Inspection on 05/09/06 for Orchard Care

This inspection was carried out on 5th September 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Orchard Care 14/02/06

Orchard Care 08/08/05

Orchard Care 24/02/05

Orchard Care 25/05/04

Orchard Care 09/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Orchard Care 202 Weston Road Meir Stoke-on-Trent Staffordshire ST3 6PE Lead Inspector Sue Jordan Key Unannounced Inspection 5 September 2006 09:45 Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Care Address 202 Weston Road Meir Stoke-on-Trent Staffordshire ST3 6PE 01782 342123 01782 595654 orchardcareltd@aol.com 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) Orchard Care Mrs Carol Ann Forys Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2006 Brief Description of the Service: Orchard Care is a large two storey detached house situated in a residential area of Weston Coyney. The Home is registered with the Commission for Social Care Inspection to care for four younger adults with a learning disability. At present there are four gentlemen living at Orchard Care. The property is situated on a main road with access to the rear of the property. The gardens are spacious, secure and well maintained and there is a patio area with ample seating and private lawned area. The inside of the property is homely and domestic in character and each service user has their own bedroom. There is a selection of communal rooms, which means that the service users can have some private time if they wish, or entertain their visitors. The weekly fees charged range from £1232.43 to £1407.64. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector who used the National Minimum Standards for Care Homes for Younger Adults, (18-65), as the basis for the inspection. This visit was a key inspection and therefore covered all of the core standards. Some additional standards were also assessed. The inspection at 202 Weston Road took place over a period of six and a quarter hours and included an examination of records including service user care plans, staff recruitment files, training records, health and safety documentation and relevant policies and procedures. The manager and two members of the staff support team were interviewed. The inspector sat in on a staff handover and observations of staff and resident interaction were made. Where possible, informal discussions were held with the residents and the inspector sat with one of the residents whilst they had lunch. One of the service users took the inspector to see his bedroom. Prior to the inspection visit, survey information was obtained from two relatives, one health and social care professional and one general practitioner. Scrutiny of pre-inspection information completed by the manager was also undertaken. There were no outstanding requirements from the last inspection, however three were made as a result of this visit and seven recommendations. What the service does well: Support for the service users is provided on an individual basis. The Home uses a person centred planning approach to care planning and each person is allocated a key worker. Health care needs are well monitored and the appropriate medical services accessed. Individual risk assessments are in place and any lifestyle restrictions are justified. The care plans and risk assessments are regularly reviewed. There are adequate staff numbers to support the service users. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 6 New staff undertake a comprehensive induction. The staff also undertake Learning Disability Awards Framework training, which covers a number of specialist areas. Activities are arranged on a weekly basis and the service users spend much of their time in the community. Two of the service users are supported to go to college. On the day of this visit, one of the service users went out for a walk, another went shopping, two went out for a pub lunch and one was away on holiday. All of the service users will have had a holiday by the end of 2006. The service users are enabled to maintain friendships and family relationships. There have been no complaints made either to the Commission for Social Care Inspection. The financial procedures were checked during this inspection and it was established that robust systems are in place. The service users live in a clean and comfortable environment. Staff receive regular supervision, which takes the form of individual sessions with a manager and attendance at staff meetings. The manager has systems in place to ensure that the Home is managed safely. The manager monitors the quality of the service delivered. What has improved since the last inspection? What they could do better: All staff must receive medication training and be regularly assessed as competent by the manager. Although regular staff training is organised, there are a few gaps in the provision of mandatory training, for example food and hygiene training. A recommendation has been made that the manager examine ‘equality and diversity’ with the staff team and explore further ways of ensuring that Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 7 residents are supported to make choices, particularly those unable to verbalise their preferences. This may include the provision of specific training applicable to diverse and specialist needs. 