Inspection on 05/06/08 for Orchard Avenue 10

This inspection was carried out on 5th June 2008.

CSCI found this care home to be providing an Adequate service.

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

Orchard Avenue 10 16/04/07

Orchard Avenue 10 22/11/06

Orchard Avenue 10 05/04/06

Orchard Avenue 10 08/09/05

Orchard Avenue 10 04/05/05

Orchard Avenue 10 29/11/04

Orchard Avenue 10 15/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Orchard Avenue 10 10 Orchard Avenue Whetstone London N20 0JA Lead Inspector Tom McKervey Key Unannounced Inspection 10:00 5 & 10th June 2008 th X10015.doc Version 1.40 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 Orchard Avenue 10 DS0000010473.V362555.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 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. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Avenue 10 Address 10 Orchard Avenue Whetstone London N20 0JA 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) 020 8445 2014 No email address Mrs Mabel Blanche Watkins Mrs Mabel Blanche Watkins Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users with mobility difficulties who are unable to use the stairs may not be accommodated on the 1st floor of the home. 27th November 2007 Date of last inspection Brief Description of the Service: 10 Orchard Avenue is a privately owned care home, which is registered to provide personal care for a maximum of three older people. The provider/manager lives on site at the home and occupies a first floor bedroom. The homes stated aims are to provide a safe, secure, homely environment for older people, where they will be free from physical, sexual and emotional abuse. The home consists of a detached two-storey property, located in a cul-de-sac / private road, in a quiet residential area of Whetstone, Barnet. There are three single bedrooms, one on the ground floor, and two on the first floor. There is a toilet on the ground floor, and a bathroom with toilet on the first floor. Also on the ground floor, there is a kitchen, leading to a conservatory, where the laundry equipment is located. There is also another small toilet downstairs. A small garden fronts the property and there is a large garden at the rear. There are good public transport links to the area. The fees for the service range from £700 to £800 per week. Following Inspecting for Better Lives, the provider must make information available about the service, including inspection reports, to people living in the home, and other stakeholders. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection took place over two days in a period of five hours. It was carried out as part of the Commission’s inspection programme to check compliance with the key standards. The registered provider/manager was not present on our first visit. We made an appointment to return to the home to address issues that were identified on the first day and to check how the manager had complied with requirements that were made at the last inspection. There were three people living in the home, all elderly women and there were no vacancies. Two of the residents were privately funding their care. As part of the inspection process, specific issues were discussed with the proprietor, including her Annual Quality Assurance Audit, (referred to as the AQAA in this report). This is a self-assessment by the manager, which is intended to describe how outcomes are being met for people who live in the home. It also gives some numerical information about the service. The overall management of the service was also discussed. A full tour of the premises was carried out, and all three residents were spoken to. We also contacted the residents’ relatives to seek their views about the quality of the service. Staff were observed in how they supported people and were interviewed about their work. Residents’ files, staff records and other documents that related to the running of the home were also examined. What the service does well: The home consistently provides a high standard of care to the people who live there and the residents say that they enjoy living in the home. The residents’ relatives also have a very high opinion of the service and say they enjoy an excellent relationship with the manager and the staff. There is a relaxed and friendly atmosphere and the home is well maintained, safe and attractive to live in. The residents, who are very frail and elderly, have a lifestyle that is appropriate for their ages and abilities, and their wishes about how they spend their time are respected. The people who live in the home are very appreciative of the meals provided and say they are always asked about what they would like to eat. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 6 The bedrooms are comfortable and well-decorated and people are able to bring their own furniture and other possessions with them when they move in to the home. What has improved since the last inspection? What they could do better: There are serious concerns about particular aspects of this service. These has been continuous failure to ensure that staff are trained to at least Level 2 of the National Vocational Qualifications to ensure their competence to fully meet the needs of the people who live in the home. The manager has also failed to ensure that staff have been trained in food hygiene, which puts the health and safety of the residents at risk. There has also been repeated failures to keep accurate records of the staff who work in the home and who are on duty at any given time. Requirements to address these issues have