Inspection on 10/03/09 for Orchard House

This inspection was carried out on 10th March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Orchard House 27/09/06

Orchard House 01/02/06

Orchard House 04/08/05

Orchard House 08/03/05

Orchard House 04/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Orchard House 401 Shoreham Street Sheffield South Yorkshire S2 4FB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janis Robinson     Date: 1 0 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Orchard House 401 Shoreham Street Sheffield South Yorkshire S2 4FB 01142494255 01142494256 none Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Orchard Care Name of registered manager (if applicable) Ms Linda Margaret Anne Wake Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The service can accommodate existing service users when they reach the age of 65 provided their care needs can be met. Date of last inspection Brief description of the care home Orchard House is a care home providing services for up to ten adults with a learning disability. It is based in an inner city area of Sheffield. The home was originally two terraced houses, which have been converted into one dwelling. Accommodation is provided on the ground and first floors. The second floor provides office and sleeping in space for staff. All of the ten bedrooms are single, six have en-suite facilities. A communal bathroom is provided on the ground and first floor. Communal space consists of two lounges, a dining room and kitchen. A small laundry is provided. There is a small garden to the front of the property. Written information about the home and the latest CSCI (Commission for Social Care) inspection report is available from the home. Care Homes for Adults (18-65 years) Page 4 of 27 care home 10 Over 65 0 10 Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This unannounced inspection was carried out by Janis Robinson, regulation inspector. We have reviewed our practice when making requirements, to improve national consistency. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Prior to the visit the registered manager had submitted an Annual Quality Assurance Assessment (AQAA), which detailed what the service was doing well, what had Care Homes for Adults (18-65 years) Page 6 of 27 improved since the last inspection of 27/09/06, and any plans for improving the service in the next twelve months. Questionnaires about the home were sent to people living at the home, staff and health professionals. Four people that lived at the home, two staff and two health professionals returned their questionnaires. Comments from these are included in the report. On the 10th of March 2009, a visit to the home took place. A selection of records were examined, including two peoples care plans and records relating to the running of the home. The manager, deputy manager and the two staff on duty were spoken with about their roles, skills and knowledge. Five people that lived at the home were spoken with about the support they received. At the time of this inspection charges ranged from 307 pounds to 539 pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: Parts of the environment must be redecorated or refurbished so that good standards are maintained. Care Homes for Adults (18-65 years) Page 8 of 27 All staff recruitment records must be available for inspection to evidence that thorough checks have taken place. Staff supervision should take place more often so that staff are appropriately supported and appraised. Checks on the fire alarm must take place regularly to keep people safe. Staff must be provided with all aspects of health and safety training so that they have relevant skills. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were assessed prior to moving into the home to make sure these could be met. Evidence: The file of the most recent person to be admitted was checked, and it contained a comprehensive package of information that included a full needs assessment that was obtained prior to admission. Staff spoken with confirmed that, as part of the assessment process, this person had visited the home on several occasions to meet staff, other people living at the home and stay for meals before a decision to move in was made. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person had a care plan, to ensure his or her opinions had been sought and their needs identified. People were supported to make decisions and risks were identified to enable them to have some control over their lives. Evidence: Two peoples care plans were checked. They were well set out and easy to read. Where they had chosen to do so, people had signed them to evidence that they had been involved in the drawing up of the plan. Staff said that care plans were explained and discussed with people in individual key worker meetings. The plans contained a comprehensive range of information covering all aspects of personal, social and health care needs. The plans set out the staff action required to ensure identified needs were met. The plans seen had been regularly updated. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Risk assessments were in place in the plans checked. People spoken with said that they were able to make decisions. Staff were observed offering choices and discussing with people their plans for the day. All of the people spoken with said that they liked living at the home. Comments included Staff are smashing Cant get better than living here Staff give me all the help I need I can decide what to do, I am going to the shops today Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were provided with choice and opportunities to enjoy a good lifestyle. Evidence: Risk assessments had been undertaken and a minority of residents had been identified as needing staff support to access the local community to maintain safety. A range of activities was offered to people. A weekly activities programme was on display, this included games in the home, trips to local pubs and shops. People said that they often went out with staff, and regularly went to a local park. They said that they enjoyed the different activities. People were involved in local clubs and day centres, and took part in a local allotment project. The local church coffee mornings were also regularly attended. Staff confirmed that contact with family and friends was maintained, and the home Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: had an open visiting policy to encourage contact. People said that they helped with some house work, and were seen to wash and dry breakfast pots. Some people did their own laundry, and most were responsible for tidying their rooms. People helped plan and shop for the weekly menu. They confirmed that they were provided with food that they liked, and could have different things to eat if they wanted them. Plentiful stocks of food were available at the home, including fresh fruit and vegetables. People were seen to enjoy different foods at breakfast. All of the comments from people living at the home were positive and included I can go out when I want, and I enjoy going to the shops The food is good I can have different things to eat if I want Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs were monitored and supported so that these could be met. Evidence: The care plans checked contained information on personal care needs in detail. The plans set out the staff action required to ensure all identified needs were met. The recordings were specific and comprehensive. Staff spoken with had a clear understanding of peoples needs, and the knowledge to ensure personal care needs were met respectfully. All of the people living at the home were able to independently meet their personal care needs. The plans contained information on encouragement and advice. The care plans seen contained information on health care. Appointments and treatments with health care professionals were recorded. Access to specialists was supported. People said that they could see their doctor when needed, and had contact with dentists and opticians when required. