CARE HOMES FOR OLDER PEOPLE
Orchard House The Walk Withington Herefordshire HR1 3PR Lead Inspector
Wendy Barrett Unannounced Inspection 16th February 2006 09:20 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 DS0000060771.V284022.R01.S.doc Version 5.1 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 DS0000060771.V284022.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Orchard House Address The Walk Withington Herefordshire HR1 3PR 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) 01432 850671 Shaw healthcare Ltd Mrs Tina Jane Morgan Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th September 2005 Brief Description of the Service: Purpose built as a residential home in the 1970s, Orchard House is situated in the village of Withington, approximately 5 miles from the city of Hereford. The home is just off the main A4103 Hereford to Worcester road and it is situated in large gardens. There is a good-sized car park at the front of the building. The service is provided by Shaw Healthcare Limited who were registered as the Providers in June 2004. Orchard House aims to provide personal care in a homely setting for up to 28 older men and women who have care needs arising from the normal ageing process. Twenty of these places are in two self-contained living units on the first floor. There is a passenger lift so that residents don’t have to use the stairs. The two units are for permanent care. Eight places offer respite care and this service is based in a separate ground floor living unit. The accommodation and facilities have been substantially upgraded since Shaw Healthcare Limited were registered as the Providers. This work has resulted in a high quality environment that is well equipped to suit the needs of the residents. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that was undertaken between 9.20am and 12.50pm. All but one of key National Minimum Standards were addressed when the home was last inspected in October 2005. The remaining Standard relates to the catering service and was inspected this time. There was one requirement and two recommendations arising from the last inspection. The Care Manager was present during the inspection and she described action taken to develop the quality of the service since last October. Eight residents were met and were invited to comment on the meals provided. The cook was interviewed and assisted with an inspection of the main kitchen facilities and records. The report of the last inspection should be referenced to gain an overall view of the service provided at Orchard House. What the service does well: What has improved since the last inspection?
There has been more recruitment of permanent staff and now the home doesn’t have to use many agency staff at all. The support and supervision arrangements for each staff member have been strengthened now that the staff team is more stable. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 6 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 DS0000060771.V284022.R01.S.doc Version 5.1 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 DS0000060771.V284022.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 9 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): EVIDENCE: A resident described how he had recently fallen in his bedroom and had been unable to reach the call alarm. He had to shout for help. He suggested that a pendant alarm would be helpful in these situations. A recommendation is made for this idea to be given further consideration e.g. can pendant alarms be linked into the existing standard alarm system and should a few pendants be made available for residents who may benefit from this facility? Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 10 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 Residents are very happy with the meals and feel their views and requests are taken into account by the staff. There is good attention to ensure that meals are prepared in a hygienic setting by staff who understand about nutrition. EVIDENCE: The main kitchen has recently been extensively refurbished. It was clean and tidy when the inspection took place. The cook has extensive previous experience of catering in the health service and has obtained relevant qualifications for his role. He has also undertaken additional training to keep up to date with things like food hygiene regulations and dietary needs. Records were seen to confirm pre-planned menus, choice of dishes, cleaning rotas, temperature checks of food storage facilities and hot meats etc. before serving to residents. Residents gave examples of choice and were satisfied with the quality of the meals. There was also an example of a positive response from staff when the soup was not hot enough – ‘now it’s marvellous, very hot’. A resident had a poor appetite and was appreciative that there had been attention to his request to have less runny porridge. He also enjoyed being able to ask for ice cream when he felt like it. Staff were providing a liquid food supplement to ensure the resident received a balanced diet despite his poor appetite. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 11 Residents have a dining area and a kitchenette in each unit. The tables were attractively presented in readiness for lunch. Meals can be served in the privacy of the residents’ bedrooms if this is requested. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 12 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): EVIDENCE: Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: The home was clean, tidy and warm at the time of this unannounced inspection. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 14 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): EVIDENCE: There has been additional recruitment of permanent staff since the last inspection. Agency staff use is now minimal. There is work underway to recruit an activities co-ordinator who will be able to offer residents extra support in pursuing their leisure interests. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: The registered Care Manager continues work on her Registered Manager’s Award and expects to complete this work in a few months time. This is the currently recognised qualification. She has considerable previous experience and has undertaken relevant training. Shaw Healthcare operates an internal accreditation that is linked to the Registered Manager’s Award. This offers staff guidance in collating evidence in their work on achieving the recognised management qualification. A bi-monthly programme of one to one staff supervision has been reintroduced now the staffing situation has settled down. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x 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 x 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x 3 x x Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action 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 8 Good Practice Recommendations The resident’s suggestion that a pendant alarm would be helpful for some people should be given further consideration. Orchard House DS0000060771.V284022.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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