Inspection on 29/09/05 for Orchard House

This inspection was carried out on 29th September 2005.

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

Other inspections for this house

Orchard House 12/03/09

Orchard House 17/07/08

Orchard House 30/05/06

Orchard House 23/01/06

Orchard House 26/10/04

Orchard House 17/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Orchard House 155 Barton Road Kettering Northants NN15 6RT Lead Inspector Ms Sarah Jenkins Unannounced Inspection 3rd October 2005 13:25p 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 DS0000012879.V252548.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 DS0000012879.V252548.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Orchard House Address 155 Barton Road Kettering Northants NN15 6RT 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) 01536 514604 01536 485599 daryl.wilson@btopenworld.com R Sons (Homes) Limited Mrs Daryll Louise Wilson Care Home 33 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (33), of places Physical disability over 65 years of age (33) Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26 October 2004 Brief Description of the Service: Orchard House is located in a quiet residential area in Barton Seagrave, on the outskirts of Kettering. It is an extended detached property offering accommodation, in 26 single bedrooms and 3 double bedrooms, on the ground and the first floor, which can be accessed via stairs or a lift. There are extensive well-maintained and attractive grounds that are fully accessible to Service Users. Orchard House offers 32 places for older people over the age of 65 who require personal care and support due to age. Its registration includes the capacity to care for older people with physical disabilities and some with Dementia conditions. Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the afternoon to observe practices by staff and to meet with service users. Some service users have dementia conditions and thereby communication for some is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector spent an hour and a half preparing for the inspection and two and three quarters hours in the home. As the Registered Manager had not been available at the time of the inspection the Inspector also had a telephone conversation with her about aspects of the Inspection and management of the home. Eight comment cards were received from Service Users, responses were mainly positive. What the service does well: What has improved since the last inspection? The staff spoke positively of the training opportunities at the home. The target set for the achievement of National Vocational Qualification training has been met and there are currently 3 staff on National Vocational Qualification Level 3 and 2 staff on National Vocational Qualification level 2. The Registered Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 6 Manager has achieved the National Vocational Qualification level 4 since the last inspection. Activities have been increased, and there is a programme for morning and evening activities. Although the Inspector did not observe any activities at the time of the inspection, she was informed about a clothing party that had taken place the evening before. Previous Requirements and Recommendations made at the last Inspection have been met. 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 DS0000012879.V252548.R01.S.doc Version 5.0 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 DS0000012879.V252548.R01.S.doc Version 5.0 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): 1,3 Prospective Service Users needs are assessed and they are given sufficient information to make an informed choice about the home. EVIDENCE: Service Users who were able to chat with the Inspector, informed her that they were very happy with the process of admission. They had been enabled to make visits to the home, and felt that their needs and wishes had been thoroughly checked by staff at the home prior to their admission. The Inspector observed that the Service Users guide was available in vacant rooms. A new Service User was being admitted at the time of the inspection. The senior staff member who had visited the Service User in her own home was enabling the admission. Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 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): 7,8,9,10 Service Users needs are well met. Staff need to have greater focus on confidentiality issues. EVIDENCE: Service Users care plans have been improved since the last inspection and were seen to have been reviewed regularly. However, risk factors known to staff are not always clearly detailed. Service Users healthcare is well documented and Service Users who spoke with the inspector showed confidence in the home and its staff to support them properly in this area. Medication is generally well managed, although Service Users medication profiles did not always function effectively as a historical record of medications prescribed. There was a lack of privacy during a Service Users admission to the home as the final details of her care were being explored with the Service User and her relatives in the small sitting room. Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 10 Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 11 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 Service Users receive a nutritious and appetizing diet EVIDENCE: Service Users spoke positively to the inspector about the food provision noting that they were given choices and generally enjoyed their food. A Service User commented about the flexibility, as she had been out at the time of the main midday meal but was enjoying it on her return. The cook informed the Inspector about the way in which he consulted Service Users on a regular basis about their choices on the menu. He was observed to have a good rapport with Service Users. Records were kept of the individual variations from the menu offered. Service Users who were unwell were on food and fluid charts and their needs were checked regularly. Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 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): None These areas were not reviewed at this inspection. EVIDENCE: Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 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): 19,26 The premises are mainly pleasant and homely; some improvements are needed in the older area of the home. EVIDENCE: Service Users spoke positively about the home and its facilities. There is a large and pleasant garden area, which is enjoyed by Service Users. Two Service Users enjoy their regular involvement with the upkeep of the garden. The home was seen to be mainly very clean and free from malodour although two bathroom areas lacked disposable hand towels and the upstairs staff toilet area needed cleaning and repair. Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 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): 27,29 Service Users needs were generally well met by staff at the time of the inspection. EVIDENCE: There were two Assistant Managers, one senior care assistant and two care assistants on duty at the time of the inspection. A cook and a domestic staff member supported them. The Registered Manager had had to go out although she was detailed on the rota and one of the Assistant managers stayed on to cover during this very busy afternoon. Service Users were using several areas of the home and some were choosing to rest in their bedrooms during the early afternoon. Those who chose to speak with the Inspector were most complimentary about the staff and the Inspector observed warm and facilitating relationships. There were some periods during the Inspection when the large lounge was unattended for a short while and when the Inspector asked a Service User near to the call bell to call staff the Service User seemed not to understand, was unresponsive, and failed to call staff (although the senior on duty informed the inspector that she would normally do so). No other Service Users near by responded either, and therefore a Service User who was anxious about the mobility of another Service User was unable to alert staff to this. Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 15 The Inspector spoke with a recently recruited staff member who described a professional recruitment process. Staff records were not reviewed at this Inspection. Staff informed the inspector that they had regular training opportunities and a Senior felt that uptake of training had been good. Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 16 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): 33,35 Service Users best interests are central to the ethos of the home. EVIDENCE: The Registered Manager was not available at this inspection but the Inspector spoke to her later on the telephone and it was clear that she continues to have a good overview of the service. Staff were alert to Service Users needs and wellbeing, and had a good knowledge of their individuality. Senior staff were seen to be flexible in their working in the interests of the wellbeing of Service Users, and reported good team work among the management team and staff generally. A sample of records of monies safe kept on behalf of Service Users were reviewed and discussed. It was evident that staff promote Service Users independence through ensuring that their money is made available to them for purchases (such as the clothing party the previous evening) through discussion Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 17 with relatives. Advice was given on good practice relating to the records (see Recommendations) Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 18 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 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 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 2 x x x Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 19 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. 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 2 3 4 5 6 Refer to Standard 7 9 10 19 27 35 Good Practice Recommendations Care plans should include details of the management of known risks in relation to individual Service Users. Medication profiles should serve as a historical record of Service Users prescribed medications. Staff should be reminded of, and alert to the way in which Service Users confidentiality can be inadvertently breeched. Care should be taken to ensure the older part of the home is maintained and decorated to a reasonable Standard Service Users needs in the lounge areas should be regularly reviewed and monitored to ensure that there is sufficient staff supervision to minimize risk. Where Service Users are unable to verify what they are signing for, staff should ensure a second witness signature on financial transactions. (Monies safe kept on behalf of Service Users) Orchard House DS0000012879.V252548.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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. 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