Inspection on 03/03/06 for Orchard Cottage

This inspection was carried out on 3rd March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 19/09/05

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 Announced Inspection 03rd March 2006 10:00 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.V272787.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 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.V272787.R01.S.doc Version 5.1 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 Mr Parmvir Singh Khaira Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 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.V272787.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection at Orchard Cottage took place on 3rd March 06 at 10.00 am to 14.30pm. The Inspector agreed and explained the inspection process with the owner. 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 undertaken during this visit. The focus of the inspection was to assess Orchard Cottage in accordance to the National Minimum Standards for Older People. Judgement of compliance was based on verbal responses given by those spoken with and the responses to the pre-inspection survey. 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 and staff need to document the time care provision and events occur in the daily report Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 6 rather than the time the report was written. The owner/ manager needs to arrange for the testing of the lifting equipment every 6 months in the home and obtain the required LOLER certificates. 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.V272787.R01.S.doc Version 5.1 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.V272787.R01.S.doc Version 5.1 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): 1-6 The Statement of Purpose and Service Users Guide provide the information for prospective service users to make an informed choice about the home. All service users benefit from visiting the home for assessment before being 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. The documents have been reviewed 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. The owner explained that by doing the assessment at the home they can also see if the prospective service user will fit in with the current service users. It gives the service user an opportunity to sample the meals, get a feel of the home and see the accommodation being offered. The assessments covers all the information required to make an informed decision. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 9 The survey done before the inspection and talking to individual service users during the day confirmed that the home is able to provide the care that is required on an individual basis. Staff are being trained and the home is giving staff the opportunity to do NVQ’s. One new service users explained how she was able to visit the home prior to admission and how this helped her make up her mind to move in. Several service users said that the first month of their stay was on a trial basis for both parties. The home does not provide intermediate care. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 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): 7,8,10,11 All service users have a care plan, which includes their assessed care needs, as well as social needs, however these do not detail the staff action required at this time. 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, although identifying the care required by the service users did not document the action staff should take to ensure the care needs are met. These plans need then to be 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, so it was possible to evidence that the service users care needs are being met. The owner agreed that these would be reviewed to include the necessary information. The owner 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 individuals confirmed their needs were being provided for. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 11 The home arranges for health professionals such as Chiropodists, Opticians and Dentists to visit. Initially this is identified during the assessment process and arrangements are made accordingly. Any service users who are already registered with a dentist for example would be enabled where possible to stay with the same person. Service users are also encouraged to keep their own GP if that is possible. Evidence was seen that service users’ health is documented in daily records. They also indicated when the GP had been called in to give treatment or advice. 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 the service users may choose to take family and friends to their bedrooms. All bedrooms have phone points, and service users can have a phone installed if they wish at there own expense. Several service users spoken with confirmed that they felt staff at the home respected their privacy and dignity at all times, that nothing was too much trouble. Staff observed during the day were seen treating the service users with respect and took care when enquiring about personal issues. Staff responded quickly when help was called for. Several service users commented that they didn’t feel they were living in a “HOME “ as such, as they saw the staff as friends who were there to help them. The home is not currently ensuring that they have recorded the wishes of the service users and /or the family in the event of that service users death. It is important for the staff to have this information as if the family are not contactable for any reason the GP will need to know what the plans are before he certifies death. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 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): 12-16 Service users are well motivated through a varied activity programme, which includes trips out. Service users benefit from the flexibility of the routines in the home. The home provides a varied and nutritious menu and meals are taken in a congenial setting. EVIDENCE: It was apparent from talking to service users that they are highly motivated. This being due in part to the activities arranged by the home which they are actively encouraged to participate in, and the way they are encourage to continue outside activities that they did before they come into the home. Service users talked about their visitors that come through the week, the home does not have visiting times and there are no restrictions on visiting; the service users confirmed. During the inspection the local priest came to give Holy Communion to several service users who had requested it. 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 are encouraged to make decisions throughout the day and retain as much control over there everyday lives as possible. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 13 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 home has recently had a visit food the food standards agency that was pleased with the standard of hygiene in the kitchen. The agency has issued a new set of standards “Safe Food Better Business” the home has six months to complete the new regulation, which the owner said they are already working towards. The service users confirmed that there is still no lunchtime choice. Again the owner 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. One of the service users was seen laying the table for the meal a task, which is enjoyed. The lunchtime meal was sampled and was very taste and well presented. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 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 home protects the service users by having a complaint and adult protection policy and procedure in place. EVIDENCE: The homes complaint procedure sets out the way complaints are dealt with at the home and the time scales for action the complainant can expect should they make a complaint. The home has the local authority adult protection protocols which their policy and procedure is based on. Both procedures and policies have been reviewed and reflect current changes in legislation where a appropriate. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 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): 19-26 Service users benefit from a homely environment which is both well maintained and furnished to a high standard through out. EVIDENCE: The home is an extended family home, and it has retained its family feel in every way. When you walk into the home it does not look like a residential care home and there are certainly no unpleasant odours. All bedrooms are individually decorated and furnished with some service users choosing to bring in items from home. One bedroom has an en-suit facility and there are a further 3 toilets, 1 bath and 1 shower available to service users. There are bedrooms on both floors and there is a stair lift for those less mobile. The communal space is both spacious and tastefully decorated and furnished to a high standard. Most service users choose to sit in what could be described as a garden room, it is a very light room that over looks the large well maintained garden. The home has a small laundry, which deals with both the homes washing and that of the service users. The home does not have a washing machine with a sluice facility as normally required, but this home does not Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 16 cater for service users who are doubly incontinent. The laundry area like the rest of the building was very clean and tidy. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 17 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 Service users benefit from having sufficient staff skill staff to provide for their care and other needs. EVIDENCE: The home has currently 50 of its staff to NVQ level 2 or above. The staffing levels reflect the current needs of the service users they are caring for. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 18 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, 33, 38 Service users benefit from the open and inclusive atmosphere generated in the home. Service users live in an environment they can feel safe in. EVIDENCE: The service users at the home are all well motivated and it was apparent when talking to them that their views are sort by staff and that they do have a say in the way things are done in the home. The interaction seen between staff and service users was good and service users obviously felt comfortable voicing their opinions about the staff and the home. The home also holds various meeting through the year that included service users meetings and service users relative meetings. The home has ensured that all the required maintenance tests have been completed on a yearly basis. This was evidenced form the list of date and comments recorded in the pre-inspection questionnaire completed by the Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 19 manager/owner. The LOLER certificate for the lifting equipment was not however available. The owner/manager had put in place weekly checks in house for the lifting equipment unaware of the statuary requirement for the 6monthly LOLER certificate. the owner/manager agreed to look in to this as a matter of urgency. The home has an accident book and fire log and fire training and drills are being done during the year. The home has a programme of staff training in place with has been designed to ensure that all staff not only receive the required training but that it then remains current. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 20 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 3 3 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 4 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 4 4 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X X X 2 Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? no 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. The registered manager ensures so far as is reasonably practicable the health, safety and welfare of service users and staff by ensuring lifting equipment is tested 6 monthly and the home obtains the required LOLER certificates. Timescale for action 10/05/06 2 OP38 12,13 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP11 Good Practice Recommendations Ensure that the funeral arrangements are recorded in the DS0000040147.V272787.R01.S.doc Version 5.1 Page 22 Orchard Cottage service users care file. Orchard Cottage DS0000040147.V272787.R01.S.doc Version 5.1 Page 23 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.V272787.R01.S.doc Version 5.1 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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