Inspection on 29/11/05 for Orchard Court Residential Home

This inspection was carried out on 29th November 2005.

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

The inspector 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 24/05/05

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 Residential Home Bacchus Lane South Cave East Yorkshire HU15 2ER Lead Inspector Jo Bell Unannounced Inspection 09:30 29 November 2005 th 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 Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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 Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Orchard Court Residential Home Address Bacchus Lane South Cave East Yorkshire HU15 2ER 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) 01430 421549 01430 421630 Mr Stephen Waltham & Mrs Sheila Waltham Mrs Sheila Waltham John Paul Weldrick Care Home 42 Category(ies) of Dementia - over 65 years of age (42) registration, with number of places Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 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 Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The 2nd unannounced inspection of 2005 took place on Tuesday 29th November. The registered manager and deputy were available to assist with the inspection. One inspector spent 5 hours at the home. A tour of the premises took place, service users and staff were spoken with and documentation including care plans, nutritional assessments, recruitment files and training records were inspected. Policies relating to adult protection and infection control were discussed. 11 key standards were assessed and the previous requirements and recommendations had been actioned. The home provide good quality of care within a pleasant environment. The home is committed to providing NVQ Level training for care staff which the residents benefit from through the care they receive. What the service does well: What has improved since the last inspection? The home’s recruitment practice has improved. Potential employees have enhanced CRB checks which include protection of vulnerable adults check. The home now have a robust system in place which helps to safeguard residents. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 6 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 Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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 Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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): 3 (Standard 6 is not applicable) The home completes a detailed assessment on potential residents and only admits new residents if their needs can be met. EVIDENCE: Pre-admission assessments are carried out by either the Manager or the Proprietor of the home. This information is obtained for all residents regardless if they are self funding or care managed. This assessment contains detailed information relating to health, social and psychological well being of an individual. This then is used as a basis for developing the service users’ care plan. The assessments inspected were user friendly and gave a good understanding of how to care for each individual. The home could clearly make a judgement as to whether a person’s needs could be met by the home. The manager had the experience and skills to make a judgement as to the suitability of an individual living in the home permanently, and was clear about the categories of registration. This included the rationale for reassessing a person if their needs could no longer be met and the outside agencies which would be involved in this process. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 9 Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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 Service user plans clearly identify how an individual is cared for. Healthcare needs are met. EVIDENCE: Service users care plans were inspected. These were based on the activities of daily living. Specific care plans were implemented where necessary. Risk assessments for moving and handling, falls, prevention of pressure sores were all in place. Care plans were reviewed on a monthly basis and these were discussed with the service user where appropriate. The home have access to healthcare services provided through the local hospital and surgery. Evidence in the care plans identified that the chiropodist, community mental health team and district nursing services visit the home when needed. A discussion took place regarding the completion of nutritional assessments. Currently the home records resident’s weight on a monthly basis. A nutritional assessment tool is available, however this is currently only used when a need has been identified. It was suggested that this assessment is carried out on all service users to provide baseline information, from this a decision can then be made as to whether a specific care plan needs to be implemented. The home Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 11 stated that they would refer to a GP who would then liaise with the community dietician for support and advice. The home have an accident book and are aware of how to report incidents under Regulation 37. Appropriate action is taken when an incident occurs and staff know how to complete the accident book correctly. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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): 15 Service users enjoy home cooked food which is provided in a congenial setting. EVIDENCE: At lunchtime residents were observed eating stew and dumplings, jacket potatoes and vegetables. Those residents who were spoken with all said how good the food was. One lady stated she was really looking forward to her lunch, the portion sizes were suitable and the food was home cooked by the chef who has worked in the home for 11 years. Care staff ask the residents what they would like to eat for breakfast, lunch and supper. A menu is available which is rotated on a three-four weekly basis. The home has two dining areas and residents are able to eat in their own room if preferred. These areas are clean and tidy and suitable seating, tables and crockery are provided. The chef is aware of how to provide a diabetic diet, soft, pureed and normal diet. Staff liaise with the chef to ensure individual needs are met. The chef may speak to the residents through informal discussions. The home have residents meetings where food and drink can be discussed. The kitchen area was inspected which was found to be well maintained. Food was stored correctly and the chef was aware of how to probe food to ensure the temperature was correct. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 13 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 Service users are safeguarded by the robust complaints and adult protection procedures in place. EVIDENCE: The home have a robust complaints procedure in place. Residents are aware of how to complain and staff feel confident in discussing any issues with the manager. A copy of the procedure is available. The home previously received a complaint which was investigated by the CSCI. The outcome of unsubstantiated has been discussed with the home and the complainant in the past few weeks. No further complaints have been made. Adult protection was discussed in detail with the deputy and manager of the home. Staff have received training in this area and are aware of the different types of abuse. The home have a policy and procedure in place and the manager is clear on the action to take if an allegation is made. Service users spoken with said they felt safe in the home and the staff were kind and caring and looked after them well. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 14 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): 26 In general the home is clean and hygienic and infection control policies ensure service users live in a pleasant environment. EVIDENCE: The home have an infection control policy in place alongside a policy for the laundry area. Staff have attended training in this area and are aware of handwashing techniques, and the use of gloves, aprons and wipes. The home has a sluice room with a disinfector and red and white skips. The laundry room has a suitable floor covering with two washing machines and two driers available. Information regarding washing of ‘kylie sheets’ and soiled linen is on display. There are designated laundry staff who are responsible for washing, drying and ironing clothes. The home in general was clean and tidy and residents said they enjoyed living in this environment. It was evident in the lounge close to the dining room that there was a strong smell of urine. One resident was eating her lunch next to this area. This smell must be removed. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 15 The manager of the home stated that many carpets in the home had been replaced, this was evident. However in the ‘green wing’ the carpet in the corridor was stained and dirty looking. This is due to be replaced early next year. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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 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): 28,29 & 30 Service users are cared for by competent staff who have received appropriate training. The home has a robust recruitment system in place which protects service users. EVIDENCE: The home currently have 10 out of 16 staff who have achieved an NVQ Level 2 or above, this equates to 62.5 . This has a positive impact on the residents. Staff have the skills and knowledge to meet individual needs. The home is committed to supporting and training staff in all aspects of care. The home have a robust recruitment system in place. All staff now have undertaken an enhanced CRB check which includes POVA. These were inspected. Staff records were examined and two written references are obtained prior to employment, a standard form is sent to referees to complete. Application forms and details of the interview were available and found to be completed appropriately. The home have a recruitment policy in place and the manager is aware of equal opportunities. Staff training was discussed with the manager. Induction is given which is equivalent to Skills for Care, this covers fire safety, moving and handling, health and safety and practice issues. Staff spoken with felt this was extremely valuable and records were available to confirm the completion of the induction. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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 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): 38 Service users feel safe and comfortable in their environment. EVIDENCE: A tour of the premises identified that areas were safe and well maintained. Fire extinguishers had been checked, emergency lighting was available and water temperatures were within expected parameters. Records were available to confirm this.This was confirmed by residents. The maintenance person is responsible for facilitating mandatory training for staff. This includes fire safety, moving and handling, health and safety, infection control, first aid and food hygiene. Records inspected showed that this generally takes place. A qualified first aider is on duty at all times and staff are aware of the fire procedures and how to move and handle residents and use specific equipment. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 18 A visit from the environmental health officer took place in November 2004, one recommendation was that staff attend a food hygiene course. It was evident that the kitchen staff spoken with had not attended this course since 1995. However, in discussions with the Manager it was stated that a course is due to take place in January 2006 relating to food hygiene. This course should have been completed sooner. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x 1 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 2 Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 20 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 OP26 Regulation 13 Requirement The smell of urine in the lounge area must be removed The stains on the carpet in the green wing need to be either removed or the carpet needs to be replaced. Timescale for action 06/12/05 2. OP26 13 06/12/05 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 OP38 Good Practice Recommendations Catering staff should attend food hygiene training within the next 3 months. Orchard Court Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection York Area Office 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 Residential Home DS0000000946.V265678.R01.S.doc Version 5.0 Page 22 - 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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