been restated in this report and a warning letter has been sent to the registered proprietor/manager to enforce compliance with regulations. The manager failed to obtain a Criminal Records Bureau check or references on some people who work in the home, which could put residents at risk. An immediate requirement was made to ensure that no-one is permitted to work in the home until satisfactory clearances have been obtained for them. The manager must obtain authorisation from the G.P for a specific resident to be given their medication covertly. This is to protect the rights of this individual who is not able to give consent to this practice. There must be at least two staff on duty at all times to ensure that the needs of the residents are being met safely. The manager must inform the Commission about how the home is to be managed in the future, particularly how she intends to improve compliance with all the regulations. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 7 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. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 4 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are given a Statement of Purpose/Service User Guide, which provides appropriate information to enable them to decide if the home will meet their needs. The people who live in the home are well cared for and say they are happy with the service they receive. However, a new resident had not been assessed before admission This could pose a risk of people being admitted whose needs in the end, cannot be fully met by the home. EVIDENCE: There is a Statement of Purpose/Service User Guide that describes the service and the fees charged. A named copy is provided in each resident’s room. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 10 Since the last inspection, one new person had been admitted to the home. This meant that the home is fully occupied and there are no vacancies. All three people living in the home are women. There was evidence in the case files that the new resident’s needs had been assessed at the time they were admitted to the home. However, the manager said that she had not carried out a pre-admission assessment when the person was referred from hospital. This is not good practice because the manager needs to assess people herself to be confident that the home is an appropriate place to meet n the person’s needs, rather than simply rely on the hospital’s assessment. A requirement is made to address this issue. Through observation and discussion with the residents and their relatives, and reading their records, we were satisfied that their needs were being met very well in the home. Two residents told us that they were very happy about living in the home and said the manager and her staff looked after them very well. The two newest residents are funding their care privately. We saw that contracts for the service had been drawn up and signed by the residents and/or their representatives. The contracts stated the fees charged for the service. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including speaking to residents and examining their records. Each person has their own care plan that is regularly reviewed to ensure that their needs are being met. Residents can be confident that they will be seen by appropriate health professionals if they are ill, and their medication will be administered safely. However, permission has not been obtained to administer medication covertly for a person who is confused, which infringes their rights. The staff treat the residents with dignity and respect. EVIDENCE: All three residents have their individual care plans. The care plan shows that their needs had been assessed when they came to the home. The assessment includes peoples’ likes and dislikes and there is guidance for staff about what care is to be provided. Residents and/or their representatives had signed the care plans and there was evidence that the care plans were being reviewed every month. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 12 The residents are registered with a G.P, and there are records of the G.P’s visits to the home. At the time of the inspection, one resident was being treated by the doctor, and the District Nurse had recently been in to tend to another resident. We noted that doctors and nurses sign the visitors book when they come to the home. Risk assessments had been carried out regarding the risk of pressure ulcers and of falling. The residents’ weights are monitored monthly. All the residents are very elderly and frail, with limited mobility. One person is mostly bed-bound. This person’s position is regularly changed whilst in bed, to minimise the risk of developing pressure ulcers. A record is kept of regular turning and also of when she is supported to sit out in an armchair for periods during the week. Each person has pressure-relieving mattresses, supplied by the Primary Care Trust. At the time of the inspection, no-one had any pressure ulcers. The staff were observed supporting residents safely when taking them to the bathroom. We observed staff interacting with the residents. The conversation was respectful and friendly, and the residents’ wishes were taken into consideration. All three people looked well cared for, and two residents told the inspector that the staff were very attentive and treated them with respect and dignity. One resident told us; “The people who look after me are excellent. They can’t do enough for you”. None of the residents are able to manager their medication by themselves. Records are kept for ordering, storing and the administration of medicines, which were checked and found satisfactory. We were informed that one resident who is confused, sometimes spits out their medication, so this is being disguised in yoghurt. This has not been authorised by the G.P or relatives. A requirement is made for permission to be obtained for covert administration of medicines to protect the rights of this individual. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including observing staff and speaking to residents and their relatives. Residents can be confident that their wishes about how they want to spend their time in the home will be supported and respected. They can also expect to have the meals they like and to be supported sensitively by staff if they need assistance to eat. EVIDENCE: Two of the people who live in the home are one hundred years old, and the third person is in her late nineties. Two residents have upstairs bedrooms and are not mobile enough to use the stairs. The person who lives on the ground floor, is mainly confined to bed, due to her disability and frailty. Two residents have televisions and radios, but one person told us that they did not want a t.v or radio in their room. In the daily records, we noted that staff read to the residents regularly. Two people told us that they liked their rooms and were very happy to spend their time in them. One person said; “I’m very happy here and I feel safe”. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 14 The staff ensure that residents’ birthdays are celebrated by everyone, especially the hundredth birthdays. This was confirmed by the residents and relatives. The visitors’ book showed that relatives visit the home frequently, mainly in the evenings and weekends. We spoke to the relatives of all three residents on the telephone to seek their views about the home. They were all very complimentary about the care the residents received. They said that the staff were very welcoming when they visited and were always offered a cup of tea. One relative remarked; “The care is absolutely out of this world; it is wonderful and the staff can’t do enough for the residents”. Another said; “My aunt picked up hugely since being in Orchard Avenue, I can’t speak highly enough about the care she is getting. Nothing is too much for the staff”. Two residents, with whom we were able to converse, said that staff always respected their wishes regarding when to get up or go to bed, what to wear and what they wished to eat. Preferences are recorded in residents’ care plans, for example; “does not like fish. To have a cup of tea any time of day”. None of the residents require specific ethnic meals. We observed staff supporting a resident who needed assistance with eating. The food was finely chopped to prevent choking, which was identified as a risk in the care plan. The member of staff engaged the resident in conversation while supporting her. The home does not have a daily menu, but residents said that they are asked each day what they would like to have. A record is kept of what each person has to eat, which showed that different meals were often provided for different residents. There was a good variety of wholesome food provided and fresh fruit was available Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including observation and speaking to residents and staff. The people who live in the home say that they are happy, feel safe and well supported by staff who have their safety and protection as a priority. EVIDENCE: As stated in other sections of this report, the people who live in the home and their relatives, were very satisfied with the service and they had no concerns. The complaints procedure is attached to the residents’ contracts and there is a book for recording any complaints. There is space in the complaints book for recording the response time and the outcome of any investigations. No complaints were logged in the complaints book and the manager said there were none outstanding at the time of the inspection. The local authority’s adult protection procedure is available in the home, and the staff have attended training in adult protection procedures. One staff member who was spoken to, demonstrated a good awareness about their responsibilities to protect residents from potential abuse. Our observations of how staff interacted with the residents, was that they were very friendly and caring towards them. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 16 Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 23 & 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including visiting all areas of the home. Residents can be confident that they live in a safe, clean and pleasant home. People are encouraged to bring personal possessions with them when they move in to the home. EVIDENCE: Orchard Avenue is a large detached house in a private cul-de-sac. It is situated in a pleasant residential area in Whetstone. All areas of the home were visited during the inspection. The residents are accommodated in single rooms, one downstairs and two on the first floor, all of which are attractively decorated. (One bedroom had recently been refurbished). Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 18 The lighting is domestic in style and although it was a hot day, a comfortable temperature was maintained in the home by windows being open. There was plenty of hot water, which was at a safe temperature. There was evidence of personal possessions and mementoes in the bedrooms, which residents had brought with them when they came to the home. Two people had their own television and radio; one person preferring not to have these. There is a safety gate at the top of the stairs to prevent someone accidentally falling down the stairs on the way to the bathroom. There is a bathroom and toilet upstairs and another toilet on the ground floor. There is a communal lounge/dining room for the people who live in the home. This provides somewhere for the people who live in the home to meet and socialise if they want to, however, the current residents prefer to stay in their rooms most of the time. The gardens are very attractive and were well maintained. There is also a large summerhouse in the garden. The manager said she had recently purchased a new washing machine and dishwasher for the home, which are located in the conservatory. The standard of décor throughout the home was good and the property appeared well maintained. All areas of the home were very clean and tidy and smelled fresh. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 19 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All these standards were assessed. People who use this service experience poor outcomes in this area. This judgement has been made using available evidence including a visit to this service and examining records. Residents’ well-being and safety could be at risk because people have been employed in the home without proper checks being made on them and also because staff have not been trained in food hygiene. Furthermore, residents cannot be confident that sufficient numbers of staff are always available to meet their needs at all times. EVIDENCE: On the first day of this inspection, the manager was absent on personal business. There was only one staff on duty when we arrived at 10 am. We were informed that an agency staff had been booked and should also have been on duty. This was not clear on the duty rota. (The agency carer arrived at 11.30am). We were concerned that the person in charge was not on the duty rota; (this person added their name subsequently). The staff member told us that they had worked in the home once before and they were “helping out” the manager today. We were also concerned that the staff rota for this week and previous week, did not accurately detail what staff were actually no duty. A requirement was made at the last random inspection that an accurate rota be maintained to identify those staff who were actually on duty at all times. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 20 This requirement had not been complied with and the manager was issued with an immediate requirement with regard to this matter. The manager telephoned the us during the inspection, and we notified her that we would be returning to the home to speak to her about concerns about the staffing. On the second visit, there were three staff on duty in addition to the manager. There were no records to show that the person who was in charge on the first day of the inspection, had been properly recruited, i.e., there was no application form and no references or Criminal Records Bureau check had been obtained. We issued an immediate requirement that no-one be permitted to work in the home until satisfactory clearances have been obtained. The staff rota indicated that only the manager was on duty between 5 or 6 pm, and 9pm when a night staff arrived. When we returned on the second day, the manager confirmed that she worked alone at these times. Given the frailty and level of disability of the residents, this is not safe as they may need two staff to support them, for example in transferring. One of the residents privately funds a night carer, but the manager stated that this staff member supports this person solely, and is not responsible for the other residents at night. We had another concern about a man who was present in the home during both visits. The manager said, this person is a relative who is staying temporarily in the home. (The manager lives in the home as well). The manager stated that this person is not a member of staff but helps out with the gardening. One of the residents referred to a “male staff” in conversation with the inspector. However we accepted the manager’s explanation that this person sometimes offers to make residents a cup of tea and has chats with them, which could lead to the residents thinking he is one of the staff. The manager intends to give this person the status of “volunteer”, and as such, she must obtain a CRB check for him, which she agreed to do. A requirement is made about this issue. Staff records indicated that some staff had attended some training courses in the past, for example medication and manual handling. At the last inspection, a requirement was made for all staff to attend training in food hygiene. The manager stated that this training had not been done because she has been unable to source an appropriate training agency. This is not a satisfactory response, as residents could be put at risk from poor food hygiene. This requirement is restated in this report. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 21 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 & 38 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The provider/manager is experienced at managing the home, but does not have the qualifications required by the National Minimum Standards, which could result in the home not being run efficiently. There is a relaxed and friendly atmosphere in the home and there is a positive relationship between the manager, staff and the people who live in the home. Residents have not been consulted about their views, so they have not been able to have a say about whether the home is run in their best interests. Residents financial interests are safeguarded through managing their own financial affairs. Staff are regularly supervised in their role of supporting residents. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered provider/manager has very many years experience of running the home. However, she has no formal qualifications, and she stated that she was unwilling to undertake the National Vocational Qualification, level 4, or equivalent qualification. The manager does not employ anyone to support her with the administration aspects of the home. Prior to this inspection, the manager sent a document to the Commission called an Annual Quality Assurance Audit, (AQAA). It is a legal requirement for care services to complete an AQAA each year. This is a self-assessment by the service manager, which is intended to describe how outcomes are being met for people who live in the home. It also gives some numerical information about the service. However, the information in this home’s AQAA was poor and many sections of the document were not completed regarding outcomes for people who use this service, including, “How we have improved in the last 12 months”, and “Our plans for improvement in the next 12 months”. The manager has not conducted a quality assurance audit of the service to seek the views of residents and/or their representatives. This information should have been incorporated in the home’s AQAA document. A requirement is made to address this issue. The manager has stated several times in the past that she struggles with meeting some of the legal requirements of managing the home and prefers to be “hands-on” in caring for the residents. This issue has been discussed several times with the manager, including appointing someone else to manage the home, or providing admin support. On this visit, the manager stated that she was considering employing a person to carry out administrative tasks and oversee staff issues such as processing recruitment and training etc. We observed that there was a relaxed and friendly atmosphere in the home. This was also confirmed by the relatives who were spoken to. The staff confirmed that the manager was very approachable and appreciated that the she gets involved “hands-on”, in supporting residents’ personal care. We were informed that the financial affairs of the people who live in the home are managed by their relatives, and no money is held in the home on their behalf. There was evidence that the manager carries out supervision sessions with staff at least six times a year. Staff performance is discussed in these sessions and staff are able to add their own items to the agenda about what they want to discuss. The majority of records required are being kept up to date, but as referred to under “Staffing outcomes”, the staff duty rota was not being kept accurately and a requirement is made to address this issue. There were certificates of safety for the gas central heating system, fire equipment and the water system. Portable electrical appliances had been tested in the past year and the fire alarms were tested weekly. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 23 Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 3 X X 3 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 2 3 Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14(1) Requirement Timescale for action 31/07/08 2 OP9 12(3) 3 OP27 18(1)(a) 4 OP28 18(1)(c) The manager must carry out a full needs assessment of people who are referred to the home before accepting them for admission. Authorisation must be obtained 14/07/08 from a specific resident’s G.P for the covert administration of medicines to protect the rights of this individual. There must be at least two staff 14/07/08 on duty at all times to ensure that the needs of the residents are being met safely. Care staff must undertake 31/08/08 training in National Vocational Qualification at least to level 2. This requirement is restated from the last inspection. The previous timescale was 30/09/07. 5 OP29 7,9,19 (Sch 4) No-one must be permitted to work in the home until satisfactory clearances have been obtained. This is an immediate requirement. DS0000010473.V362555.R01.S.doc 10/06/08 Orchard Avenue 10 Version 5.2 Page 26 6 OP37 17(c) Sch 4.7 An accurate rota must be maintained to identify those staff who are on duty at all times. This is a restated, immediate requirement. The previous timescale was 31/12/07 All staff who work at the home must attend training in food hygiene. This requirement is restated from the last inspection. The previous timescale was 31/07/07. Residents, their representatives and other stakeholders must be consulted so they are able to have a say about whether the home is run in their best interests Any person acting as a volunteer in the home must have a Criminal Records Bureau check before they start work in the home to protect residents’ best interests. The registered manager must write to the Commission for Social Care Inspection to inform about arrangements for better management of the service, particularly how she intends to improve compliance with all the regulations. 10/06/08 7 OP30 18(1)(c) 31/08/08 8 OP33 24(3) 31/08/08 9 OP29 7,9,19 (Sch 4) 31/07/08 10 OP31 9(2)(1) 31/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 27 No. Refer to Standard Good Practice Recommendations Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Orchard Avenue 10 DS0000010473.V362555.R01.S.doc Version 5.2 Page 29 - 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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