Inspection on 24/05/06 for Orchard Cottage

This inspection was carried out on 24th May 2006.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Orchard Cottage 04/01/06

Orchard Cottage 21/07/05

Orchard Cottage 25/08/04

Orchard Cottage 18/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Orchard Cottage Orchard Cottage 25 Orchard Grove Orpington Kent BR6 0RX Lead Inspector Ann Wiseman Unannounced Inspection 24th May 2006 09.00 Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 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 DS0000038246.V293212.R01.S.doc Version 5.1 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 Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Orchard Cottage Address Orchard Cottage 25 Orchard Grove Orpington Kent BR6 0RX 020 8464 3333 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) London Borough Bromley Ms Susi Hall Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 service users may have a sensory impairment (SI). Date of last inspection 4th January 2006 Brief Description of the Service: 0rchard Cottage is a large older style two story detached house providing care and accommodation for four adults with learning difficulties. Orchard Cottage has recently had a full refurbishment and now has five single bedrooms, one being new built with connecting bathroom and there is also a new conservatory off the kitchen. The home is within walking distance from Orpington town centre with its wide range of shops and leisure facilities. Entrance to the house is up a slight incline with steps to the front door. Wheelchair access is through the rear garden. The house has no parking facilities but there is a pay and display car park close by. At the time of Inspection there were three Ladies in residence and one vacancy. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Orchard Cottage has a workforce that is committed to supporting the Service Users to live as full and active a life as possible. The house is homely and comfortable and decorated to a high standard and there are photographs of the Service Users throughout the home. The Regulation Manager accompanied the Inspector as she had some areas of concern noted at a previous Inspection that she wanted a second opinion on, we were welcomed into the home by Service Users and staff alike and the Registered Manager facilitated the Inspection until she had to go out with two of the Ladies who had a prior engagement. The Inspector would like to thank everyone involved. During the Inspection all of the Service Users were around and made their feelings known about the service they receive. The Inspector spoke with two staff members and two family members at a later date by phone. The Inspector returned to the home at a later date to complete the Inspection with the Manager. While the overall ethos and management of the home is good and the Service Users enjoy living in the home and their feelings and aspirations appear of paramount importance, the moving of a Service User to another room against her will does not reflect well on the service and concerns of how the move was done and the slow response to the requirements made during the previous inspection have detrimentally effected the overall outcome of this report. What the service does well: What has improved since the last inspection? What they could do better: The fire procedures and guidelines are out of date and very basic they need to be updated. Although the fire officer has visited the house since the construction of the extension on the ground floor the and has raised no issues, the Inspector has misgivings about existing arrangements and would like the Fire Officer to be consulted on areas highlighted during the Inspection. Please contact the provider for advice of actions taken in response to this Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 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 the following standard(s): Key standard 2 was inspected on this occasion Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Service User files show that they are given all the information they require to be able to make informed decisions about the house before moving in and that prospective Service Users individual aspirations and needs are assessed. EVIDENCE: The Service Users in this house have lived together for many years so the house policy for receiving new Service Users into the home has not been tested. Some one have moved out so the home now has a vacancy and the Registered Manager has assured the Inspector that she will follow the required practice and procedure in filling the bed. The Manager is particularly concerned that the present client group is not disrupted by the addition to the home and intends to make the introduction as smoothly as possible. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 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 the following standard(s): All of the standards in this group have been assessed on this occasion. Quality in this outcome area is adequate. This judgment had been made using available evidence including a visit to this service. Changing needs are assessed, Service Users are enabled to make decisions, are consulted on and participate in all aspects of their lives. Private information is stored appropriately. EVIDENCE: Very good care plans are in place that are detailed and a shorter document has been developed that concisely sets out the Ladies likes, dislikes and preference in support as a point of reference for new staff or agency workers. The Care plans are reviewed at regular intervals. On the whole Service Users are enabled to make decisions about their day to day lives, there is a wide choice of activities on offer. The Inspector has seen Service Users being supported to make decisions and supported to do so. One of the young Ladies supports an animal charity and wanted to make a donation. She has been helped to organize a raffle, buying several small prizes Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 10 arranging them prettily in a basket to display them, she is a very persuasive salesperson and has made a good sum of money for the charity. It is evident that the staff believe in promoting independence and enabling the Service Users to make informed decisions for themselves by making sure they have the information needed to do so in a format they will be able to understand. However