Inspection on 04/01/06 for Orchard Cottage

This inspection was carried out on 4th January 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Orchard Cottage 24/05/06

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 4th January 2006 10:30 Orchard Cottage DS0000038246.V275251.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.V275251.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.V275251.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.V275251.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 21st July 2005 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.V275251.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Inspection and when the Inspector arrived all the Service Users were at home and there was two staff members on duty, including the Manager. This service has a homely and friendly atmosphere; it is freshly decorated and has new carpets, there are photographs of the ladies that live in the house as well as their pet cats and there are plenty of ornaments dotted around the house. The ladies were all interested in the Inspection process and were laughing and chatting about what they had done over Christmas, visits to families and how much they liked the staff and house. 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 Cottage DS0000038246.V275251.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 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 the following standard(s): All standards in this section were assessed during this inspection. The house has all information necessary for a prospective service user to be able make an informed choice about where to live. EVIDENCE: The house has a statement of purpose, a guide and each of the ladies have an individual contract. Not all of the ladies have an updated Care Assessment on file and for one of the Service Users this is quite an issue at the moment. The Lady in question moved rooms against her wishes and against the judgment of the staff in the house and her Advocate on the strength of her assessment that no one other than the care manager seems to have seen despite requests for it to be made available. It a requirement that all the Service Users have updated copies of their Care Assessments. Please see Requirement 1 The was no evidence that the Service User had been given assurance in writing that the home will meet their needs and aspirations, it is appreciated that the present group have lived in the home much longer than the National Minimum Standards have been in place, but it is expected that standards 2, 3 and 4 be followed in full when filling the vacancy. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 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 the following standard(s): All standard in this section were assessed. Care plans are detailed and reviewed regularly. Issues around standard 7 need to be addressed. EVIDENCE: Care plans within the home are detailed and enable staff to get to know and understand Service Users goals and aspirations quickly. They are reviewed regularly. One Lady has long-standing vision impairment, now that the home has a new downstairs bedroom a decision has been made that she should move into it. When consulted she expressed the wish not to move as she liked her room and knew her way around it and the bathroom she knew was nearby. Against the better judgement of staff members and her Advocate her room was changed based on a new community care assessment that has not been made generally available. At the multi-disciplinary meeting, held to discus the issue, the Advocate was excluded on the grounds that it was a “professional” meeting. 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. Please see Requirement 2 Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 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 the following standard(s): All standards in this section were assessed on this occasion. The house offers a full range of activities that make all Service Users part of the community and enables them to develop. EVIDENCE: No one attends a day centre by choice, but an appropriate program of activities has been developed that reflects each individual’s tastes and needs making everyone a part of the community and includes collage courses. Family visits are usual and all but one of the service users spent Christmas at their families’ home. The interaction between the Ladies and staff members was lively and friendly. Staff talked to the Service Users in a respectful way and they assured the Inspector that they would uphold and advocate for their rights in the home and in the community. It is practice in the house to cook food from scratch and the fridge was full of fresh food and vegetables. Everyone participates in the cooking and there were jars of jam that the Ladies had made themselves. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 10 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): Standards 18, 19, and 20 were assessed on this occasion. Each Care Plan is detailed and cover all aspects of the Service Users care needs and preferences. EVIDENCE: The Manager has developed a document, getting to know you, for each Service User that gives comprehensive and detailed information enabling staff to get to know a Service Users needs and preferences quickly; it is a good tool for introducing new staff to the Service User . The document is reviewed regularly. All of the Ladies are registered with a GP and there is evidence that they visit him when need arise. Two of the Service Users were going for blood tests when the Inspector arrived. Other health needs are accesses through the Central Learning Disability Team such as Psychology department and the Community Nurse. None of the Ladies administer or control their own medication, the homes medication policy meets requirement and staff receive training in the safe handling and administration of medication. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 11 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): 22 and 23 were assessed during this Inspection. There were no new complaints recorded. Abuse procedures are in place in the home. EVIDENCE: There have been no new complaints since the last inspection. The complaints procedure is evident in the house and in the past the Ladies have been encouraged and assisted to complain when they have been unhappy with any aspect of the service they receive. The house has copies of the no secrets and whistle blowing policies and staff receive training on managing challenging behaviour and procedures are in place to protect the Service Users monies kept in the house. