Inspection on 10/08/05 for Orchard

This inspection was carried out on 10th August 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

Orchard 03/05/07

Orchard 19/01/06

Orchard 08/02/05

Orchard 27/10/04

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 ORCHARD Ravenswood Village Nine Mile Ride Crowthorne Berkshire, RG45 6BQ Lead Inspector Stewart Mynott Unannounced 10 August 2005 10:45am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Orchard, Norwood Ravenswood Address Nine Mile Ride Crowthorne Berks RG45 6BQ 01344 755581/2 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) Mrs Norma Briar Norwood Ravenswood Foundation Mrs Susan Ravey Care Home 11 Category(ies) of Care home only (PC) registration, with number of places ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8 February 2005 Brief Description of the Service: Orchard is part of Ravenswood Village and is registered to provide support and care for eleven adults between eighteen and sixty-five years of age with learning disabilities. Two of the service users live in a flat that is linked to the main house. Several service users also suffer mental health problems and present challenging behaviour. The aims and objectives of the home is to provide a secure and comfortable home; encourage and support residents to make decisions and choices in their lives; support and assist service users to make and maintain satisfying relationships; assist service users to develop their skills; and enable service users to engage in valued day time occupation and use the community facilities. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection lasting for 5¼ hours. The manager and a staff team member gave a full tour of the building. Time was spent with the home manager and staff on duty. Most service users were at home during the inspection and observation of staff interaction and daily life within the home was made. Some of the homes and service users records were examined. What the service does well: 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. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards 1 to 5 were not assessed during this inspection. EVIDENCE: ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Service users are supported by their individual plans and risk assessments, which are regularly reviewed. Service users are supported to make decisions by staffs that have a detailed understanding of each persons needs. EVIDENCE: Each service users has a “key file” and “daily record”. The key file contains detailed and relevant information recorded in the past year and includes an individual plan as well as positive programs and guidelines designed to support each service user. Three service users key files were examined in detail. The individual plans seen were very detailed and clear making clear references to other documents relating to care needs within the files. Outcomes and goals were established within each plan and further reviews of these plans clearly stated the progress that had been made. Some service users have very complex needs and many of the positive programs were seen to be highly supportive to assist service users making decisions. These programs detailed the support required from staff. Each service user has a key worker that further reviews progress on a monthly basis and this is recorded in monthly summary reports. These were seen and up to date. Two key workers were spoken to and in each case clearly conveyed a very detailed knowledge of service users complex needs. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 9 Each service users is further supported in all aspects of daily living by comprehensive risk assessments. These documents are kept separate from key files for ease of staff reference. Three service users were focused on and in each case each assessment was detailed and supportive and not unnecessarily restrictive. Each service users key worker reviews these documents on regular basis. One service users risk assessments was discussed with their key worker who demonstrated an excellent understanding of these assessments and demonstrated how they supported the service users complex needs. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 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 standard(s) Standards 11 to 17 were not assessed during this inspection. EVIDENCE: ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. A knowledgeable staff team meets service users personal support and healthcare needs. Further training is required for staff involved in the recording the administration of medicines to service users. EVIDENCE: All service users require assistance and support from staff to ensure their personal needs are met. Staffs were observed interacting with service users in a supportive, kind manner with emphasis on inclusion and independence. Care records included guidelines, which covered a 24-hour period to ensure continuity of care and records included likes and dislikes. Positive guidelines also contributed to service users personal support. Staffs spoken to were highly knowledgeable about these records and observations confirmed a good standards of personal support provided for service users. Daily logs were also inspected which detailed support and personal care required, these were seen to be up to date and confirmed that care provided is flexible. The health needs of four service users were focused on and were fully met. All had access of local NHS health care facilities and these appointments were clearly documented in the “key files”. More specialist support included dietician and psychologist input. The medication system was explained by the senior on duty. The system for ordering and administration of medicines was examined. Each service user had ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 12 a separate medication record. Five records were examined which contained a list of medication and potential side effects, medication guidelines and indication for use of “as and when required” medicines which were clear and informative. Stock control sheets for medicines not contained in the cassettes were completed and a spot check revealed these tallied. Medication administration record (MAR) charts were completed but on one record the use of corrective fluid was noted. On two other MAR charts medicines had been administered but not signed for. A requirement that staff receive training in the homes medication policy in regards to correctly recording the administration of medicines is required. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 Service users are protected from harm from trained staff and comprehensive policies. There is a complaints policy in place. EVIDENCE: There is a comprehensive complaints policy within he home and a pictorial policy within the service user guide. The complaints record for the home was examined and there were no complaints received since the last inspection. A complaints officer in the village further reviews all complaints. The manager identified that many service users would need assistance to access the complaints procedure. Key workers were fully aware of this policy and confirmed they would access the procedure should the need arise. In each key file a record confirmed that the key worker had explained the complaints procedure to the service users. The home also has a comprehensive abuse policy, which serves to protect service users. Staff training records demonstrated that staff had received protection of vulnerable adults. Some of the service users have complex needs and behaviours that may lead to potential harm. The support worker level at the home provides a high ratio, which clearly safeguards service users. Guidelines examined on one service users file gave clear instructions to staff on how to deal with certain complex behaviour in an appropriate manner to prevent escalation. The key worker for this service user was clear on using this guideline and was able to explain when physical intervention was needed and how this would be recorded. Staff training records examined confirmed training in challenging behaviour and SCIP procedures is provided for staff supporting service users with such complex needs. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 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 standard(s) 24, 26, 27 and 30 Service users live in a comfortable, well maintained home that is cleaned to a high standard. EVIDENCE: A senior support worker and the home manager gave a full tour of the buildings and grounds. The home benefits from a large lounge with an additional dining area, which was comfortable and homely. A further dining room was also seen which service users eat most meals in. There is also further communal space provided in a conservatory that one service user in particular used. Service users bedrooms were viewed and one service user showed the inspector with a staff member present their bedroom containing personal belongings and photos. Other bedrooms seen were clean and tidy and personalised to that service user. Toilets and bathrooms were clean, tidy and decorated to a satisfactory standard. The floor in the upstairs bathroom was worn. The manager confirmed that the home was due a cyclical redecoration and confirmed that ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 15 this would be given consideration. The shower seals in another upstairs bathroom had been renewed following a prior recommendation. The grounds outside were maintained and service users were seen to be enjoying individual activities. The laundry is organised and appropriate procedures to prevent the spread of infection were in place. Equipment provided was suitable to meet the needs of service users. ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards 31 to 36 were not assessed during this inspection. EVIDENCE: ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards 37 to 43 were not assessed during this inspection. EVIDENCE: ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 18 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 ORCHARD Score 4 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 19 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 YA20 Regulation 13 (2) and 17 (1)(a) Requirement The registered manager provides training for staff in line with the Royal Pharmaceutical Society guidlelines to ensure that medication administration records are completed by staff appropriately. Timescale for action 31/10/05 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 Good Practice Recommendations ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 2nd Floor 1015 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. Extracts may not be used or reproduced without the express permission of CSCI ORCHARD H52-H01 S11367 Orchard Ravenswood V229126 100805 Stage 4.doc Version 1.30 Page 21 - 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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