Inspection on 24/05/05 for Orchard Court Residential Home

This inspection was carried out on 24th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Orchard Court Residential Home 03/07/07

Orchard Court Residential Home 04/07/06

Orchard Court Residential Home 29/11/05

Orchard Court Residential Home 12/01/05

Orchard Court Residential Home 24/09/04

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

CARE HOMES FOR OLDER PEOPLE Orchard Court Care Home Bacchus Lane South Cave East Yorkshire HU15 2ER Lead Inspector Jo Bell Unannounced 24 May 2005 9.30 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 Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Orchard Court Residential Home Address Bacchus Lane South Cave East Yorkshire HU15 2ER 01430 421549 01430 421360 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) Mr Stephen Waltham and Mrs Sheila Waltham Mr John Paul Weldrick Care Home only 42 Category(ies) of DE(E) Dementia - over 65 registration, with number of places Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2005 Brief Description of the Service: The Orchard Court is a care home offering personal care for up to forty two older people who have dementia care needs. The home is purpose built and accommodation is on two floors and within single and double rooms, some with en-suite facilities. There are communal areas for the service users and gardens with seated areas for the service users to enjoy.The home is situated in South Cave village close to the local bus route and is within walking distance of the shops and local amenities. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Tuesday 24th May 2005 and lasted for six hours, with two hours preparation time. During the inspection six residents were spoken with in detail, six members of staff and two healthcare professionals. The manager of the home and the provider were available throughout the inspection. The home has a pleasant atmosphere with friendly and professional staff attending to service users. 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 Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 6 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 Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 7 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) None of these standards were assessed (Standard 6 is not applicable) EVIDENCE: Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 8 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) 9, & 10 Residents are treated with respect and dignity and their medication needs are met. EVIDENCE: Residents were observed taking their medication, the home have a policy in place for the administration of medication. The medication room was inspected, this was clean and tidy. Daily fridge temperatures were recorded and were kept at four degrees centigrade approximately. The manager said that only those staff who had completed a twelve week intensive medication course with an NVQ Level three or above are responsible for medication. When speaking with staff they confirmed that they had attended a good medication course in which they had learnt lots about administration, safe keeping and disposal of medications. The book where controlled drugs are recorded was inspected, this was completed correctly and controlled drugs were stored appropriately. The manager is a registered mental nurse and clearly has a good knowledge of the medication system in the home. Medication charts were examined and these were completed and well maintained. The drugs trolley had bottles and packets of medication stored correctly. The home does not offer homely remedies for staff or visitors. One resident self medicates. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 9 Privacy and dignity in the home are maintained, whilst observing in the lounge it was evident that residents were smartly dressed in their own clothes, with combed hair (the hairdresser is available every Wednesday) and make up for the ladies. One resident said that the staff look after her well, one man was observed being helped to put his cap on as he could not manage himself. Staff were observed knocking on doors prior to entering and staff throughout the day were observed speaking in a pleasant manner with residents. The manager had a good rapport with the residents which was clearly reciprocated. Doctors and District Nurses consult with residents in their own rooms, this was observed and confirmed when speaking with residents. Staff were also observed moving and handling residents using slings, hoists and a range of equipment. This was carried out in a dignified manner with full explanations given by staff to residents as to what was about to happen. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 10 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 The current activities on offer are not sufficient. However, this should be addressed when the new activity schedule is implemented. Residents are encouraged to voice their opinions. EVIDENCE: Residents discussed the activities they like to participate in. Previous activities included dominoes, cards, bingo, painting pots, entertainers and trips in the local village. There are also visits from the local church. One lady said she liked to go out for long walks as she used to be part of the community walkers. Some residents said that there were very few activities, the hairdresser is available on a Wednesday, however no other activities were planned for the rest of the week. Currently one of the three deputies is responsible for the activities and in discussion she felt that she did not have the time to organise these activities and continue her care work. This was discussed with the manager who following the last residents meeting has developed a daily schedule for activities. Residents have discussed their preferences and a specific member of the care team will have designated time to facilitate a range of activities. These will also be displayed on the activities board near reception. The manager is hoping to implement this shortly. Six staff members were spoken with who all felt more activities needed to take Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 11 place. Care staff should then be responsible for documenting the activities in individual care plans. Residents spoken with said they often have visitors and sometimes this is in the morning, afternoon or evening. The home have a notice in reception stating that visitors can come at any reasonable time. The visitors book confirmed that friends, healthcare professionals and relatives had all visited. Staff spoken with discussed which residents had frequent visitors. One ninetytwo year old lady said it was recently her birthday and she had lots of visitors bringing cards and presents. Residents have a range of needs within dementia care. The dependency levels currently in the home are low to medium. Some residents spoken with are clear that they like to have breakfast at a certain time, then stay in the lounge and have morning coffee and perhaps watch television until lunchtime. One resident was seen reading her newspaper before coffee time. One member of staff was observed asking residents what they would like to eat for tea that day. A choice was offered and residents were able to decide which food they preferred. Some residents were observed in their rooms having lunch whilst others were in the dining room. This was through personal choice. Residents said they join in with meetings and issues are discussed and actioned promptly. This was confirmed when speaking with the manager. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 12 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) 16 & 18 Complaints are dealt with appropriately and staff are knowledgeable on adult protection. EVIDENCE: Residents said they were happy to complain to staff if they had any concerns. Throughout the day the manager and staff were seen chatting with residents and asking them how they were. One resident said that they have residents meetings and any issues are raised there. No new complaints have been reported since the last inspection, and it was evident that the culture of the home promotes openness and transparency. Residents were heard being vocal and asking for drinks, the toilet, and newspapers. Staff were happy to oblige with a friendly manner. The complaints procedure is available and residents obtain a copy of this with the service users guide when they are admitted to the home. All six staff spoken with said that the manager would deal with minor issues before they became a complaint in a friendly and professional manner. Residents said they were treated well and staff looked after them. When speaking with staff they had a good understanding of adult protection. Scenarios of potential issues with staff, relatives and residents were discussed. Staff suggested that they would like some formal adult protection training to consolidate the information they already have. During the day no areas of concern were raised regarding the treatment of vulnerable adults. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 13 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 The environment is pleasant, clean and well maintained. EVIDENCE: The home has pleasant communal areas with colour coded corridors to assist the residents who have dementia needs. Some residents spoken with said they knew how to find their room independently. There are plenty of communal areas for residents and the dining room is bright and airy. One resident said that she did not have a choice of rooms but she is quite happy with the room she has. There are pleasant grounds for residents to sit in when the weather is good. A refurbishment plan is in place and the maintenance person ensures the home is well maintained and safe for the residents. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 14 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) 27 & 29 Staffing levels in the home are satisfactory. Service users are not protected by the home’s recruitment procedure. EVIDENCE: The home meets the minimum staffing levels. There are 804 care staff hours provided per week, this excludes the manager of the home. The minimum level is 760 hours as set down in the previous health authorities staffing notice. Residents felt that on some occasions there were enough staff and sometimes there were insufficient. Currently there are three overseas staff who have completed their induction training. It was evident through interaction observed between two of these staff and residents that their communication skills needed to be improved. In discussions with staff this was consistently highlighted as an issue that needs to be addressed. The manager is aware of this issue. During the inspection staff dealt with residents in a prompt and efficient manner. One deputy was on duty in the morning with five care staff. This was adequate for forty one residents with low to medium dependency levels. The home has a housekeeper and domestic staff during the week. Recruitment in the home was discussed, through observation in the lounge, dining room and in residents rooms it was evident that staff were knowledgeable on the client group. Six staff were spoken with and all had undertaken appropriate induction training enabling them to carry out their role. Two staff records were examined and in one the individual had one reference Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 15 instead of two, which was from a family friend, and in another the CRB check was standard and not enhanced. This was discussed with the manager and provider who were not aware of the guidance from the CRB. Staff who provide direct care must have an enhanced check with a protection of vulnerable adults check at the same time. This must be addressed as soon as possible to safeguard the vulnerable adults in the home. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 16 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, 32, 33, 34, 35, & 37 The manager runs the home in an efficient and professional manner. Quality assurance systems are in place. EVIDENCE: The manager of the home is a registered mental nurse who has completed the NVQ Level 4 in Management. He is a very experienced nurse who is aware of how to meet the needs of residents in the home. Residents spoken with all commented that he was friendly, professional and a good manager. One lady said he was more of a friend who she could discuss any issues with. The home has an open culture where concerns can be discussed either on a one to one basis or through the quality assurance process. The process covers philosophy and aims of the home regarding quality assurance. Audits take place on a regular basis and the outcomes are analysed in detail, action is then taken by the home. On a yearly basis there is a customer satisfaction questionnaire, Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 17 residents meetings take place monthly and staff have optional meetings which have good attendance, these are all minuted. The home has a business plan in place this was inspected for 2003-2004. The home received the investors in people award in 1997. This shows a commitment to maintaining a good standard of care within the home, this information also interlaces with the quality assurance process. There is evidence that the home is financially viable. A plan of refurbishment is in place and residents commented that their environment was pleasant with plenty of communal areas. The home does not deal directly with residents’ finances. All rooms have locks on the doors and lockable spaces. When inspecting residents’ rooms this was evident. The manager said that residents can choose to lock their rooms if they wish to safeguard personal belongings. Some residents were observed carrying handbags and purses with them in the lounge. Relatives come in on a regular basis and settle the account for hairdressing or chiropody as needed. All fees are handled separately away from the home. Records are all well maintained and stored appropriately in accordance with the Data Protection Act 1998. Residents or relatives can have access to care plans and records as needed. Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 18 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 3 3 3 x 3 x Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 19 NA 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 OP29 Regulation 19 Requirement Two written references must be obtained prior to employment. All staff who provide personal care to residents must apply for an enhanced CRB check(with POVA check). The manager and provider must familarise themselves with the latest CRB guidance. Timescale for action 1st June 2005 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 OP12 OP18 Good Practice Recommendations The activities schedule should be implemented within 4 weeks Staff should undertake specific adult protection training Orchard Court Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross YORK YO32 9GZ 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 Care Home J53-J04 S946 Orchard Court V226435 240505 Stage 4.doc Version 1.30 Page 21 - 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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