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Inspection on 11/10/05 for Orchard House

Also see our care home review for Orchard House for more information

This inspection was carried out on 11th October 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

An experienced Registered Manager, who is able to discharge her responsibilities fully, manages the home. Residents are well cared for with their care plans well organised holding all the required information. Meals served at the home are varied and offer choice with fresh local produce often served. The home is clean, homely and comfortable. A communion is held monthly and is well attended. Staff are well trained and competent to do their jobs. Record keeping is up to date.

What has improved since the last inspection?

Resident`s health care and medication management have improved. Training for catheter care has been provided to care staff. Glass tumblers are available to residents if they require them.

What the care home could do better:

Advice to be sought from the fire authority around improving fire evacuation procedures; and arrangements to be made to check for asbestos. These safe working practices protect residents and staff. Seek advice from the Occupational Therapist for disability equipment to be arranged to meet the needs of a designated resident. For good practice improvements to be made to the residents needs assessment format and staff recruitment records to ensure relevant information is recorded.

CARE HOMES FOR OLDER PEOPLE Orchard House Weston Drive Market Bosworth Warwickshire CV13 0LY Lead Inspector Helen Abel Unannounced Inspection 11th October 2005 1:00 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 House DS0000001702.V254560.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 House DS0000001702.V254560.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Orchard House Address Weston Drive Market Bosworth Warwickshire CV13 0LY 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) 01455 292988 01455 292988 Mr John William Nunn Mrs Barbara Elsie Nunn Mrs Sharon Heather Turner Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (5), Physical disability of places over 65 years of age (5) Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one under the age of 55 years may be accommodated in the home in category PD. Service User Numbers - PD or PD(E) No more than 5 people who fall within categories PD or PD(E) may be admitted in the home when there are already 5 persons within those categories/combined categories already accommodated within the home. 4th April 2005 Date of last inspection Brief Description of the Service: Orchard House is one of fifteen homes owned by Mr and Mrs Nunn. The Registered Providers set up the Broadoak Group of Care Homes in 1986. Mr and Mrs Nunn have 17 years experience in providing nursing and residential care. Orchard House is set on a quiet residential road in Market Bosworth. The home is a modern building set on one level surrounded by pretty garden areas, which are maintained by a gardener and enjoyed by residents. The accommodation comprises of single rooms and double rooms all with en-suite facilities. The home provides care for 30 service users. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection during a weekday afternoon over a 4hour period. A part tour of the building took place with care records, policies and procedures inspected. There was the opportunity to talk with three residents. A visitor and staff were also interviewed. The Registered Manager was present throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 to 5 Residents benefit from an admission process, which works well and ensures that the placement is right for the individual. EVIDENCE: A Statement of Purpose/Service User Guide is available in the foyer. The Registered Manager undertakes written assessments of prospective residents before entering the home. A suggestion was made around improving the assessment format. Trial visits are flexibly arranged with new residents and their families/supporters with a copy of the Statement of Purpose/Service User Guide always made available. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 to 10 Residents health, personal and social care needs are satisfactory and set out in an individual plan of care. EVIDENCE: Care plans were comprehensive, well presented and included a residents photograph. Residents medicine records were sampled and examined and were compliant. The administrations of medicines systems were in good order. A resident confirmed “ They look after you here. I have had my eyes tested and my feet seen to, and the dentist has been to see me”. Another resident said, “ My clothes are cleaned frequently, it’s good.” Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 9 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 Mealtimes meet the lifestyle of individuals. EVIDENCE: Meals provided are freshly prepared and cooked with fresh products obtained from the local outlets, the butcher’s supply’s sausages, bacon and free-range eggs. Special diets are catered for. A range of meals and choice is available each day. A likes and dislikes list has been drawn up to ensue all residents wishes can be met. A menu is displayed in the dining room. Resident’s comments around meals are as follows: “The food is okay, you pick what you want. Sometimes it’s not hot food”. “The meals are good some days and bad others but are varied” A visitor confirmed, “There is a good choice of food. They all ways have different meals”. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 10 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): 17 Residents’ legal rights are protected. EVIDENCE: The Registered Manager confirmed voting papers for the general election had been secured for all residents and distributed, resulting in some residents using their postal votes. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 11 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): 19,21,22,23,24 Orchard House is homely, comfortable, clean and hygienic. There is a shortfall around fire safety and protecting residents. EVIDENCE: The Registered Manager discussed a recent incident around fire evacuation procedures and the ability to move a resident to the designated fire point. The Registered Manager should seek further guidance from the fire service on this matter and update fire procedures and the fire risk assessment accordingly. All other fire checks were in order. The Registered Provider has almost completed upgrading the windows with UPVC. This was due to some of the windows being cold and draughty. All bedrooms viewed were clean and homely. One new resident said “I was allowed to bring my furniture from my house into my room, and I have my hair done every Wednesday.” Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 12 A resident raised with the Inspector about the need for adaptations. This was discussed with the Registered Manager whom agreed to pursue this with an occupational therapist. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 13 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): 30 The staff group are effective and able to meet the individual needs of residents. EVIDENCE: Staff receive ongoing training in manual handling, medication management, infection control, food hygiene, emergency first aid and other training. The District Nurse has provided catheter care and insulin care training to key staff. More than 50 of the staff group have National Vocational Qualifications in care level 2. This ensures staff are trained and competent to do their jobs. A visitor reported, “I have seen staff be very patient with residents and caring.” A resident said, “Staff are good. I get on with them ever so well.” Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 14 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): 31,32,34,36,37,38 Residents live in a home, which is run and managed by a person fit to be in charge. Policies and procedures are generally in place; these promote and safeguard the well being of residents and staff. EVIDENCE: The Registered Manager has been in the care industry for 23 years since her mental health nurse training in 1981. She has worked within the NHS, Social Services and the Independent sector concentrating on caring for the elderly. She has been a Registered Manager at Orchard House since February 2001 and is still a Registered Nurse. She has also undertaken training with the staff team to update her knowledge and skills whilst running the home. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 15 Resident’s money and financial records are safely held and well organised. Supervisions are held regularly for all care staff and yearly appraisals are held. All record keeping examined was up to date and accurate. The Registered Person has a legal duty to check for Asbestos in the premises. This requirement is outstanding since December 2004 and must be met to in order to confirm a safe environment for residents and staff. Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 16 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x 2 x 3 2 3 3 x x STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x 3 x 3 3 2 Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 17 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 OP19 Regulation 13 Requirement The Registered Person shall after consultation with the fire authority make adequate arrangements- For the evacuation, in the event of fire, of all persons in the care home and safe placement of residents. Prompt advise to be sought from the fire authority with any subsequent action taken, and the home’s fire risk assessment updated to reflect advice and any changes made. 2 OP22 23 The Registered Person shall ensure that suitable adaptations are provided. For the identified resident arrange support from the Occupational Therapist. The Registered Person is required arrange a competent person to undertake a check for asbestos and produce a report/risk assessment to this effect. Timescale expired 4th December 2004. DS0000001702.V254560.R01.S.doc Timescale for action 12/10/05 12/10/05 3 OP38 12 11/11/05 Orchard House Version 5.0 Page 18 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 OP3 Good Practice Recommendations The needs assessment format should be updated to include the following: • The date of the assessment • The person competing the assessment printed name and signature. • The names of people present contributing to the assessment • The resident’s signature (where possible). Include on staff recruitment files evidence of when criminal records (CRB) checks were completed and sent for processing. 2 OP37 Orchard House DS0000001702.V254560.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 DS0000001702.V254560.R01.S.doc Version 5.0 Page 20 - 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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