Inspection on 10/05/05 for Orchard House

This inspection was carried out on 10th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orchard House 29/06/07

Orchard House 02/12/05

Orchard House 07/10/04

Orchard House 06/07/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Orchard House Maureen Terrace Seaham Co Durham SR7 7SN Lead Inspector Kathy Bell Unannounced 10th May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Orchard House Address Maureen Terrace Seaham Co Durham SR7 7SN 0191 581 7668 0191 513 0388 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) European Services for People with Autism Ltd. Tracy Porter Care Home 7 Category(ies) of Learning Disability (7) registration, with number of places Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 07.10.2004 Brief Description of the Service: Orchard House is registered to provide care (but not nursing care) for 7 people with learning disabilities between the ages of 18 and 65 years. The home provides a specialist service for people with autism spectrum disorders, including challenging behaviour. The home is a large detached building, with seven single bedrooms, two living rooms, kitchen/dining room and a garden area. It is near the town centre of the coastal town of Seaham. Orchard House is managed by the organisation now known as European Services for People with Autism Limited which was established in 1987 and runs a range of services for younger adults with autism. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two inspections which have to be carried out each year. It took place during one day in May 2005 and during the inspection, Kathy Bell looked at the building and some records, met with all the residents and talked to seven of the staff. Residents were not able to take part in the inspection fully because of their learning and communication difficulties. Relatives had said they were very pleased with the care provided when they had been asked to complete a survey form by the home. The current registered manager has just returned to work from maternity leave but plans to work only part-time now. The deputy manager, who has been acting as manager while she was off, is going to apply to be registered as manager. For some months, one of the residents has needed much more attention after becoming ill and this has had effects upon other residents. The home has shown its commitment to its residents who have lived there for many years by continuing to provide care in these circumstances. However the management of the home accept that this has been a difficult time for staff and are aware of the stresses upon them. What the service does well: The home provides a service specially for people with autism. The staff receive training to help them understand residents needs and to communicate with them. A number of staff have worked in the home for many years and residents benefit from their knowledge and confidence in responding to them. Staff write down a very detailed description of the care each person needs, making sure that the staff act consistently which is particularly important for the people in this home. They are active in arranging for any health care needs to be met and work closely with doctors. The cook helps residents have a healthy diet but also recognises food should be a pleasure. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 6 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 House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 7 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 House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 8 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) EVIDENCE: Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 9 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 The information staff need to meet each resident needs is written down and kept up-to-date. EVIDENCE: Each resident has a plan which describes the care they need. These were very detailed and included all the information staff need to make sure they respond to needs in a way suitable for each person. They include assessments by specialists such as a speech therapist. They are kept up-to-date and every six months a meeting is held about each resident to discuss whether the home is meeting all their needs and if they should be doing anything differently. Records also showed that staff tried hard to find out the cause if a resident seemed unhappy. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 10 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, 15 & 17 Staff try and provide suitable activities to help the residents enjoy life and develop their skills. Staffing levels recently have made this more difficult to do. The home helps residents keep in touch with their families. Residents are offered healthy, enjoyable meals, suitable for each persons needs. EVIDENCE: The activities which residents can take part in are limited by their special needs. Although the organisation which runs the home has a special day centre this is only suitable for one of the residents at the moment. Staff do help residents lead a healthy life with lots of walks and there is a poly tunnel for a resident who is interested in gardening . Residents can choose from a wide stock of videos and music videos. Staff also involve residents in day-to-day tasks such as tidying their rooms. However staffing levels have been lower than usual recently (see standard 33) and this has prevented staff taking residents out as much as they would like to. They have managed to continue providing short holidays in small groups or individually. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 11 Staff help residents keep in touch with their families and if necessary, take them for visits home. There is a choice of two different meals at mealtimes and residents come to the kitchen and pick which they want. The cook knows which residents need special diets . She makes sure each person has the food they need but does not feel they are treated differently. The menus seem varied, balanced , healthy and enjoyable. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 12 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) 18, 19 & 20 Staff know how personal care must be provided for each person to meet their needs and respect their wishes. They pay attention to medical needs and make sure any medical problems are investigated and treatment is provided. The systems for giving medication to residents are satisfactory. Although the current staff had received training , written guidelines about the care of a resident with diabetes were not available. It is essential to have these in case other staff who are not so familiar with the care of this resident have to take responsibility for her care. EVIDENCE: Staff keep up-to-date the care plans which describe the personal support each person needs and how they like to live their lives. Records showed how staff had responded to a residents behaviour by trying to find out any possible medical causes for it. Staff work closely with residents doctors to make sure that residents health needs are met. They keep detailed records so that they can advise the doctor on the effects of any changes of medication. They keep good records of treatment , including routine appointments for dental checkups, eye tests and chiropody. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 13 There is a proper system for handling medication and recording when it is given to residents . Staff had received training in checking the blood sugar levels for a diabetic resident but there were no written instructions on what to do when the blood levels were above or below a certain point. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 14 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 A satisfactory complaints procedure means that staff know how to respond to complaints and any relative or resident who wants to complain knows how to do this and how ESPA should respond. Staff respond when residents are unhappy about something, even though they are unable to complain formally. The home takes all reasonable steps to protect residents from abuse, by providing training, procedures and oversight by senior staff. EVIDENCE: The home has a satisfactory complaints procedure and this has been produced in a form which could be easier for some residents to understand.Staff have recorded when they have tried to explain this to residents. Although a resident is not making a complaint as such, staff are responding to his unhappiness about the placement. Staff receive regular refresher training on preventing abuse and the organisation has satisfactory policies and procedures to protect residents. Care plans include detailed guidelines on how staff can respond to any challenging behaviour, including the use of restraint . Senior staff check the records of any incidents involving restraint to make sure that residents are kept safe from harm. Full records are kept of money handled for residents and these are checked by ESPAs finance department. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 15 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 home provides comfortable accommodation, which although it does not meet new standards, meets residents’ needs in most ways. However the building needs rewiring to meet current standards and ESPA is making plans to have this work done. The building appeared clean on the day of inspection but there were slight unpleasant smells in some areas . Although staff always have to work hard to control these, it has not been a problem previously and it is possible that recent difficulties and staffing levels have caused some problems. (See standard 33) EVIDENCE: The home provides domestic style accommodation in a large detached house. There are two living rooms and a kitchen/dining room. All the bedrooms are single but none have ensuite toilets. They do not have the recommended wash hand basins and few have the recommended four electrical sockets. It is generally well maintained but is an older building and now needs rewiring.ESPA is making plans to carry out this work as well as other refurbishment. There was a slight unpleasant smell in one bedroom and a living area used by one resident. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 16 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 Reduced staffing levels have made it harder for staff to provide enough activities for residents. EVIDENCE: It has been difficult for the home to provide its usual staffing levels of at least 4 staff during the day for a number of reasons including staff sickness. At times there have only been 3 staff on duty which severely limits the activities staff can provide for residents outside the home. For several months two residents have needed individual attention for much of the time which has increased the stresses and demands upon staff. The management of ESPA has recognised these problems and are trying to increase the number of staff available to work in the home. Staff from other homes have helped out at times. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 17 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) EVIDENCE: Orchard House B54_S8494 Orchard House V224258 100505_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 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 2 x x 3 x 4 Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Orchard House Score 4 4 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 42 Regulation 23 Requirement A safety certificate for the electrical wiring of the building must be provided. This requirement has not been met within the previous timescale set (30.11.04) but ESPA has firm plans to carry out the work necessary. Written guidelines on how staff should respond after checking blood sugar levels should be provided for staff. A minimum of 4 staff must be on duty during the waking day Timescale for action 1.12.05 2. 20 13 30.6.05 3. 33 18 30.6.05 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. 2. Refer to Standard 37 33 Good Practice Recommendations The manager must achieve NVQ 4 in care and management by 2005 or be working towards these qualifications. 50 of the care staff must achieve NVQ 2 in care by 2005. Orchard House B54_S8494 Orchard House V224258 100505_stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 House B54_S8494 Orchard House V224258 100505_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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