Inspection on 13/02/07 for Orchard House

This inspection was carried out on 13th February 2007.

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

The inspector 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 17/09/08

Orchard House 18/10/05

Orchard House 13/12/04

Orchard House 04/05/04

Orchard House 27/01/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Orchard House 4 Orchard Road Havant Hampshire PO9 1AN Lead Inspector Mr E McLeod Unannounced Inspection 13th February 2007 10:00 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 DS0000012274.V323538.R01.S.doc Version 5.2 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 DS0000012274.V323538.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard House Address 4 Orchard Road Havant Hampshire PO9 1AN 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) 02392 475 038 Ms Margaret J Tompkin Ms Margaret J Tompkin Care Home 15 Category(ies) of Dementia (15), Mental disorder, excluding registration, with number learning disability or dementia (15), Old age, of places not falling within any other category (15) Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: Orchard House provides residential accommodation for a maximum of fifteen older people, of either sex, with mental health problems. The home is a detached building situated in a residential area of Havant and has benefited from several improvements to include expanded car parking and garden area. Accommodation is provided for by way of eleven single bedrooms, one of which has an en-suite facility, and two double bedrooms. There is a lounge/day room and a separate dining room, and seating is provided in the large landscaped garden. The home is within walking distance of the town centre, where the residents can access the local shops and amenities, and access public transport. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was arranged to update assessments of key standards from the National Minimum Standards made at the previous inspection. The key unannounced inspection visit to the home was undertaken by one inspector on the 13th February 2007 from 9.50 a.m. until 2.20 p.m. The registered person had completed a pre-inspection questionnaire and information from this plus evidence from previous inspections has been used to inform the planning and inspection process, and this report. Evidence gained during the inspection visit also informs this report. Eleven “Have Your Say” surveys were received by CSCI, some completed by residents and some completed by their relatives, and information provided in these surveys has been used in this report. On the day of the inspection visit, the inspector spoke with three residents, three staff, and the registered manager. A partial tour of the premises was made. The inspector sampled four sets of admission records for residents, and four sets of care plans. Three sets of staff recruitment and training records were also sampled. The inspector observed a lunch sitting, and interactions between staff and residents. A number of policies, procedures, and health and safety records were also sampled. What the service does well: What has improved since the last inspection? Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 6 Improvements to the premises include the refurbishment of two bathrooms, ongoing redecoration, and double glazing. Hot water temperature valves are being introduced to all hot water outlets to ensure safe hot water. Registered manager Ms Tompkin believes that a more settled resident group has allowed the staff to provide more leisure activities in the home. 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. The summary of this inspection report can be made available in other formats on request. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No resident moves into the home without having had his/her needs assessed and been assured that these will be met. No residents are being referred solely for intermediate care. EVIDENCE: Fees are £420 per week. Four sets of preadmission information were sampled, which indicated that the needs of residents are being properly assessed before admission is agreed. Specialised intermediate care is not being provided. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 9 Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All the resident’s health, personal and social care needs should be set out in the individual plan of care. The registered person is promoting and maintaining the health of residents and ensuring access to health care services to meet assessed needs. Residents, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Residents feel they are treated with respect and their right to privacy is upheld. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four sets of care plans and care records were sampled. In one set of care plans, guidelines for staff were not provided for dealing with aggression or unwelcome visitors which were noted as issues for that resident. Otherwise, care plans were seen as setting out the resident’s needs and how they will be met, and regular reviews of the care plan are being carried out. Specialist medical visits, such as GP, chiropody and CPN visits were being recorded on all care records sampled, which indicated that residents’ health care needs are being met. Staff interviewed gave examples of how residents’ psychological health is monitored and supported. The inspector was advised by registered manager Ms Tompkin that no resident is at present assessed as being able to hold their own medication, excepting one resident who holds inhalers. Medication policies and procedures are in place. No residents were due to receive medication during the time the inspector was on the premises, so medication procedures were not observed during this visit. Staff interviewed gave examples of how personal care giving is ensuring that the resident’s privacy and dignity are respected at all times. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities available are flexible and varied to suit residents’ expectations, preferences and capacities. Residents maintain contact with family, friends and the local community as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing diet in pleasing surroundings at times convenient to them. EVIDENCE: The inspector sampled a monthly diary where the manager logs what activities have gone on. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 13 On the day of the inspection, the hairdresser and a lady who comes to do residents’ nails were providing what staff described as a “pampering day”. Period music was playing in the main lounge, and residents were responding to this. Staff said that residents enjoy the ‘music for health’ sessions and musical entertainment, and that the crafts session is attracting 8 or 9 residents at present. Many links are being maintained with the local community – the local school come in at festival times, the church visit to do communions and services, and the townswoman’s guild visit. Staff advised the inspector that a tea tray is always provided for visitors, and gave examples of how staff are assisting residents to maintain contact with family and friends. Staff said that baths are given in the evening, which suits residents more and accords with when they would take baths in their own homes. The inspector observed during the visit that residents are supported to make their own choices in how they are cared for and in how they spend their day. A member of staff who does sleep ins said that all the residents sleep well. Menus seen indicated that a balanced diet is being provided. The inspector observed a lunch sitting, where the food provided was hot and appetising and well enjoyed by the residents. Residents who needed help with eating received this discreetly and sensitively, and there was a calm and unhurried atmosphere in the dining room. The cook said that she has come to know what residents like and don’t like, and the alternatives they like to be offered. Diabetic diets are catered for. Residents interviewed said they like the food provided Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: The record of complaints was seen, and this indicated that complaints are being recorded, investigated, and outcomes are passed on to the complainant. The adult protection policy and procedure for the home was seen, and this helps protect residents. Training records seen indicated that staff are receiving regular training in adult protection. Staff interviewed said that to deal with aggression they would take the resident to their bedroom, give them a cup of tea, sit down and talk with them. Staff said that residents seem to forget their outbursts quite quickly when this is dealt with in a calm and supportive manner. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 15 Mrs Tompkin said that the home does not manage the financial affairs of any resident, and that cash is not generally held on behalf of residents. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: A partial tour of the premises was made by the inspector. Improvements to the premises since the previous inspection have included the retiling of two bathrooms, and new carpets in several rooms. Improvements to the garden and patio areas have been beneficial for residents. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 17 Mrs Tompkin said the garden area was secure enough for residents to go for walks in the garden, and that some enjoyed doing this. The main communal areas are the sitting room and dining room, which are comfortably arranged and furnished. Bedrooms visited were noted to be lockable, and suitable for meeting the resident’s needs. Some residents had brought their belongings and some of their furnishings with them. Good bathroom and toilet facilities are provided for residents. Mrs Tompkin advised that hot water valves were presently being installed to ensure that hot water temperature at outlets used by residents is controlled. The kitchen was found to be orderly and clean. The laundry room is in a separate building in the garden, and has washable floor and walls, and industrial washing machines with a sluice cycle, which are being regularly serviced. All areas of the home visited were clean, hygienic, and odour free. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by the numbers and skill mix of staff. Residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: On the day of the inspection visit, staffing numbers provided were adequate to ensure that residents’ needs were being met in a calm and unhurried way. There were sufficient staff on duty to ensure that residents who needed assistance at lunch time were receiving this. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 19 One relative responding to a CSCI survey wrote that “there is always a member of staff if needed” and that “everyone in Orchard House is very supportive”. Mrs Tompkin has advised the Commission that of 11 care staff employed, 6 have achieved the National Vocational Qualification (NVQ) in care at least at level 2, and 2 care staff are presently undertaking NVQ in care at level 2. Three sets of staff recruitment records were sampled, which indicated that a thorough recruitment procedure is being implemented which helps protect residents. It was the view of Mrs Tompkin that the careful selection of staff was ensuring that the atmosphere in the home remains good. Staff training records sampled indicated that regular staff training in core topics is taking place. Evidence was seen that structured induction training is being provided for new staff. A staff meeting takes place once per month, and staff interviewed felt well supported by the managers in the home. It was the observation of the inspector that residents were being treated with respect, and no incidents which indicated that residents were being discriminated against on account of their disability, gender or race were noted. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents 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 her responsibilities fully. The home is run in the best interests of service users. The health, safety and welfare of residents and staff would be promoted by the implementation of recent food health legislation. EVIDENCE: Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 21 Mrs Tompkin advised that the inspector that she continues to update her knowledge and skills, and has been undertaking the registered manager’s award at NVQ level 4. The inspector observed that Mrs Tompkin is accessible to her staff and residents, and this helps provide a relaxed and supportive atmosphere in the home. A quality review system which includes the views of residents is in place, and the recorded views of residents and others on the service provided were sampled. A summary of the views expressed and action to be taken has been made available. Mrs Tompkin has advised the Commission of the most recent services and inspections which have been carried out in relation to health and safety matters. Mrs Tompkin said she was not aware of recent changes to food safety legislation or the “Safer Food” system which has been introduced with the new food hygiene legislation since the previous inspection. Four sets of risk assessments on residents were seen. For one of the residents concerned, risk assessments did not cover all the risks identified on care records. Mrs Tompkin advised subsequent to the inspection that this risk assessment had been put in place. Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15 Requirement The service user plan must set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the resident are met. The provider must ensure that current food hygiene legislation is being complied with. The provider must ensure that all risk assessments are kept under regular review (previous timescale 20.9.05 not met) Timescale for action 27/04/07 2 3 OP38 OP38 12.1(a) 13.4 27/04/07 27/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Orchard House DS0000012274.V323538.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000012274.V323538.R01.S.doc Version 5.2 Page 25 - 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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