Inspection on 09/09/05 for Orchard Close

This inspection was carried out on 9th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orchard Close 09/10/06

Orchard Close 17/05/05

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 9 September 2005, 9:30 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 V248166 090905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Orchard Close Address 28 Westfield Road, Hayling Island, Hampshire PO11 9AG 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) 023 9246 8313 Hampshire County Council Care Home 15 Category(ies) of Learning disability (15) registration, with number Learning disability over 65 years of age (2) of places Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 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 17/05/05 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 V248166 090905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection lasting for two and a half hours during which the Inspector toured the premises and spoke with service users, staff and the Manager. A sample of three service user files and three staff files were seen. All other records referred to in the report were seen by the Inspector on the day. This inspection concentrated on the core standards that had not been assessed at the previous inspection and this report should be read in conjunction with the report from 17th May 2005. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 Service users benefit from having access to clear information about the service. EVIDENCE: There was a requirement at the previous inspection for the home to produce a Service User Guide and Statement of Purpose. Although both of these documents were in place at the previous inspection, the Manager was unable to find copies. Copies were made available at this inspection and so this is no longer a requirement. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 Service users benefit from being supported to make their own decisions. EVIDENCE: Service users’ Care Plans contained information on how they each made and expressed choices and staff were aware of this information. The plans also contained information for staff on what kind of support each service user might need to make their own decisions. Where service users did not manage their own money it was made clear on the Care Plan and records were kept. Advocacy groups were involved where necessary and particularly in supporting service users to be involved in the recruitment process. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 9 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) 13 and 16 Service users benefited from being part of the community and having their rights respected. EVIDENCE: As the service is a respite/holiday service, the emphasis is on service users making a lot of use of the community and taking part in activities they enjoy. Staff rotas were organised around which service users were staying at the home and the activities they wanted to take part in. The staff at the home had built relationships with local places of interest, which encouraged integration for service users in the community. One service user had recently started a college course and staff at the home supported him to attend the course while he was staying at the home. The Terms & Conditions of residence were clear about the rules in the home regarding smoking and drinking and respecting the rights of other service users. The routines of the day were structured by mealtimes and the activities available to service users. Service users were able to opt out of activities if they wished and could also eat their meals at different times if necessary. There were no rules or routines in place that restricted service users unduly. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 10 Service users had a key to their own room and to the lockable space within their room. As a rule service users did not have a key for the front door. This was felt not to be necessary as a member of staff was always in the home. The Manager acknowledged that if a service user was going out on their own and wanted a key to get back in then one would be provided. Although service users did not receive much mail while they were staying at the home they opened it themselves with support from staff where necessary. The Manager was in the process of recording on Personal Profiles the preferred form of address for each service user. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 20 Service users have their personal care needs met but this would be enhanced further by comprehensive records of staff training in handling medication. EVIDENCE: The Inspector observed staff supporting service users in a sensitive manner and were flexible around the wishes of the people they were supporting. Service users’ personal appearance demonstrated that they were receiving adequate support. The Manager confirmed that service users wee supported by someone of the same gender wherever possible and service users’ wishes were taken into account when deciding who would support them. Consistency of support was maintained by clear care plans and a keyworking system. Service users were not necessarily encouraged to manage their own medication. Where a service user managed their own medication at home they were offered the opportunity to continue doing so while at Orchard Close, provided their was adequate information from the Care Manager and GP that the person was able to do so safely. Some service users who managed their own medication at home chose not to do so at Orchard Close. Where service users received support managing their own medication at home, that same support was put in place during their stay at Orchard Close. There was a requirement from the previous inspection that the home keep records of the medication training staff receive. This had begun to happen for Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 12 new staff but the retrospective records for existing staff had not yet been completed. The Inspector and the Manager agreed a date by which this would be completed. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Neither of these standards were assessed on this occasion. EVIDENCE: Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed on this occasion. EVIDENCE: Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 15 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) 34 and 36 Service users benefit from being involved in a thorough recruitment process and from having staff who receive regular support and supervision. EVIDENCE: The home operates a thorough recruitment process based on equal opportunities and protecting service users. References and Criminal Records bureau checks were in place prior to staff beginning work in the home, all staff received copies of the General Social Care Council Code of Practice and had Terms and Conditions of employment. The home had made significant progress in actively involving service users in the staff selection process. The selection of the new Deputy Manager included a service user panel. The panel were supported to identify questions to ask the applicants and supported to take notes on each applicant. As the home is a respite service, service users were identified in advance and staff at the home went to pick them up on the day of interview. The interview date had been set around the availability of the service users involved. On the day of interview service users took photographs of each applicant to assist them in remembering each person. The home had taken time to ensure that the service users involved did not know the applicants. After the interview the service user panel met with the management panel and jointly made a decision on whom to appoint. The views of service users were given an equal weighting in making the decision. The records taken by service users during the interview are kept with the other Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 16 records of the selection process on the personnel files of each applicant. The home is looking into ways of paying service users for their involvement in the process, but at present they compensate for this by taking the people involved out for dinner in the evening. The level of service user involvement was impressive and definitely not tokenistic. All staff are employed subject to a six month probationary period that is closely managed on a regular basis to ensure that any difficulties are identified early on. The Manager is currently identifying ways to actively involve service users in the probationary process. The home required detailed information on each agency member of staff used including a profile, details of experience and details of references and checks. No voluntary workers were used in the home. There had been a recommendation at the previous inspection that all staff receive regular support and supervision. This had become infrequent prior to the new manager being appointed but, since the previous inspection, it has been re-introduced for all staff. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 Service users would benefit from a more coordinated quality assurance process. EVIDENCE: There was a recommendation from the previous inspection regarding quality assurance. Although there was a range of quality assurance measures in place, 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. Since that time the Manager has begun the process but still has some work to do to complete the process. There remain a number of strategies in place to seek the views of service users and the service is largely based around the needs and wishes of service users. Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x N/A 3 x x 3 x Standard No 31 32 33 34 35 36 Score x x x 4 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Orchard Close Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 19 yes 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 20 Regulation 13 Requirement The Manager must ensure and be able to demonstrate that medication is administered by designated and appropriately trained staff Timescale for action 1/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 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 V248166 090905.doc Version 1.40 Page 20 Commission for Social Care Inspection Hampshire Area Office 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Orchard Close H54 S39585 Orchard Close V248166 090905.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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