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: A policy on medication was in place. All staff administered medication and had been provided with training on the safe administration of medicines. All medication was stored securely. Medication administration records were fully recorded and up to date. A pharmacist audited the medication systems at the home. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and safeguarding procedures in place protected people. Evidence: The complaints procedure was included in the information packs provided to people. It included contact details of the local office of the CSCI. In addition, the contact details were provided in each bedroom. The staff were confident that any compliant received would be listened to and taken seriously. No complaints had been received by the home. People spoken with were confident that any concerns would be responded to, comments included I can talk to any staff if I am worried and they will sort it out I have nothing to worry about There was an adult protection policy in place, which included the Department of Health guidance ‘No Secrets’. Staff undertook adult protection training as part of their National Vocational Qualifications (NVQ). People said that they felt very safe at the home. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. On the whole the building was well maintained. Some refurbishment and redecoration was required to maintain and improve standards. Evidence: A partial tour of the premises was undertaken. The majority of the home was maintained and decorated to an acceptable standard. However, some areas required attention to maintain standards. The stair and some corridor carpets were marked and dirty. It is acknowledged that these are due to be replaced within the ongoing maintenance plan. Some bedroom furniture was worn and showing signs of age, with handles missing. One bedroom seen had damaged decoration. One dining chair was dirty and a drawer front was missing off one kitchen cabinet. One bathroom had damaged flooring near the toilet. Halls and corridors showed some marks and damaged decoration. All of the people spoken with said that they had everything they needed in their rooms, and were happy with them. All of the bedrooms seen were well personalised and reflected the individual interests of the occupants. The home was clean and staff were seen to wear appropriate protective clothing. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment and training procedures protected people Evidence: The rota checked showed that agreed levels of staff were maintained. An on call system was in operation and staff reported that this worked well. Staff spoken with confirmed that they had been provided with job descriptions. The interactions observed between people living at the home and staff appeared respectful, and staff could detail peoples individual needs. People spoken with said that there was always enough staff on duty. Three staff files were checked. These contained the majority of the documentation required, and included proof of identity, a photograph and criminal records bureau (CRB) check. One file did not contain any references, however, the manager confirmed that these had been obtained and would locate them to place in the file. Copies of these would be sent to the inspector to evidence this. All of the staff on duty confirmed that they had given two references and other staff files sampled in addition to those checked in detail contained two references. Two of the application forms examined only detailed the years of previous employment and did not include the full dates. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: Staff spoken with confirmed that they had been provided with induction training, which included shadowing duties. Regular training was provided to staff, and individual training records were held. Nine of the ten staff had achieved NVQ level 2 in care, and the remaining staff member was applying to undertake the award. In their surveys, both staff said that they were given sufficient training that was relevant to their role. All staff confirmed that they received one to one supervision regularly. Supervision records examined indicated that supervision was provided to all staff , but some were not at the recommended frequency. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well managed. Health and safety systems, in the main protected people. Evidence: The registered manager was experienced and qualified. All of the staff and people living at the home said the managers were approachable and supportive. In their survey, one staff said Managers are very supportive and will always make time A quality assurance system was in operation, annual questionnaires were sent to people. The results of the most recent survey were seen, and all appeared positive. An action plan had been produced in response to the annual audit and was available at the homes office. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: Health and safety systems were in operation. No hazards were identified during the check of the premises. The fire book was checked, whilst weekly checks had been made on the fire alarm and emergency lighting, only two checks had been carried out since January 2009. This was brought to the attention of the deputy manager who carried out a test during this inspection visit. All of the staff spoken with said that they had been provided with fire training, and regular practice drills. One staff said that she had participated in four drills since she had started working at the home a year ago. Health and safety training was provided to staff on induction and as part of NVQ training. Refresher training was provided in food hygiene and first aid on an annual basis. However, further training under health and safety was not routinely provided, the records seen did not evidence that staff had been provided with infection control training other than that covered in food hygiene. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 24 23 All worn and dirty furniture must be cleaned or replaced to provide a pleasant place for people to live 30/06/2009 2 24 23 All parts of the home must be reasonably decorated. Identified areas must be redecorated to maintain standards 30/06/2009 3 34 17 Full staff recruitment records 30/06/2009 must be available for inspection to evidence that full checks have been carried out 4 42 13 Staff must be provided with all aspects of health and safety training, including infection control to keep people safe 30/06/2009 5 42 13 Checks on the fire alarm systems must be regularly carried out, in line with written guidelines 30/06/2009 Care Homes for Adults (18-65 years) Page 25 of 27 to protect people Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 34 36 Full dates of previous employment should be obtained so that thorough checks can be made Staff should be provided with supervision at least six times each year so that they are appropriately supported and appraised The physical condition of people should be monitored with a view to providing moving and handling training as soon as any person begins to require assistance to make sure needs can be met. 3 42 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!