant subject for staff to have knowledge about. Staff receive MIDAS [minibus driver awareness scheme] training to drive the home’s minibus. A staff member has been appointed fire officer, to replace the previous fire officer who left. The new fire officer is due to commence a fire-training course next week. Little Orchard is introducing a yearly planner to ensure staff receive a minimum of twice yearly fire instruction. A system of supervision is in place, which is linked to staff appraisals. The manager is up to date with supervision and staff had received supervision, both on an individual one-to-one basis as well as in group sessions. There was evidence of a good team spirit and staff working well together. Staff, spoken to, appreciate the management style in Little Orchard and enjoy working in the home. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 38 Little Orchard is a well run home by a qualified and experienced manager, who provides effective leadership. EVIDENCE: Mandy Henry is the registered manager. She has worked in Little Orchard eight years and has obtained NVQ level 4 as well as the registered managers award. The manager undertakes periodic training to update her knowledge and skills and communicates a clear sense of direction and leadership through staff meetings, which are held every three months, staff supervision and education. There was evidence of a good team spirit and staff members working well together. The rest of the standards were not inspected on this occasion, although the home previously met all the standards on the last inspection. Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 21 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 X X X X X Little Orchard DS0000012281.V275845.R01.S.doc Version 5.1 Page 22 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.V275845.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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