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 Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 8 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 Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The needs of prospective service users are carefully assessed to ensure that the Home can meet their needs. EVIDENCE: The Statement of Purpose and Service Users Guide are available in the hallway of the Home. One of the four present service users is a recent admission to the Home. Prior to coming to live in the Home, the manager obtained assessments from the Local Authority Community and Adult Services Department and from his previous placement. The owner of Orchard Care, Greg Millar also undertook a comprehensive assessment. Multi-disciplinary meetings were held to discuss the suitability of the new home and opportunities provided for the service user Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 10 and his family to visit the Home. The service user visited the Home regularly over a period of six weeks. A review was held one month after admission. The placement appears to have been very successful and this particular service user said that he liked the Home and was happy. He has formed a friendship with one of the existing service users. He showed the inspector his new bedroom and seemed to be very proud of it. The staff and manager reported noticeable improvements in his behaviour since coming into the Home. A discussion was held at this inspection as to whether the Home respects the equality and diversity of the present residents. The staff at 202 Weston Road provide support to four adults with a learning disability. Within that there are a range of abilities and needs, communication and behavioural difficulties. The Home is able to demonstrate that it supports the individual; each person is involved, where possible in person centred planning, which provides a holistic approach to the identification of need. The residents, if able, can use this forum to express their preferences and an action plan is drawn up as to how these are to be met. The Home provides each resident with key workers from the staff team. Some staff have undertaken Learning Disability Awards Framework training, which covers a number of specialist areas. Weekly activity planning ensures that the service users enjoy a range of community-based activities and two are able to attend a local college. 20 of the staff team have achieved the National Vocational Qualification level 2 or above and three staff have recently been registered. The manager is aware that further work is needed in this area. Mandatory training is provided on a rolling programme and new staff undertake a comprehensive induction. Some omissions were noted in the mandatory training programme and these are further identified later in this report. Staff are trained to manage challenging behaviour, with an emphasis on diversion and distraction and behaviours are closely recorded and monitored. Some staff have attended autism awareness training. Health needs are closely monitored and access to health professionals provided. This includes the general practitioner, optician, chiropody and dental appointments. Specialist help has also been sought for some individuals, including speech therapy, behavioural management, physiotherapy and a dietician. Some of the residents are unable to verbally communicate and some of these understand simple makaton symbols. Guidance is available for staff, although Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 11 the training records do not indicate that they have been provided with any formalised training. The use of alternative formats for pertinent information was discussed. For example, the Statement of Purpose, Service Users Guide, Care Plan records and menus. At the present time those service users unable to verbally communicate rely on staff observations and knowledge of their likes and dislikes. It was recommended that this information be expanded in their care plans and the manager was able to demonstrate that this was being done in readiness for one person’s planned Person Centred Plan meeting. The manager was recommended to examine ‘equality and diversity’ with the staff team and explore further ways of ensuring that residents are supported to make choices, particularly those unable to verbalise their preferences. This may include the development of ‘user friendly’ formats and more evidence of the provision of specific training applicable to diverse and specialist needs. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 12 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, 7, 9, 10 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. Care planning centres around the individual resident and provides staff with the information required to meet their needs and aspirations. EVIDENCE: The care plans for two residents were checked on this occasion. Both have a Person Centred Plan in place, which covers all areas of need, emotional and physical. The Person Centred Plan is developed with the resident and other significant people in their life at a formal meeting and this is then further developed into care plans and risk assessments. A Person Centred Plan will be developed for the newest service user when he has lived at the Home for six months. However, there is comprehensive information available from his former placement. The manager has however completed his risk assessments. The care plans and risk assessments are reviewed regularly and the key workers periodically meet to discuss the resident’s support. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 13 The staff have sufficient information as to how they are to meet the residents’ needs and this was confirmed during a discussion with staff. The staff were observed offering the service users a choice as to whether they wanted to go out and do the shopping. The service users move freely around the Home and daily routines were observed to be flexible. One service user was having his breakfast as the inspector arrived at 09:45. Any limitation or restriction placed on a service user is explained and justified in risk assessments. The manager is going to examine further the area of choice, particularly for those unable to communicate verbally. For example, she agreed that the menu appears to be rather ‘rigid’, although in reality the service users can choose an alternative. It was explained that the service users with autism prefer a more structured approach. Risk assessments are a fundamental part of the care planning process and they are regularly reviewed. Hazards and risks are monitored and new assessments undertaken when required. All of the service users are enabled to take part in community based activities even if it means that they require additional staff support. The service users’ confidential information is locked away, although the staff have access whenever it is required. It was recommended that all records be individualised rather than be filed collectively. For example accident and incident forms. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14, 15, 17 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents are supported to live varied lives, dependent on their wishes and abilities. EVIDENCE: An activities plan is developed weekly and staff are allocated to accompany the service users on community-based trips. Some of the activities enjoyed by the service users are shopping, going for a walk, going to the local pub and playing pool. On the day of this inspection, two service users went out for a pub lunch, one went for a walk and the other was on holiday. One has already been on holiday and another arranged for the following week. The manager is hoping to organise a holiday for the newest service user. Two staff members support each service user to have a holiday. Two of the service users are going to college from October 2006 onwards and the courses planned are rambling, creative art, team building, horticulture and sports. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 15 Where possible, the service users are encouraged to keep their own personal space clean and tidy and be involved in some simple meal preparation. Most of the families are actively involved in their relative’s lives and home visits and stays are facilitated. The families are encouraged to visit their relatives and are made welcome. Two questionnaires were completed by relatives and sent to the Commission for Social Care Inspection prior to this inspection, which were generally positive. However one family expressed concerns about the Home’s lack of communication regarding their relative. This was discussed with the manager, who satisfactorily explained the steps taken to communicate with families, including inclusion in the Person Centred Plan process. She did however agree to look into these particular concerns further. The food is prepared by the support staff and written menus are available although a discussion took place as to whether pictorial or photograph formats could be introduced. This could form part of the project on the meeting of diverse needs and enabling choice. At the moment the menu does not indicate any choice, although in reality the service users can and do choose an alternative meal. It was recommended that these alternatives be documented. The manager also said that she would look to expand the menus. Nutritional screening takes place and where applicable dietician advice sought. Two of the service users have been supported to loose some weight and another is on an ‘eating programme’ due to unwanted weight loss. The service users are regularly weighed. It was ascertained that staff do not hold current food and hygiene certificates and a requirement has been made under National Minimum Standard 35. The kitchen is domestic in style and where possible the service users assist in some simple meal preparation. The service users can choose to eat alone or in the company of others and they regularly have meals out in the community or enjoy a ‘take away’. A Food Safety inspection was carried out on 16/03/05, which was positive. The staff continue with food safety procedures, including twice daily recording of fridge and freezer temperatures. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 16 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, 20, 21 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents are provided with health and personal care support based on their individual needs. EVIDENCE: Personal care needs and preferences are recorded within the residents’ person centred plans and care plans. Staff monitor the residents’ personal care, where necessary and this was confirmed during the staff handover. The residents look clean and well cared for and are clothed appropriately. Health needs are closely monitored and access to health professionals provided. This includes the general practitioner, optician, chiropody and dental appointments. Specialist help has also been sought for some individuals, including speech therapy, behavioural management, physiotherapy and a dietician. All health visits and appointments are recorded, including any action to be taken. A questionnaire was completed by a general practitioner and another by a physiotherapist assistant and received by the Commission for Social Care Inspection prior to the inspection. They were both positive about the care Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 17 provided in the Home, the communication from the staff and the action taken to manage the residents’ care needs. The medication procedures were checked. The medication is stored appropriately and all administration recorded. Protocols have been developed for the use of PRN medication, however the general practitioner should be asked to sign them. It was recommended that copies of the PRN protocols also be placed into the medication administration file. The staff undertake ‘in-house’ medication training from the manager during induction and some have received external training. This was discussed at the inspection. All staff must receive medication training and be regularly assessed as competent by the manager. The Commission for Social Care Inspection pharmacist inspector advises a quarterly or minimum six-monthly assessment. It is recommended that the staff complete the ‘Safe Handling of Medicines’ distance learning, module based course. None of the present service users administer their own medication. The manager is presently liaising with families to ascertain their wishes with regard to the aging, illness and death of their relative. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 18 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): 22, 23 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The systems and procedures within the Home protect the residents. EVIDENCE: One of the service users recently made a complaint to the manager and as a result she initiated disciplinary procedures. The manager also sought appropriate advice and a Protection of Vulnerable Adults referral was considered unnecessary. The Commission for Social Care Inspection was also kept informed. Records were made of all action taken. There have been no further complaints made either to the Home or the Commission for Social Care Inspection. There is a complaints procedure, although the development of alternative formats should be considered. The staff have access to Adult Protection procedures and some staff have received formalised training. The manager discusses adult vulnerability and abuse with staff at induction and during their appraisals. Protection of Vulnerable Adults and Criminal Records Bureau checks are carried out on all prospective staff. There are clear behavioural management guidelines in place and the staff have received training in the management of challenging behaviour. Comprehensive monitoring is undertaken, including the recording of all incidents. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 19 A member of staff explained the systems used to manage the service users’ finances. Two staff members witness each transaction and monthly monitoring is undertaken by the organisation. Where possible, receipts are obtained for each item purchased. One service user’s financial records were checked and the total found to be correctly available in their tin. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 20 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, 30 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents live in a clean and comfortable environment. EVIDENCE: Regular maintenance checks are made throughout the Home, including an assessment of any risks and hazards. The home comprises of two lounges and two dining areas. Each service user has their own bedroom. There is a separate laundry area. There are bath and toilet facilities both upstairs and down. The manager’s office also doubles as a ‘sleep-in’ room for staff. The environment is clean, comfortable and homely and improvements have recently been made to one of the lounges and one of the bedrooms. A new bathroom suite is being fitted in the downstairs bathroom. The Home has enclosed garden and patio areas. The Home has recently purchased a new washing machine. Maintenance and Health and Safety are high priority. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 21 Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 22 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, 36 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents are protected by a well-recruited and supervised staff team, although more emphasis is required to ensure that all staff complete mandatory training at the required frequencies and that they are trained to support more diverse needs. EVIDENCE: New staff sign to say that they have received an induction pack, which includes Health and Safety policies and procedures, first aid handbook, job description, philosophy of care, the Home’s Statement of Purpose and a code of practice. 20 of the staff team have achieved the National Vocational Qualification level 2 award or above and three staff have recently been registered. Some staff have undertaken the Learning Disability Awards Framework award, which is pertinent and more specific to the residents. Usually three support staff and the manager work in the mornings, two in the afternoon/evening and there is one ‘waking’ and one ‘sleep-in’ staff available at night. There are also flexible hours, which are used to facilitate activities. The staff group is comprised of both male and female members. New staff undertake a comprehensive induction and staff members confirmed in discussions that they have good training opportunities. However, inspection Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 23 of the staff training records showed a number of gaps, including current food and hygiene training. There is some evidence of additional, supplementary training, although this could be extended. Deficiencies may be identified when the manager and staff team explore whether they are fully meeting diverse needs. For example, some of the residents are unable to verbally communicate and some of these understand simple makaton symbols. Guidance is available for staff, although the training records do not indicate that they have been provided with any formalised training. Not all the staff have received training in the understanding of autism. All staff have been trained to manage challenging behaviour, which provides an emphasis on diversion and distraction. The staff were seen putting this into practice on the day of inspection, whereby they took a service user out for a drive when they recognised certain triggers to a possible behavioural difficulty. The manager is to train as a manual-handling trainer. A recently recruited support worker confirmed that she had an initial twoweek induction and had completed the Learning Disability Awards Framework award. Two staff recruitment files were examined and the procedures comply with Schedule 2 of The Care Homes Regulations 2002. Staff receive regular supervision, which takes the form of individual sessions with a manager and attendance at staff meetings. Each staff member attends an annual appraisal. A staff member interviewed confirmed that she feels supported by the manager. The staff have a handover period at the beginning of every shift. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 24 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, 39, 41, 42, 43 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents receive a well-managed and safe service. EVIDENCE: The manager, Carol Forys is registered with the Commission for Social Care Inspection. She has many years experience of working with adults with a learning disability and her role in the Home is clearly defined. She receives bimonthly supervision from her manager and is due to be trained as a manualhandling trainer. The manager maintains contact with the Commission for Social Care Inspection, however she was reminded that she must inform the Commission of all the elements listed in Regulation 37 of The Care Homes Regulations. Additional guidance and a reporting format is to be sent to the Home. It was also ascertained that the Home does not presently have a fax machine. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 25 The Home provides each resident with a Quality Assurance questionnaire and two were seen in the residents’ care records. However their ability to complete them was discussed. The creation of more innovative ways of ascertaining service users’ views could form part of the manager’s ‘equality and diversity’ project. However, the manager and staff monitor the service including the review of Person Centred Plans, care plans and risk assessments and the holding of key worker meetings and staff supervision. Local Authority reviews are also facilitated. The organisation has achieved and maintained the Investors in People standard, which places emphasis on robust management of an effective service or business. The proprietor visits the Home regularly to audit the service. The manager was informed that Regulation 26 visit reports no longer have to be sent to the Commission for Social Care Inspection, as long as they are available in the Home for inspection. However, the visits should still be carried out on an unannounced, monthly basis. The proprietor has recently sent all staff members a questionnaire to ascertain their views of the service provided. The results are to be collated shortly and an action plan developed. Generally, record keeping and maintenance is of a high standard. However the manager was asked to remind staff to date and sign all records. Comprehensive and extensive records indicate that Health and Safety is high priority in the Home. Regular checks are made of the fire safety systems, hot water temperatures and food safety procedures. Some mandatory training is required to further support this. Allocated staff and the manager monitor safety in the Home and generic risk assessments are undertaken and reviewed. Accidents are appropriately recorded, although the manager was reminded to file these individually. The gas and electrical supplies are inspected and maintained appropriately. Staff undertake fire training and are involved in regular ‘mock’ fire evacuations. The Home has an emergency contingency plan and the manager has recently attended a conference regarding the introduction of a new fire risk assessment. She is aware that this comes into force from October 2006 onwards. Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 26 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 4 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 3 X 3 3 2 Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 27 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) Requirement Staff must undertake medication training and their continuing competency be regularly assessed. Staff must undertake mandatory training at the required frequencies, including food and hygiene. Timescale for action 01/11/06 2 YA35 3 YA43 18 13 13 13 13 19 23 16 (1ci) (2) (6) (3) (4c) (5b) (4d) (2aii) 01/11/06 The registered person shall provide appropriate facilities for communication by facsimile transmission. 01/11/06 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 YA3 Good Practice Recommendations The manager was recommended to examine ‘equality and diversity’ with the staff team and explore further ways of DS0000008320.V299625.R01.S.doc Version 5.2 Page 28 Orchard Care ensuring that residents are supported to make choices, particularly those unable to verbalise their preferences. This may include the development of ‘user friendly’ formats and the provision of specific training applicable to diverse and specialist needs. 2 YA10 It is recommended that all service user records be individualised rather than be filed collectively. For example accident and incident forms. It is recommended that the staff complete the ‘Safe Handling of Medicines’ distance learning, module based course. It is recommended that the general practitioner sign the PRN protocols. It is recommended that copies of the PRN protocols also be placed into the medication administration file. The manager should consider developing the complaints procedures in alternative formats. It is recommended that all records be dated and signed. 3 YA20 4 5 6 7 YA20 YA20 YA22 YA41 Orchard Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Care DS0000008320.V299625.R01.S.doc Version 5.2 Page 30 - 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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