Inspection on 19/09/05 for Orchard Cottage

This inspection was carried out on 19th September 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 Cottage 16/04/07

Orchard Cottage 03/03/06

Orchard Cottage 18/01/05

Orchard Cottage 27/07/04

Orchard Cottage 16/02/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Orchard Cottage 78 Old Road East Gravesend Kent DA12 1PE Lead Inspector Sally Hall Unannounced Inspection 19th September 2005 09:30 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 Cottage DS0000040147.V250182.R01.S.doc Version 5.0 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 Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Orchard Cottage Address 78 Old Road East Gravesend Kent DA12 1PE 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) 01474 321127 Mrs Tersaim Kaur Khaira Mrs Jacqueline Barnes Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2005 Brief Description of the Service: Orchard Cottage is a detached property situated in a residential area of Gravesend. It is privately owned and is currently registered to provide residential care for ten older people. The accommodation consists of six single rooms, one of which has an en-suite facility, and two double rooms. There is a chair lift to the first floor. Each room has telephone and TV points and a call system. There is an emergency lighting system in place throughout the building. The entire building is decorated to a high standard; the furniture and fittings are also of a high standard and are very homely. The home has attractive gardens. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection at Orchard Cottage took place on 19th September 2005 at 10.20am. The Inspector agreed and explained the inspection process with the Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was not undertaken during this visit. The focus of the inspection was to assess Orchard Cottage in accordance to the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: Service users could have more direct input with their plan of care. The policies and procedures in the home need to be reviewed annually to ensure they remain current and reflect any changes in legislation. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 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 Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 7 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 Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 The Statement of Purpose and Service Users Guide provide the information for prospective service users to make an informed choice about the home. Service users have a comprehensive assessment before they are offered a place at the home to ensure it meets their individual needs. All service users and, or their families are encouraged to visit and service users are offered a trial period of stay. EVIDENCE: The home’s Statement of Purpose and Service Users Guide are detailed and well-presented documents that fulfil the regulatory requirements. However, this document does need to be reviewed at least yearly to ensure the information remains current. The owner/manager explained that the usual practice is for prospective service users to be invited to spend a day in the home and assessments then take place during this visit. If it were not possible for the service user to visit the home, the assessment would take place in the service user’s current place of accommodation. The owner explained that by doing the assessment at the Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 9 home they can also see if the prospective service user will fit in with the current service users. The assessments cover all the information required to make an informed decision. Care records evidenced that the needs of service users are met as documented in care plans. It was also evident in talking to service users that importantly they feel their care needs are met fully within the home. The owner/manager explained how prospective service users are able to visit the home with their relatives prior to admission and they are provided with information about the home to help them make an informed decision whether to move in. Several service users said that the first month of their stay was on a trial basis for both parties. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 All service users have a plan of care, which includes their assessed care needs, as well as social needs. Service users’ health care is monitored and action taken when required. The Service users are treated with dignity and respect at all times. EVIDENCE: The care plans in the files sampled, identified the care required by the service users and this was cross-referenced with the pre-admission assessments. These plans are not however, being reviewed monthly by staff. Service users within the home are able to voice their individual choices and opinions and could therefore be involved with their care planning process, at the time of this inspection there was no evidence of this input. Daily records covered much of the care provided as detailed in the plans of care. The Manager agreed that these would be improved if more detail were available in this daily recording. The manager was also advised that the time of care delivery and events etc. should be recorded rather than just am or pm. During the inspection process service users were seen receiving a high standard of care and individual needs were being provided for. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 11 Service users’ health is documented in daily records. These records also indicated when the GP had been called in to give treatment or advice. The care plans detailed the care required for a service user and it was evident from talking with the staff that they had a good understanding of the measures required to prevent pressure sores developing. The home arranges for health professionals such as Chiropodists, Opticians and Dentists to visit. The staff explained that medical examinations and consultations take place in the service user’s own bedroom. The home does not have a visitor’s room but there is a lounge area that is seldom in use, or visits can take in place in bedrooms if the service user wants privacy. All bedrooms have phone points, and service users can have a phone installed if they wish. Staff treated the service users with respect and took care when enquiring about personal issues. Staff responded quickly when help was called for. Service users spoken with confirmed that the staff at the home respected their privacy and dignity at all times. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Service users are well motivated through a varied activity programme, which includes trips out. The home’s routines do not restrict the service users as staff have a flexible approach. The home provides a varied and nutritious menu and meal are taken in a congenial setting. EVIDENCE: Service users confirmed that they were actively encouraged to participate in a range of activities appropriate to their needs. Included in the activities that happen daily is a period of exercise. Service users were able to list the various activities that they join in with during the week. They explained how inventive some of the staff are and how they enjoyed “Guess that Tune”, that a staff member had organised the previous week. It was evident that outings are arranged by the home but other service users also arranged some of their own outings. Staff confirmed that the home operates an open visiting policy. Some service users stated that they go out into the community, attend church and visit friends and relatives. At the time of the inspection two service users went out on a trip with the local church. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 13 Several service users acknowledged that there was a need for some routine in the home, however, they stated that the home’s staff were sufficiently flexible to allow for individual preferences in respect of personal care. From talking with the service users it was evident that service users make decisions based on information and choice. The home’s menu provides a varied and nutritious diet, fresh vegetables and produce are used daily. A choice of hot or cold drinks is offered and special diets are catered for. All of the service users spoken with spoke very highly of the quality of the meals served and confirmed that their individual preferences were known. The service users also said that the lunchtime meal was always a surprise, as they were not aware of what they would be served. It was advised that the service users should be informed of the content of the meal prior to it being served and a choice of meals should be offered. On the day of the inspection the large dining table was attractively set in preparation of the meals being served. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The complaints and adult protection policies and procedures ensure that service users are not put at risk. EVIDENCE: Service users spoken with were well aware of their right to complain and said they would be comfortable with talking to either staff or the owner should they have any concerns. There were no complaints recorded in the home’s records since the last inspection. The home’s complaints procedure needs to be updated to reflect the change in the name of the Commission. The owner is aware of the recent changes to the local authority’s adult protection protocols and is adopting these new practices. In light of the changes the home’s policy does need to be reviewed to reflect this. It was recommended that a procedure be made available for staff for the reporting of suspected abuse. The owner explained that staff have had adult protection training and that they would be made aware of the recent changes. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected during this inspection. EVIDENCE: Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 The home provides sufficiently trained staff to ensure the service users needs are met. EVIDENCE: The total number of hours covered by care staff appears to be adequate to ensure the service users’ personal care, social, recreational and cultural activities requirements are met. However, the home does not employ a cook and care staff are required to prepare and cook all meals. A cleaner is employed at the home. The home has ensured that at least 50 of it’s care staff have the required NVQ level 2 or above. The homes’ training programme ensures that the staff have the skills required to meet the needs of the service users. The owner/manager is aware of the training that staff are required to have and has arrangements in place to ensure that their training and knowledge remains up to date. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35, 37, The way the home is run ensures service users live in a homely environment. Their rights to have access to their personal records are protected. The home encourages the service users to maintain their financial independence. EVIDENCE: It was evident when talking with service users that they considered the home was well managed and met their needs. The home has a very positive and friendly atmosphere, with all the service users knowing each other well. Service users said that they felt they were part of one big family. They benefit from the small size of the home, which they said feels homely. The owner/manager confirmed that the staff did not deal with the service users’ personal money. The service users presently in the home are able to handle their own finances. All service users have been offered a lockable Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 18 facility in their bedrooms and keys for their bedrooms, however, all service users have refused these. The owner/manager said that this has been documented and the letters are kept on file. The home ensures that records are kept securely in the home. The owner/manager understood the data protection legislation and how that effects the way information is recorded. The use of the home’s diary was discussed and minor changes to what is recorded within this in future are to be made. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 19 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 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 2 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X 3 X 3 X Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 20 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 OP7 Regulation 15.1,2 Requirement A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. Entries in the daily record show the time of the care delivery or event. Timescale for action 30/11/05 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 OP18,OP16 & OP1 Good Practice Recommendations The Statement of Purpose, Service Users Guide, the complaints procedure, and the adult protection policy/procedure needs to be reviewed annually to ensure the information remains current and reflects any changes in legislation. Orchard Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Cottage DS0000040147.V250182.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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