a situation highlighted in the previous Inspection regarding a service user being moved from a room she had used for many years into another despite her desire to stay where she was has not yet been resolved yet. The way this move was carried does not fit in with the overall ethos of the home and had caused distress, disappointment and disruption to the Service User who is still having difficulties getting around the new bathroom due to a sight impairment. The reason put forward for the move was that she had mobility problems and could no longer safely manage the stairs. The Inspector was able to talk with the Service User and she clearly indicated that she still wanted to move back to her old room and offered to show the Inspector that she could manage the stairs which she did with minimal supervision and having gone upstairs she went to her old room, that is still empty, and immediately hugged the bed and went around the room stroking various pieces of furniture, then went to the window to look out as she enjoyed doing when she was stayed in the room. It is a large, light room benefiting from two large windows. She then walked down the stairs, carefully holding on to the rail, with very little difficulty, she then agreed to show the Inspector her new room which is smaller and dark due to it overlooking a wall and trees. The Service User opened the door for the Inspector and did not enter the room despite the Inspector trying to engage her in conversation about photos and personal objects in the room. It is the Inspectors opinion that there is no doubting which room she prefers and wants to live in. A meeting has been arranged to reassess the situation. The requirement made at the last Inspection will be restated to reaffirm the Commissions stand on this issue. Please see Requirement 1 Service Users can and do take risks as part of an independent lifestyle and risk assessments have been drawn up and interventions introduced to minimize dangers. Personal information is stored in the office in a locked cabinet. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 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 the following standard(s): All areas of this area were assessed during this Inspection. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Apart from letting a Service User chose the room she likes, in lesser ways this is an area that is particularly well addressed in this home. EVIDENCE: The Service Users chose not to attend a day centre so a program of daily activities have been set up and the activities are those requested by the Ladies. The activities include adult education classes and monthly summaries included evidence that the ladies had been swimming, on trips to London, a picnic, to the pub, to the cinema, walk in the park, going to the Gateway Club, a theatre trip and out for meals at local restaurants. The Service Users who have contact spend time with their families and will often stay for weekend and overnight visits. One of the Ladies who does not have family contact has been appointed an advocate.All of the Ladies are expected to help with housework, shopping and the cooking within their abilities. The Service Users are offered a healthy diet and the home prides itself on offering freshly prepared, home made food. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 12 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): All standards were assessed on this occasion. Quality in this outcome area is adequate. This judgment had been made using available evidence including a visit to this service. Personal care is offered in a way that is preferred by the Service Users, physical and emotional needs are addressed and medication is stored and administered in a way that is appropriate, but the staff member interviewed did not show any understanding of the medication given and why it was needed. EVIDENCE: Care plans in use are detailed and give clear information of how each lady likes to be supported with personal care, the is a shortened version of the care plan that is designed to be used for quick reference by agency workers and new staff members. The care plans are reviewed annually with the help of the service user at Person Centred Planning meetings. Files hold evidence of visits to the doctor and other medical and other professional input such as psychology, speech and language and the Kent Association for the blind. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 13 Medication is stored in a locked cupboard and records are kept and were in order. No medication was found to be out of date and an Inhaler was marked with the date that they were opened, but eye drops were not. The was a medication, Clobazen 10mg marked as prescribed for one of the Service Users but it was not noted on the her medication sheet. When asked why it was there and what it was taken for the staff member was unable to answer the Inspectors questions. Nor was she able to say what other medications were prescribed for or inform the Inspector how she would be able to find out. The staff member phoned the Manager on her mobile, who had left to take two of the Service Users to an appointment, and she was directed to a folder that had information about medications held at the house. Further investigation led to the discovery that the Clobazen was used as a PRN for one of the Service Users that gets agitated at times and needs to take the medication to help her calm down. It had not been carried over to a new sheet. It is essential that staff receive training not only in the safe handling and administration of medication, but also that they are trained to know why each medication has been prescribed, what they are used for and what adverse side effects to look out for. Please see requirement 2 Safeguards and checks should be put in place that reduces the risk of medication being left off on the recording sheet. Please see Recommendation 1 It is the homes policy and expectation that Service Users will be cared for at home in the event of any serious illness as long as it falls within the capabilities of the staff group. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 14 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): Both Key standards were examined on this occasion. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. No complaints have been received either at the home or the Commission since the last Inspection. Safeguards are in place to protect the Service Users from abuse. EVIDENCE: Neither the Commission or the home have received any complaints about the service since the last inspection. Evidence was found on staff records that CRB checks are taken up on any staff member prior to them starting work in the house. Protection of Vulnerable Adults training is give and conversation with staff members indicated that they had a good understanding of the vulnerability of the Service Users to abuse. The homes financial arrangements were discussed and monies were checked and both were found to be order. Were possible the Service Users manage their own monies with support from staff, the receipts and balances where checked on a daily basis and recorded. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 15 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): Standards 24, 25, 26, 27, 30 were examined on this occasion. Quality in this outcome area is adequate. This judgment had been made using available evidence including a visit to this service. This home has a homely, comfortable and safe environment, bedrooms generally suit the needs and lifestyle of the Service Users and it is clean and hygienic. EVIDENCE: It is the Inspectors opinion that Orchard Cottage is as homely and comfortable as it could be and still take into account the need to comply with the health and safety at work act. Both the Inspector and the Regulation Manager have reservations around the existing fire precautions in the house in regard to the bedroom that is accessed via the kitchen and conservatory, urgent consideration should be given to whether this room is adequately protected from both fire and smoke as there is no fire door between it and the kitchen, a major source of a fire risk, and there is a clear gap between the floor and the bottom of the door. Also the Inspector does not feel the escape route from that room is clearly defined and safe. Taking into account the bathroom door may be locked from the bathroom side and therefore closing one means of escape to the Service User. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 16 The staircase is open and there is only one fire door between it and the kitchen and the laundry. These stairs are the only means of escape for those Service Users and staff members that sleep upstairs. The Inspector does not believe the staircase and upper floor are adequately protected from fire and the egress of smoke. The only fire exit is the front door, consideration must be given to designating the exit from the conservatory a fire exit? The exit from the conservatory is secured with two locks and the keys are removed and placed in a box by the door. In a time when this exit is needed under extreme circumstances it may be possible that the keys are lost or misplaced. Therefore trapping people inside the building in the event of a fire blocking access to the front door. An Immediate Requirement Notice was issued that asked for independent professional fire safety advice to be sought regarding the present arrangements generally and particularly in regard to the issues raised above. Please see Requirement 3 The current fire safety procedure was inspected and found to be too vague and not robust enough taking into account the complex layout of the building. An Immediate Requirement was made that the Fire procedures must be redrawn and must include evacuation plans for the event of a fire occurring both night and day and also using various different scenarios i.e. Fire in the kitchen, fire in the front hall and fire in an upstairs room etc. Please see requirement 4 In the previous Inspection Report it was a requirement that fire extinguishers are either fixed the wall by a bracket or placed on a stand. This action has not been carried out and the Requirement will be restated. Please see restated Requirement 5 One of the bedrooms tends to be cold so a free standing electric oil filled heater was being been used to help warm the room. However when examined it was found by the Inspector that the surface became so hot that it was likely to cause serious injury to anyone who was to lean on or fall against the heater. The inspector explained her concerns to the staff member on duty and it was removed. Please see Requirement 6 Also it is recommended that ambient temperatures throughout the house are checked and steps be taken to enable the whole house to be heated to an appropriate level that is comfortable to those living in the home, using means that will not become a danger to the Service User. Please see Recommendation 2 Each room is individual to the Service User, is well decorated and comfortable and meets their needs, however one of the Ladies has been moved to a room that is not of her first choice and she finds the bathroom attached to her room large and difficult to manoeuvre around as she has impaired sight and the toilet, sink and bath are too well spaced for her to easily go from piece to piece by feel as she did in the smaller bathroom she has used in the past. This has Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 17 reduced her independence as she gets disorientated in the larger room and needs assistance. The move is being reassessed and it is hoped that the Service User will be allowed to use the room of her preference, and therefore showing that the service respects Service Users rights, listens to their views, allows them to make decisions on how they live and to take risks as part of an independent lifestyle; which are some of the underpinning National Minimum Standards in providing social care. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 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 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): Standards 31, 32, 33, 34, 35, 36 were judged during this Inspection. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Staff appear competent and are working towards achieving the appropriate qualifications, the recruitment policy is as required and staff are well supported and supervised. EVIDENCE: Only some staff records are stored at the home and the Inspector examined what there was for two staff members. They showed that the recruitment policy is followed. The records showed evidence of reference’s being taken and that CRB checks are made before a staff member starts work at the house. The application forms were available as was the interview record. The Registered Manager will make arrangements for the Inspector to see all of the complete staff records during the next Inspection. Rotas were checked and staff on duty corresponded to those detailed. There are two staff members on duty each shift, which enables the three Service Users to have ample 1-1 support. Polices in place refer to the Designated Person taking responsibility in certain situations, but the rota does not identify who that person is. It is a requirement that the Designated Person is clearly indicated on the rota. Please see Requirement 7 Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 19 On talking to staff on duty and the Manager it became apparent that the Service User and their aspirations are very important to them and that they were committed to offering a high standard of care. One of the Service Users who talked to the Inspector was unhappy that there was a staff member who she could not understand, she also felt that the staff member could not understand her. In the words of the Service User “It’s like talking to myself”. It is reported that this Service User seems withdrawn when that this staff member is on duty. The Registered Manager confirmed that English was not that staff members first language and that she was having problems with communication in general she is receiving extra support to try to rectify the situation. The home offers training as evidenced form certificates placed on the staff records, including Induction, Protection of Vulnerable Adults, Health and Safety, Basic food Hygiene and first Aid. Both staff and Manager state that regular supervision is offered and that is confirmed by the number of and regularity of supervision records. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 20 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): Key Standards 37, 39 and 42 were inspected on this occasion. Quality in this outcome area is adequate. This judgment had been made using available evidence including a visit to this service. The home has an air of being well run and organized, Service Users views are sought on a daily basis. EVIDENCE: The Service Users have opted out of using the day services, but their daily life is busy and it takes a lot of organisation to make sure they attend all their different daily activities. The ethos, leadership and management of the home is based very much on the needs and aspirations of the Service User, the Service Users spent some time sitting around the table in the kitchen with the Inspector drinking tea and discussing what they enjoy doing, what they plan to do, what they think of the home and how it was run. The atmosphere was relaxed and friendly, the Service Users obviously felt able to talk openly and are very confident in talking about how they liked living in the home and how well the staff looked after them. When asked if they knew how to make a complaint all said they Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 21 did, and one said that they had nothing to complain about. All comments requested from families and others involved with the service were positive. Service User surveys are taken annually and there are plans for the Manager to write a short summery of the outcomes and to give a copy to the Service Users and their families as recommended in the last Inspection Report. Health and Safety records that were randomly examined were found to be in order. The concerns about the Fire precautions and procedures have been covered in a previous section and will pull down the scores in this section as well. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 22 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 X 2 3 3 X 4 X 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 1 25 3 26 3 27 1 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 1 1 1 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 1 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 3 2 X 3 X X 2 X Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 23 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 YA7 Regulation 12 Requirement Unless the Service User concerned has decided to stay in her new room the matter must be re-addressed and the Advocate included in all discussions. It is essential that the staff receive training not only in the safe handling and administration of medication, but also that they are trained to know why each medication has been prescribed, what they are used for and what adverse side effects to look out for. An Immediate Requirement Notice was issued that asked for independent professional fire safety advice to be sought regarding the present arrangements generally and particularly in regard to the issues raised above. An Immediate Requirement was made that the Fire procedures must be redrawn. Timescale for action 28/09/06 2. YA20 13.2 28/09/06 3. YA24 23.4 07/06/06 4 YA42 23.4(e) 31/05/06 Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 24 5. YA42 13 All fire extinguishers must be either attached to the wall or on a stand designed for that purpose. An Immediate Requirement was made that a mobile heater be removed it from a bedroom room and that it and any of a similar design must be removed from the home as the surface became so hot that it was likely to cause serious injury to anyone who was to lean on or fall against it. Polices in place refer to the Designated Person taking responsibility in certain situations, but the rota does not identify who that person is. It is a requirement that the Designated Person is clearly indicated on the rota. 28/09/06 6. YA24 23.2(p) 24/05/06 7. YA31 18 28/09/06 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. 2. Refer to Standard YA20 YA24 Good Practice Recommendations Safeguards and checks should be put in place that reduces the risk of medication being left off on the recording sheet. It is recommended that ambient temperatures throughout the house are checked and steps are taken to enable the whole house to be heated to an appropriate level that is comfortable to those living in the home, using means that will not become a danger to the Service User. Orchard Cottage DS0000038246.V293212.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 DS0000038246.V293212.R01.S.doc Version 5.1 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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