Inspection on 17/05/05 for Orchard Close

This inspection was carried out on 17th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Orchard Close 09/10/06

Orchard Close 09/09/05

Orchard Close 17/11/04

Orchard Close 26/05/04

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 Close 28 Westfield Avenue Hayling Island Hampshire PO11 9AG Lead Inspector Nick Morrison Unannounced 17 May 2005, 10:00am th 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 Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Orchard Close Address 28 Westfield Avenue Hayling Island Hampshire PO11 9AG 02392 468313 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) Hampshire County Council Rodney Haydn Elliott CRH 17 Category(ies) of Learning Disability - LD - 15 registration, with number Learning Disability, Over 65 - LD(E) - 2 of places Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of two service users in the LD(E) category may be accommodated at any one time. 2. Service users in the LD(E) category must be accommodated on the ground floor. Date of last inspection 17.11.04 Brief Description of the Service: Orchard Close is a respite / short break unit provided by Hampshire County Council for people who have a learning disability. In general people stay for one or two weeks at a time. At the beginning of each week staff and service users meet together to plan for the week ahead, which can be individual or group activities. Occasional theme weeks are organised by the service. The Registered Manager is no longer working at the home and has moved elsewhere within the organisation. The current Manager (Mair Dyer) is new to the service and is in the process of idenifying and responding to the current issues facing the home. Orchard Close H54 S39585 Orchard Close V226104 170505 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 five hours during which the Inspector toured the premises and spoke with service users, staff and the Manager. A sample of six service user files and four staff files were seen. All other records referred to in the report were seen by the Inspector on the day. What the service does well: What has improved since the last inspection? What they could do better: A Statement of Purpose and Service User Guide would ensure that service users and their families have all the information they need about the service before deciding whether or not to use it. Staff Support and Supervision needs to be re-introduced. Medication training needs to be in place for all staff involved in administering medication and the home needs to develop a system for ensuring that the views of service users are the focus of a quality assurance system. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 4 and 5. The home’s approach to enabling service users to access the service is positive and support, but service users would benefit from clearer information about the home. EVIDENCE: The new Manager was not able to find a Statement of Purpose or Service User Guide. There was a brochure available explaining the services on offer, but this was insufficient. A requirement has been made that the Service User Guide and Statement of Purpose be made available. The home requires that all service users have a Care Management Assessment in place prior to using the service. These were seen on all the service user files looked at. All service users were encouraged to visit the service for an evening or a weekend before using it on a regular basis. Statements of Terms and Conditions were seen on service users’ files. The Manager had identified that these were not in a format accessible to service users and is about to introduce an accessible version. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 9 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, 8 and 9. The combination of care planning and consultation ensure service user needs are met. EVIDENCE: Service users’ files contained Care Plans that described the kind of support each person required. Plans were kept up-to-date and reviewed each time the service user returned for another stay. The home had a questionnaire in place for service users and their families to provide any updated information prior to each stay. Plans were well written and easy to read. Care Plans seen reflected the initial assessment. None of the service users spoken to at the time of inspection were aware of their on Care Plans. The home arranges a ‘welcome meeting’ at the beginning of each week, which enables service users to decide what activities will take place for the week. Each service user can choose two activities they would like to do during the week and then these are built into the weekly programme. It is not the case that both choices will end up on the programme, but the home guarantees that at least each person’s first choice will happen. The system works well because each person will have an activity they enjoy, but also they have the opportunity to try new activities that other service users have chosen. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 10 The home had risk assessments on file for each service user and staff reminded themselves of these prior to each person staying. Staff used the risk assessments to ensure service users could safely be as independent as they chose to be throughout the week. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14, 15 and 17. The programme for each week ensures that service users have the opportunity to engage in interesting activities of their choice. Healthy food is provided in a comfortable environment EVIDENCE: As described above, the ‘welcome meeting’ enabled service users choose leisure activities for the week. Staff arrange activities in response to service users’ requests and staff support is arranged around those activities. Service users staying at the home can then choose whether or not to join in with each planned activity. Some service users were encouraged to maintain contact with their families while they were staying at the home but, as it is a respite service, staff understood that not all families wanted to be contacted every day. The home has a portable telephone that service users can use in their own rooms for privacy. Service users spoken with confirmed that the food was good and portions were adequate. Menus showed that food was varied and nutritious. Service users were able to request meals and the cook was responsive to requests as far as possible. On the day of inspection service users had baked potatoes and salad for lunch. Alternatives were available on request. The kitchen staff were Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 12 informed of which service users were in each week and what, if any, individual dietary requirements they had. As the service is seen as a holiday for service users, staff served meals and cleaned up afterwards. The aim was to ensure that the whole week, including mealtimes, was relaxing and enjoyable for service users. They were available for service users who needed help with eating. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20. Service users have their healthcare needs met but this would be enhanced further by improved staff training in handling medication. EVIDENCE: As service users use the home only for short stays it is not often necessary for the home to support service users to access healthcare services. However, there have been some occasions where they have had to contact a service user’s own GP or attend the local healthcare centre for advice. The Manager reported that the home had a good relationship with the centre and that they were always helpful when needed. A member of staff supported a service user to attend the centre on the day of inspection. Good records were kept of any occasion when healthcare services were used. Some service users retained and administered their own medication, but most had it administered by members of staff. Medication in the home was stored appropriately and records were kept of all medication administered. There was no documentary evidence that staff administering medication had received any formal training. New staff were observed on a number of occasions by existing staff and then considered competent to administer medication on their own. The Manager acknowledged that, although this was supported by the home’s policy, it was insufficient. A requirement has been made with regard to formal training for administering medication. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 14 Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. Procedures are in place to ensure Service users are listened to and protected from abuse. EVIDENCE: Service users spoken with during the inspection said that staff did listen to them and responded to requests. Amongst service users there were different views about the process for complaining, but all were clear that they could raise issues with a member of staff if they were not happy. The home has a Complaints Procedure in place and it is available to all service users and relatives. A system was in place for recording and responded to complaints. Records were also kept of compliments from service users and their relatives. Feedback from service users at the end of week was recorded and retained for future visits. Staff at the home had received some training in the protection of vulnerable adults and an update has been planned. Adequate procedures were in place for responding to instances of suspected abuse and staff were aware of the procedure for reporting these. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 and 30. The environment is safe, clean and comfortable. The communal and private spaces within the building give service users the opportunity to socialise and spend time on their own when they choose to. EVIDENCE: The home is specifically designed for a short stay service for people who have learning difficulties. The size of rooms and standard of furnishings meant it was homely and comfortable. Regular maintenance checks were made and records kept. Individual rooms were available for all service users. A double room and a twin room were also available for couples or for people who particularly wanted to share with another person. Service users who did not particularly like the room they had been allocated were able to choose another room, subject to availability. Rooms were furnished appropriately and all service users were able to lock their rooms if they wanted to. Staff could override these in an emergency. There were a sufficient number of bathrooms and toilets throughout the building and some were adapted for people with physical disabilities. There Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 17 was also an assisted bath for people who needed it. Bathrooms offered a choice of shower or bath. The shared spaces in the home consist of a lounge, a conservatory, a large dining room and an activities room set in the garden. These provide sufficient space for the number of service users. The home was kept very clean throughout by the four domestic staff. All service users’ rooms were cleaned every day, although they could choose not to have this done if they did not want it. Domestic staff were flexible and worked around times when service users wanted their rooms cleaned. Infection control policies were in place and liquid soap and paper towels were available throughout the building. The laundry was sited so that it was away from food storage and preparation areas and was well managed. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 and 36. Service users benefit from being supported by experienced and well trained staff. EVIDENCE: The home employs a Manager, a Deputy, 8 full-time and 5 part-time care staff, 3 night staff, 4 domestic staff, an Administrator, a cook and an assistant cook. Staff on duty on the day of inspection were experienced and able to demonstrate a good understanding of their role and the issues involved in providing a short stay service for people who have learning difficulties. From observation it was clear that they could communicate well with service users and had the skills to motivate people. The Manager is in the process of introducing the Learning Disabilities Award Framework for the induction of new staff and as a refresher for existing staff. The home puts aside a week in January when there are no service users and when staff complete all their refresher courses for their mandatory training. The training needs of staff are analysed annually and training courses are booked through the organisation’s training department. The new Manager has identified that formal Support and Supervision for staff had been neglected prior to her arrival and she is now planning to re-introduce it. A requirement has been made in respect of this. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 19 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) 38, 39, 40, 41 and 42. The new Manager provides good leadership and staff and service users feel involved in the day-to-day running of the home. EVIDENCE: The new Manager had only been in post since the 1st April. Staff spoken with said that senior support had been lacking prior to her arrival, but now it was clear that there was leadership and support in place for them and issues were being dealt with rather than lingering on. All the staff spoken with agreed that the new Manager was approachable and responsive. There were a range of quality assurance measures in place but the Manager recognised that these were not coordinated. She planned to introduce service user surveys, to keep written records of feedback gained through the end of the week meetings and to feed this information into a coordinated quality assurance system. A recommendation has been made in respect of this. The home has a comprehensive manual of Policies and Procedures in place and these were regularly updated. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 20 All records seen on the day of inspection were up-to-date, accurate and kept securely. Health and safety issues were discussed with all service users at the ‘welcome meeting’ at the beginning of the week. Staff had received training in health and safety issues. Risk assessments were in place where risks had been identified and all incidents and accidents were recorded and monitored. Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Orchard Close Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 2 3 3 3 x H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 22 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. 2. Standard 1 20 Regulation 4 13 Requirement The Manager must produce a Statement of Purpose and Service User Guide. The Manager must ensure and be able to demonstrate that medication is administered by designated and appropriately trained staff The Manager must ensure that all staff receive appropriate and formal Support and Supervision Timescale for action 10 August 2005 10 August 2005 3. 36 18 20 June 2005 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 39 Good Practice Recommendations A coordinated quality assurance system based on the views of service users should be introduced Orchard Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO16 3TP 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 Close H54 S39585 Orchard Close V226104 170505 Stage 4.doc Version 1.30 Page 24 - 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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