CARE HOME ADULTS 18-65
Orchard Hill 100 Orchard Hill Little Billing Northampton NN3 9AG Lead Inspector
Stephanie Vaughan Unannounced 1 August 2005 08:30
st 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Orchard Hill Address 100 Orchard Hill Little Billing Northampton Northants NN5 7QP 01604 403602 01604 403602100 Orchard Hill is a detached Home which provides personal care and support Compass Care Limited 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) Mrs Melanie Jane Lennon Care Home 4 Category(ies) of LD Learning disability x 4 registration, with number MD Mental Disorder x 4 of places Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: No person falling within the category of MD, Mental Disorder excluding Learning Disability or Dementia, may be admitted into the home unless that person also falls within the category LD, Learning Disability ie Dual Disability. Date of last inspection Brief Description of the Service: 100 Orchard Hill is a detached Home which provides personal care and support to 4 service users who require care due to a Learning Disability, some of whom may have an additional Mental Health Disorder. This is one of five homes run by the providers Compass Care and benefits from the support of a wider organisation. The Home is situated near to a large shopping centre and has good transport links to other areas of Northampton. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection was conducted over a period of four hours during which the inspector made observations and spoke to all of the residents. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where one resident was selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. A selection of staff files viewed and two members of staff were spoken to. Prior to the inspection a period of 90 minutes was spent in preparation, which included a review of previous inspection reports, previous requirements, the service history, notifications and comment cards received from residents and their representatives. Three comment cards were received from residents and these indicated a good level of satisfaction with the services provided at Orchard Hill. One comment card was received from a resident’s representatives, which indicated general satisfaction with the service provided, however indicated that their relative was not always able to make decisions and that they were not also consulted about their care. In addition the respondent indicated that there might not always be sufficient numbers of staff on duty and that they were unaware of the homes complaints policy. One requirement and one recommendation were made following the previous inspection and both of these have been met. What the service does well:
There has been one recent admission to the home and the resident was able to confirm that he had received written information prior to admission about the service provided at Orchard Hill. In addition the residents file contained appropriate pre admission assessment information formulated by the placing authorities. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 6 The resident was able to confirm that he had had the opportunity to visit the home, meet fellow residents and staff on various occasions prior to agreeing to move into the home. Residents are supported to make decisions in a variety of ways, through daily contact with staff, more formal one to one sessions and through residents meetings. One resident confirmed that he had recently acquired a bicycle and that arrangements were being made for him to receive instruction in cycling proficiency. In addition residents are involved in the recruitment process for new members of staff. Residents are supported to access a range of educational and occupational activities, within the local community. Residents were observed to be preparing to enrol at the local college for educational activities later in the day. In addition residents were able to confirm attendance at work placements appropriate to their individual interests. Residents confirmed access to social activities within the local community such as attendance at sporting and leisure facilities for swimming, football and bowling. Residents are also able to spend time with other residents from homes within the group for social activities and outings. Residents were able to confirm that daily routines are flexible within the constraints of their planned activities. Residents have appropriate privacy locks fitted to the bedroom doors and staff were seen to relate well to residents within the home, offering patient assistance with a range of activities. Individual plans of care evidenced that residents have access to appropriate general and specialist health care services. The registered manager confirmed that residents have access to annual health checks and that arrangements were being made to ensure that residents were also screened for testicular cancer, via the general Practitioner Residents spoken to confirmed access to and knowledge of the homes complaints policy. In addition they confirmed that they would know who to speak to if they had any concerns with the confidence that their concerns would be addressed. What has improved since the last inspection?
A new bathroom suite has been fitted and the bath replaced with a shower, more suitable to the needs of residents. The home now benefits from access to a permanent maintenance person employed within the group.
Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 7 The garden areas are reasonably well maintained and improvements have been made to the drainage to the rear garden. Comprehensive Movement and Handling Training has been conducted following a recommendation made at the last inspection. Training for the safe administration of medications has been scheduled for later this month and arrangements for Food Hygiene Training are currently being made. Arrangements for the management of staff training are currently being reviewed to identify staff training needs and specific issues relating to the needs of residents. Recent training in personality disorders has been conducted. The organisation is currently reviewing all of policies in the light of recent changes to the ownership of the home. Fire records were reviewed following a requirement at the previous inspection to ensure monthly testing of the emergency lighting systems. The records confirmed that this is now done on a monthly basis. What they could do better:
Individual plans of care must be reviewed to ensure that care plans are developed from the needs identified in the pre admission assessment and that care plans provide detailed instruction on the management of these needs. In addition care plans must contain detailed and specific instruction to staff regarding the management of challenging behaviour, personal care and any other needs that the resident may have. Risk management practices must be reviewed to ensure that any risks associated with the residents’ activities are identified, assessed and managed, to ensure safety of residents and others. When the management of residents care deviates from that required by the placing authority the written authorisation must be obtained and included within the individual plan of care. One resident confirmed that privacy is generally respected within the home although there had been one recent occasion where a member of staff had listened to a private telephone conversation being taken within the resident’s own room. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 8 Residents spoken to confirmed that they are involved in the menu planning process and that the meals are enjoyable. However one commented that they would like an alternative to roast chicken on a Sunday. The menu was viewed and seen to offer a varied and balanced diet, however the Sunday lunch entry was only recorded as the Sunday Roast The medication systems were generally in order. However one signature had been omitted from the morning medication, although examination of the packaging confirmed that the dose had been dispensed and the staff member spoken to confirmed that it had been given Residents confirmed that they felt safe living at the home; however there have been a number of incidents relating to the Protection Of Vulnerable Adults in recent months. Management within the organisation have addressed these through the appropriate channels and are mindful of the necessary referral processes. However a Protection Of Vulnerable Adults incident between two residents, one of which was from another home within the group, has been referred to the police and no further action is being taken. The individual plan of care was reviewed to ensure that risk assessments have been conducted to ensure that residents are protected when they meet up with residents from other homes. However no evidence was found within the care plan to demonstrate that this had been done. In the light of previous incidents within the organisation it is of concern that the residents bank statements were included within the individual plan of care thus compromising the other precautions made to protect security. In addition despite having been assessed as vulnerable to exploitation within the community by the placing authority this particular resident is now able to hold his own bankcard and there were no risk assessments in place to reduce or manage the associated risks. A spot check of cash against the records indicated a minor shortfall, although recent entrees have been signed to indicate accuracy. A significant number of staff employed are from overseas and a recent internal audit of staff files has highlighted that five of the existing staff have been employed without evidence of the appropriate Home Office Authority. 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 Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 9 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 Standards Statutory Requirements Identified During the Inspection Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 1, 2, 3 & 4 Residents and their representatives have access to appropriate written material and are assessed to ensure that the home can meet their individual needs and expectations. EVIDENCE: The Statement of Purpose is currently being reviewed to reflect recent changes to the ownership of the home. Discussion with the Registered Manager identified that this was to be addressed at the next management meeting due to be held in the near future. There has been one recent admission to the home and the resident was able to confirm that he had received written information prior to admission about the service provided at Orchard Hill. In addition the residents file contained appropriate pre admission assessment information formulated by the placing authorities. The resident confirmed that the home was generally able to meet his needs although the existing residents are somewhat older and have differing needs to the newest resident. However the individual plan of care identified that this has been considered by the placing authority and that further service developments planned for the near future will address this.
Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 11 The resident was able to confirm that he had had the opportunity to visit the home, meet fellow residents and staff on various occasions prior to agreeing to move into the home. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 6, 7, 8 & 9 Individual plans of care do not provide staff with appropriate and detailed instruction about how the needs of the residents are to be met. Risk management practices must be improved to ensure the safety of residents and others. EVIDENCE: The pre admission assessment documentation indicated that a resident was on a supervised discharge order and gave specific instruction regarding eight areas of need for this resident. However these were not developed in any detail within the care plan, to provide instruction to staff about the day-to-day management. The file contained only two care plans that related to the management of finances and unsupervised access to the community. Two risk assessments were in place relating to accessing activities unescorted and use of the lawn mower. Risk management is not adequately addressed within the plans, for example one resident was noted to be a smoker and yet his pre admission assessment had identified that he had a history of fire setting and no associated
Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 13 assessment had been conducted to consider the implications of this combination of factors. In addition, the supervised discharge order contained specific instruction that the resident must be supervised within the community at all times, whereas the risk assessment enabled the resident to have unsupervised access within the community between the hours of 09.00 hrs and 22.00hrs. There was no documented evidence found to evidence that authority had been obtained from the placing authorities. Furthermore there was very little instruction as to how other needs such as behaviour and personal care were to be managed. One of the comment cards received from a resident’s representative indicated that residents might not be able to make decisions about their care and their lives. However through observations and discussion with residents there is evidence that they are supported to do this in a variety of ways. Including one to one sessions with staff and through residents meetings. One resident confirmed that he had recently acquired a bicycle and that arrangements were being made for him to receive instruction in cycling proficiency and discussion with the manager confirmed that appropriate risk assessments were to be developed to support this activity. In addition residents are involved in the recruitment process for new members of staff. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 12,13, 15, 16 & 17 Daily life is managed well at Orchard Hill although improvements are recommended to privacy and the menus. EVIDENCE: Residents are supported to access a range of educational and occupational activities, within the local community. Residents were observed to be preparing to enrol at the local college for educational activities later in the day. In addition residents were able to confirm attendance at work placements appropriate to their individual interests. Residents also confirmed access to social activities within the local community such as attendance at sporting and leisure facilities for swimming, football and bowling. Residents are also able to spend time with other residents from homes within the group for social activities and outings. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 15 Residents spoken to were able to confirm that they were supported to maintain contact with relatives. Residents were able to confirm that daily routines are flexible within the constraints of their planned activities. Residents have appropriate privacy locks fitted to the bedroom doors and staff were seen to relate well to residents within the home, offering patient assistance with a range of activities. One resident confirmed that privacy is generally respected within the home although there had been one recent occasion where a member of staff had listened to a private telephone conversation being taken within the resident’s own room. Staff files contained evidence of a thorough induction programme, which addresses issues such as privacy and confidentiality. Residents spoken to confirmed that they are involved in the menu planning process and that the meals are enjoyable. However one commented that they would like an alternative to roast chicken on a Sunday. The menu was viewed and seen to offer a varied and balanced diet, however the Sunday lunch entry was only recorded as a Sunday roast. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 16 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 standard(s) 19 & 20 Residents have access to appropriate healthcare services, however accurate medication administration records are not consistently maintained. EVIDENCE: Individual plans of care evidenced that residents have access to appropriate general and specialist health care services. The registered manager confirmed that residents have access to annual health checks and that arrangements were being made to ensure that residents were also screened for testicular cancer, via the general Practitioner. The medication systems comprise a monitored dose system with corresponding medicine administration records. These were seen to be generally in order. However one signature had been omitted from the morning medication, although examination of the packaging confirmed that the dose had been dispensed and the staff member spoken to confirmed that it had been given. A spot check of boxed medication was checked and found to correspond with the records. Storage and disposal of medication was found to be in order. Further staff training in the safe administration of medication is scheduled for later this month. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 17 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 standard(s) 22 & 23 Residents are able to express their concerns and complaints are managed well. Protection Of Vulnerable Adults must be improved to ensure residents are protected from physical and financial abuse. EVIDENCE: Residents spoken to confirmed access to and knowledge of the homes complaints policy. In addition they confirmed that they would know who to speak to if they had any concerns with the confidence that their concerns would be addressed. The complaints policy contains appropriate information and both internal and external contact information and a copy of this is included in the resident’s individual plan of care. Residents confirmed that they felt safe living at the home; however there have been a number of incidents relating to the Protection Of Vulnerable Adults in recent months. Management within the organisation have addressed these through the appropriate channels and are mindful of the necessary referral processes. One investigation has resulted in staff dismissal and referral to the Protection Of Vulnerable Adults list. Other investigations into alleged financial irregularities are ongoing. A further Protection Of Vulnerable Adults incident between two residents, one of which was from another home within the group, has been referred to the police, however no further action is being taken. The individual plan of care was reviewed to ensure that risk assessments have been conducted to ensure that residents are protected when they meet up with residents from other
Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 18 homes. However no evidence was found within the care plan to demonstrate that this had been done. The management of residents’ monies is currently being reviewed in the light of a new corporate policy. One resident was seen to have a risk assessment in place to ensure that banking activity is supervised by the Registered Manager. In the light of previous incidents within the organisation it is of concern that the residents bank statements were included within the individual plan of care thus compromising the other precautions made to protect security. In addition despite having been assessed as vulnerable to exploitation within the community by the placing authority this particular resident is now able to hold his own bankcard and there were no risk assessments in place to reduce or manage the associated risks. A spot check of the resident’s cash was undertaken and this was stored appropriately within a locked and individual container. Balance sheets were regularly maintained and checked regarding the known withdrawal of cash from the bank. Some receipts were available to evidence expenditure although now that the home is not supervising the use of the card these records may well not correspond with the amount held at the bank. The spot check of cash against the records indicated a minor shortfall, although recent entrees has been signed to indicate accuracy. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 19 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 standard(s) 24 & 30 The premises are suitable for the stated purposes, being homely and generally safe and well maintained EVIDENCE: A limited tour of the premises was conducted, the communal areas being homely, comfortable and well maintained. A new bathroom suite has been fitted and the bath replaced with a shower, more suitable to the needs of residents. Individual rooms evidenced personalisation and the required standard of furnishing. However one of the windowpanes in a residents bedroom was cracked, some attempt had been made to secure the safety of this by means of adhesive tape. Discussion with the Registered manager confirmed that replacement glass had been delivered for fitting although this had been the wrong size. Arrangements were being made by the maintenance person to follow this up with the glaziers. The garden areas are reasonably well maintained and improvements have been made to the drainage to the rear garden.
Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 20 The home was clean and hygienic throughout. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 21 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 & 35 Staffing levels and staff training is managed to meet the needs of residents. However improvements to the recruitment processes should be made. EVIDENCE: The comment card received from a resident’s representative indicated that there might not always be sufficient numbers of staff on duty and this was confirmed by residents spoken to. Discussion with the Registered Manager confirmed that the home is currently recruiting more staff having one full time vacancy. Generally this vacancy is being covered adequately by the flexibility of existing staff, however unplanned absences occur from time to time and arrangements are made with other local homes within the group to maintain staffing levels. A selection of staff files were viewed and seen to contain appropriate Criminal Records Bureau Clearances and each of the files seen contained two references from previous employers. However a significant number of staff employed are from overseas and a recent internal audit has highlighted that five of the existing staff have been employed without evidence of the appropriate Home Office Authority.
Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 22 Staff files evidenced access to appropriate mandatory training including Induction, First Aid, Fire safety, Protection Of Vulnerable Adults and Health and Safety. Comprehensive Movement and Handling Training has been conducted following a recommendation made at the last inspection. Training for the Safe Administration of Medication has been scheduled for later this month and arrangements for Food Hygiene are currently being made. Arrangements for the management of staff training are currently being reviewed to identify training needs of staff and specific issues relating to the needs of residents. Recent training in personality disorders has recently been conducted. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 23 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Safe working practices are maintained. EVIDENCE: Staff have access to appropriate mandatory training to ensure safe working practices. The organisation is currently reviewing all of policies in the light of recent changes in the ownership of the home. Fire records were reviewed following a requirement at the previous inspection to ensure monthly testing of the emergency lighting systems. The records confirmed that this is now done on a monthly basis. Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 24 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23
ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 1 3 3 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Orchard Hill Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 25 No 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 6 Regulation 12 .1, 14.2 Requirement Timescale for action 30.09.05 2. 6 3. 6 4. 6 5. 6. 20 23 Individual plans of care must be reviewed to ensure that care plans are developed from the needs identified in the pre admission assessment and that care plans provide detailed instruction on the management of these needs. 12 .1 Care plans must contain detailed and specific instruction to staff regarding the management of challenging behaviour, personal care and any other needs that the resident may have. 13.4 Risk management practices must be reviewed to ensure that any risks associated with the residents’ activities are identified, assessed and managed, to ensure safety of residents and others 12.1, 14.2 When the management of residents care deviates from that required by the placing authority the written authorisation must be obtained and included within the individual plan of care 13.2 Accurate medication records must be maintained 13.6 Detailed risk assessments must be conducted to ensure that
C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc 30.09.05 01.09.05 01.09.05 01.09.05 01.09.05
Page 26 Orchard Hill Version 1.40 7. 23 13.6 8. 34 19 residents are protected when they meet up with residents from other homes. The management of residents 30.09.05 finaces must be reviewed to enure that residents are protected from financial abuse. Guidance must be sought from 01.09.05 the Home Office, Immigration and Nationality Direcotrate regarding the required authority for overseas staff to be working within the home 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 16 17 Good Practice Recommendations Staff should be reminded to respect the privacy of residents Menus should be a specific record of the food provided and should reflect the preferences of the residents Orchard Hill C51 C08 S63584 Orchard Hill V241659 010805 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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