Inspection on 19/07/05 for Orchard Court

This inspection was carried out on 19th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orchard Court 23/10/07

Orchard Court 10/07/06

Orchard Court 06/12/05

Orchard Court 02/09/04

Orchard Court 19/05/04

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 Court East Grinstead Road Lingfield Surrey RH7 6ET Lead Inspector Mr D Griifths Unannounced Inspection 19 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Orchard Court Address East Grinstead Road Lingfield Surrey RH7 6ET 01342 834444 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Anchor Trust Maureen Burns CRH (PC) 63 Category(ies) of Old age, not falling within any other category registration, with number (OP) 28. of places Dementia - over 65 years of age (DE(E)) 20. Physical Disability over 65 years of age (PD(E)) 15. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE. 2. Up to 8 of beds may be used for SI(E). 3. Up to 10 of the above beds may be used for MD(E). Date of last inspection 02 September 2004 Brief Description of the Service: Orchard Court is an Anchor Trust Care Home. It is situated in the village of Lingfield and is close to the local shops and community amenities. The Home is purpose built to accomodate and care for up to 63 older people some of whom may have a past or present mental health need and/or a physical disability. The Homes bedroom and community living areas are arranged into seven group living residential units. They are on two floors accessible by passenger lift. There is a Day Centre located at Orchard Court available to residents.The grounds comprise of lawns and a new patio area nearing completion. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of two to be undertaken in the Commission for Social Care Inspection (CSCI) Year April 2005 to March 2006. It was an unannounced visit and took place over a period of 6 ½ hours. Lead Inspector Damian Griffiths was assisted during the inspection by Fran Bonnell Senior Care Support Officer in the morning, and the Deputy Manager, Penny Burns in the afternoon. Assistance with the inspection of residents’ finances was received from Jill Whelan, Administrator. The inspector met several residents and one of the resident’s relatives who was able to contribute to the inspection report. Since the last inspection a series of thefts have been investigated as directed by the Surrey Multi-Agency Procedures. Two of the residents involved with CSCI following the investigations, were consulted. There have been no further reported thefts since April. A service at Orchard Lodge undergoing a period of respite care was consulted about the service offered at the home. Three more residents were consulted during the tour of the premises. Care plans were compared with the actual service they received and their comments contributed in determining whether the standards had been met. It is recommended that the reader should also look at the previous report that can be accessed using the CSCI website details on the last page of this report. The inspector would like to extend his thanks to the residents, staff and management of Orchard Court for their assistance and hospitality. What the service does well: Staff were observed helping to Residents’ at Orchard court in a respectful manner at all times throughout the inspection. Residents consulted reported they were happy with the care they received, felt safe and liked living at Orchard Court. The Home produces clear care plans, and residents’ benefit from their own personalised bedroom and a clean and tidy communal environment. Residents can stay for short periods of respite Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 6 from their own home environment and intermediate care is available to assist with rehabilitation after periods of hospitalisation. Since the last inspection the Home requested help from Police, Social Services and CSCI in accordance with the Surrey Multi-Agency Procedures, to investigate theft of money. A resident was able to confirm that the investigation was conducted in a discreet manner that was sensitive to residents’ needs and caused the minimum of anxiety. This has served to heighten the Homes awareness and importance of thorough financial procedures. 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 Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 standard(s) 3 and 6 Orchard Court assessment procedure does not comply with the National Minimum Standards by admitting a resident without an assessment of care needs. I Residents’ entering the Home for Intermediate or Respite care were able to benefit from the service offered. EVIDENCE: Assessments for the emergency placement of one resident were not available for inspection. It was reported that this would be an ongoing process while the resident was at Orchard Court. The home was therefore unable to assure the resident of their ability to meet his care needs. This does not meet the requirement for this standard. The Home provides 4 bedrooms that are used for respite or intermediate care. Staff work closely with the Local Authority Social Care Teams who include the District Nurse and Community Physiotherapist. The program generally lasts up to six weeks and is successful in assisting the resident back into their own home environment. All other assessments sampled were clear and easy to read. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 9 Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 standard(s) 7,8,9 and 10. Residents are encouraged to remain as independent as possible while still being able to benefit from a supportive residential home community. Residents’ benefit from living near the Health Centre and the good working relationship that Orchard Court staff have with the health care practitioners. Appropriate measures are taken to ensure the safety of residents who selfmedicate. Residents at Orchard Court are treated with respect and their privacy is respected EVIDENCE: Orchard Court is situated next door to the local health centre providing the residents with the advantage of easy access. It was reported that this has helped to promote a good relationship between staff and health care practitioners. The Home has a commitment to provide full and individual details of the residents’ care needs. Orchard Court uses an Anchor Trust system of care plan recording and works closely with residents, relatives, Care Managers and District Nurses to produced these. The care plan is divided into specific areas Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 11 of need and interest, i.e., personal care, mobility, activities etc. The care plans are also regularly reviewed. There were some aspects of the care plan that required further detail and this will be included further on in this report. Residents’ prescribed medication is distributed daily using a new system of lockable medicine trolleys and there is room set aside for the secure trolley. Residents on respite breaks are encouraged to self-medicate. A risk assessment is conducted with the resident to see if they are experiencing any difficulties prior to self-medication being agreed. Medication can be stored in the resident’s room in a lockable drawer if the resident is self-medicating. Residents are protected by a robust medication policy and only trained staff are allowed to give the daily medication. Respect and the dignity of the residents was observed and confirmed by the residents consulted. Staff were observed knocking on the door before entering a residents room, addressing each resident by name and asking if any help was required as appropriate. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 standard(s) 12,13, 14 and 15. Orchard Court fail to adequately record residents activities or review the quality and usefulness of these pursuits for the resident leading to some residents with changing needs being overlooked. Orchard court fail to adequately record whether residents are receiving suppertime snacks or to provide residents who have special dietary needs with a suitable choice of alternative. EVIDENCE: Residents reported being happy with the activities that were organised and have access to the day centre at Orchard Court. There was however very little evidence recorded on the residents diary sheets to state what if any participation had occurred. One resident reminisced about the loss of mobility and the past enjoyment gained from long walks. When questioned about other interests, bird watching was identified and an interest in using a computer to find suitable websites about this subject. A requirement has been made about the lack of daily recording making this the second time this standard has not been fully met. The Home has been able to demonstrate that it assists with individual choice. A resident confirmed that they have been assisted to move to another part of Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 13 the Home after when they stated that they were unhappy within the particular unit. Some of the residents consulted did not feel they could help themselves to snacks such as biscuits but stated they were happy to ask staff for these but only when tea was served. A requirement made from the last inspection for suppertime snacks to be recorded on each resident’s diary sheets was still not in evidence. Residents consulted and requiring special dietary needs due to weight loss did not have a daily record of their food intake. There remains a requirement for this standard to be met fully. A relative said he was always welcomed and consulted regularly about the well being of his father. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 standard(s) 18 Orchard Court has demonstrated that it is willing and capable to undertake action to protect its residents from financial abuse. EVIDENCE: The Home was subject to a series of alleged thefts at the beginning of the year. Families, Police, Social Services and CSCI have been involved and kept fully informed by Orchard Court. Safeguards already in place include lockable storage space located within every resident’s room or residents’ can take advantage of the safe in the office. Staff assist with the accounting of residents’ money. The residents reporting the thefts stated that they were satisfied that the Home had done all they could to protect their property and confirmed that they felt safe and well cared for at Orchard Court. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 standard(s) 19 and 26 Orchard Court provides residents with a comfortable homely environment but there are some safety concerns due to inadequate fencing of the grounds. EVIDENCE: Orchard Court was, overall well maintained, fresh and clean. There were areas that required attention and will be dealt with later in this report. A new patio area was nearing completion and will afford the residents with a pleasant area to enjoy the garden. The fence surrounding the grounds is in need of attention as there was a significant gap identified in a corner section of fence that allows full access to the Homes grounds from the neighbouring empty field. It was reported by the Deputy Manager that this has been acknowledged by Anchor Trust and is on the current maintenance programme. A requirement has been made for the repair or renewal of the fence. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 Orchard Court actively seeks to recruit staff and has a recruitment policy that meets the required standard. EVIDENCE: The management at Orchard Court have creative ideas to boost the staff recruitment, e.g. to accommodate staff with children by offering hours suitable to family responsibilities and by providing transport. A new staff member was consulted and her file inspected. New staff are required to obtain two references that are relevant to the post, a full employment history and receive a Criminal Records Bureau (CRB) check. They are supervised until the CRB has been cleared and they have satisfactorily completed induction training. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35 and 38 The manager has a good staff team and works well with meeting her responsibilities. Residents’ benefit from Orchard Court policy and management of their personal allowances. A simple system of accounting is in place. A requirement concerning health and safety made from the previous inspection was not fully met. EVIDENCE: The resident’s receive help with the safekeeping of their money. Small amounts of residents’ cash may be stored in the office safe if required. There is a limit to the amount of money that can be stored. Records of residents money is recorded in individual receipt books and all receipts are numbered and correspond with the amount spent. The resident and the staff member dispensing the money sign all withdrawals. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 18 The carpet on one ground floor unit remains in need of repair. A hole in the carpet has been repaired with gaffer tape and poses a trip hazard. This is the second requirement that has been made in relation to carpet repair. Carpets in other units mentioned in the previous report have been replaced. Fencing previously mentioned compromises the safety of the residents at Orchard Court while it remains in the present condition. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x x x 3 x x 2 Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14. (1)(b & c) Requirement The registered person must not provide accomodation to new residents unless they have received a comprehensive assessment of their care needs. The registered person must ensure that records are maintained on a daily basis of the activities carried out within the the service, as opposed to the day centre, and the level of the residents attendance must also be recorded. This is the second time this requirement has been made. The registered person must ensure that staff offer residents suppertime snacks and documented records are maintained to reflect whether suppertime snacks have been taken. This is the second time this requirement has been made. The responsible person must ensure that the premises fencing is secure and in a good state of repair and ensures the safety of residents. The registered person must ensure that all carpets are made Timescale for action 26/07/05 2. 12 16 (2) (n) 16/08/05 3. 15 16 (2)(i) 16/08/05 4. 19 23 (2)(b)(o) 11/10/05 5. 38 13 (4)(a)(c) 16/08/05 Page 21 Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 secure and are free from hazard for residents and staff. This is the second time this requirement has been made. 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 35 Good Practice Recommendations To take residents shopping to ensure that residents funds do not exceed the recommended levels agreed within Orchard Courts own policy. Orchard Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Court H09 H58 s13740 Orchard Court v240222 130905 Stage 4 unn.doc Version 1.40 Page 23 - 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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