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 12 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): All standards were assessed on this occasion. The home has a domestic feel to it and suits the needs of the Ladies; it is comfortable, well furnished and clean. EVIDENCE: The house is newly decorated and the Ladies chose the colour scheme in the communal areas as well as their bedrooms. The furniture is modern, comfortable and in good condition throughout. The Kitchen is large and well appointed. The bedrooms on the whole suite the needs of the Ladies; they are reasonable in size and reflect each individual character. It was reported to the Inspector that the lady, with sight impairment, who now occupies the downstairs room has difficulties finding her way around the attached bathroom, it is large and the toilet, sink, bath and shower are spread out and she becomes disorientated and confused to where she is. Previous to the move she could manage her own personal care with minimal support as the bathroom was smaller and set out in a way that made it possible to keep hold of the sink and reach across to the toilet or bath. It is recommended that specialist support be sought from the Kent Association for the blind or similar organisation. Please see Recommendation 1 The home is clean and hygienic and the laundry conforms to standards. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 13 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): All standards except 32 were inspected. Staff members are aware of their roles and responsibilities, receive training and supervision. EVIDENCE: The manager informed the Inspector that all staff members had contracts and job descriptions. She also confirmed that they had undertaken an enhanced police check and were asked to produce two references one from a previous employer. She regular holds supervision sessions, staff meetings and makes herself available to give advice and support as needed. There is an ongoing training program and staff members have their training needs assessed in supervision and during Personal development interviews that are carried out annually and reviewed every six months. The Inspector was informed that there is no staff records retained in the house; all records are maintained in the London Borough of Bromley personnel department. It is acknowledged that there are difficulties in storing sensitive and confidential information relating to the staff group in an unsecured environment and having them available for inspection at any time of day or night irrespective of the availability of the registered manager, Please see Requirement 3 Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 14 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): All standards. The home appears to be well run and managed by an experienced, competent person who considers the needs, rights and aspirations of the Service Users of to be of paramount importance. EVIDENCE: The house is ordered and appears to be well run, in discussion with the manager it became evident that she believes strongly that the ethos of the home should be geared towards supporting the Service Users to live a rich and fulfilled lifestyle as reflected in the Minimum Care Standards. The Inspector had the opportunity to speak with all the Ladies living in the house and they said that they were happy in their home and that they liked the manager and other staff members. They liked where and how they lived and felt that they were “well looked after”. Service Users and their family are regularly asked for their views of the service received. Service User meetings are held and there is an annual Service User Survey. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 15 At present there is no feedback made available to the Service Users and it is recommended that a short report be written and sent to them and their families, in a style that would be easily understood by Service User, summarising the outcomes of future surveys. Please see Recommendation 2 Required policies and procedures are stored in the office and information regarding the Ladies was appropriate and stored in a secure area and the inspector was assured that all records would be made available to a Service User if there was a request to see them. Health and safety checks are undertaken and all necessary certificates were in available for inspection. A fire extinguisher on the upstairs landing was neither attached to the wall or on a stand this must be rectified. Please see Requirement 4 The cupboard is used for storage and was full, although this cupboard is connected to the fire system it would be good practice to make sure that no inflammable substances are stored in this cupboard. Please see Recommendation 3 Health and Safety training is undertaken and renewed. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 16 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 3 2 2 3 3 4 3 5 3 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 3 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 X 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 2 3 Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 17 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 YA2 Regulation 14 Requirement All the Service Users have updated copies of their Care Assessments. 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. Arrangements must be made that would satisfy both the need to uphold staff confidentiality and the requirement that the Inspector to have access to records as set out in schedule 2. All fire extinguishers must be either attached to the wall or on a stand designed for that purpose. Timescale for action 30/03/06 2 YA7 12 30/03/06 3 YA34 19 30/05/06 4 YA42 13 30/03/06 Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 18 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 3 Refer to Standard YA27 YA39 YA42 Good Practice Recommendations It is recommended that specialist support be sought to look for ways of supporting the Service User to gain more independence. It is recommended that a short report be written, in a style that would be easily understood Service User, summarising the outcomes of future surveys. It would be good practice to make sure that no inflammable substances are stored in this cupboard. Orchard Cottage DS0000038246.V275251.R01.S.doc Version 5.1 Page 19 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.V275251.R01.S.doc Version 5.1 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!