CARE HOMES FOR OLDER PEOPLE
Orchard House Nursing Home Orchard House Nursing Home Kelfield York North Yorkshire YO19 6RE Lead Inspector
Mary Slattery Unannounced Inspection 14th March 2006 10:15 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 Nursing Home DS0000045991.V283803.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 Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Orchard House Nursing Home Address Orchard House Nursing Home Kelfield York North Yorkshire YO19 6RE 01757 248868 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) European Care (SW) Ltd Mrs Vikki Sara Hamblin Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30) Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Age range 55 years plus Service Users up to 30 (DE(E)) and 30 (MD(E)) up to a maximum of 30 service users 30th September 2005 Date of last inspection Brief Description of the Service: Orchard House is a care home providing nursing care for people from the age of 55 years with dementia and mental disorder. The home is owned by European Care (SW) Limited and was registered with the Commission in July 2003. Orchard House is located in Kelfield a rural area close to York and Selby and is situated in large private grounds. The accommodation provided is both in single and double bedrooms over two floors and there is a passenger lift for access to the first floor. There is ramped and level access to the home, ample parking for visitors and staff and a large garden area. Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection carried out on the 14th March 2006. The inspection took 4 hours plus 2 hours preparation time. A tour of the premises was carried out, which included service users private accommodation. Time was spent observing the activity in the home; talking and listening to the service users and the staff. The registered manager was available throughout the inspection and the findings were discussed at the close of the inspection. There have been changes to the management structure for Orchard House. There is now one registered manager who has responsibility for both Orchard and Lake House. Both of the homes are in the same grounds and the registered manager is able to oversee both homes. Each home will have a deputy manager in post to make sure that the day-to-day activity in the home is managed effectively and in accordance with the service users needs. What the service does well:
Orchard House provides service users with a bright, warm, clean and cheerful place to live. Information about the home, the facilities, the staff and the type of care service users should expect to receive is made available. The staff gather good information about the service users and put together a comprehensive plan of care to make sure that the service users health and social care needs are met. Opportunities are made available to staff to attend relevant training courses and they have regular supervision to make sure they are fully equipped to care for the service users. The staff listen to the service users and address any concerns they have and they keep relatives informed about the service users and have good and regular contact with external health care professionals on their behalf. All of the service users appeared well cared for and there was a range of communal space with comfortable seating for each person. The atmosphere was relaxed and there was good interaction between the service users and the staff and the staff were observed assisting service users in a sensitive manner. Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 6 The staff have established good communication systems, which keep them informed about the needs of the service users and any changes in their conditions. 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 Nursing Home DS0000045991.V283803.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 Nursing Home DS0000045991.V283803.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: These standards were not assessed at this inspection. Orchard House Nursing Home DS0000045991.V283803.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): 9 and 10. Staff were seen to be treating service users with kindness and respect. There are good systems in place to manage service users medication. EVIDENCE: The majority of the service users are not always able to say how they feel about life in the home or if they have any concerns about the way they are cared for. All of the service users appeared well cared for; they were well dressed and staff were observed attending to their personal needs in a respectful manner. The atmosphere was calm and there was plenty of interaction between the staff and the service users. The staff meet regularly throughout the day to discuss the needs of the service users to make sure they receive their care as assessed. The medication system and facilities were inspected and were found to be in good order with evidence that service users medication is reviewed on a regular basis. Orchard House Nursing Home DS0000045991.V283803.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): EVIDENCE: These standards were not assessed at this inspection. Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 11 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): 16. The staff take all complaints seriously and address them according to the procedure. EVIDENCE: The service users are not always able to make their concerns known to the staff and therefore it is the policy that where a member of staff may observe that a service user appears unhappy or distressed, this would be addressed according to the homes policy. There is a lot of information in the service users care plans about their daily routines, habits and behaviour that will assist the staff to determine if the service users are unhappy. Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 12 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, 22 and 26. The home was bright, warm and clean and improvements continue to be made to the premises and facilities. EVIDENCE: The home was warm, bright and clean and new carpets and flooring have been laid which has improved the corridor areas. There was a wide range of equipment being used to assist people with their mobility. The activities organiser has made the corridors very interesting. She has used her artistic talents to create pictures and tactile objects to interest the service users. Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed at this inspection. Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 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, 36 and 38. Changes have been made to the management arrangements and the staffing structure of the home. EVIDENCE: European Care has made changes to the management structure within Orchard House. The registered manager is now responsible for the overall management of both Orchard House and Lake House. To assist her in managing both services effectively, it is intended that a deputy manager will be appointed in both homes. The deputy managers will be responsible for the day-to-day running of the home ensuring that the service users receive their care as assessed. The registered manager has administrative support in both homes and has established communication systems to make sure that both services are effectively managed.
Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 15 A representative of the proprietor visits the home on a regular basis and produces a report on the conduct of the home. Copies of these reports were available for inspection and they showed that an audit of the service had been carried out. All of the staff have regular formal supervision the outcomes of which are recorded. There is a health and safety policy and procedure in place and all staff have regular health and safety training. Orchard House Nursing Home DS0000045991.V283803.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 3 X X X X 3 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 3 3 X X X 3 X 3 Orchard House Nursing Home DS0000045991.V283803.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. Refer to Standard Good Practice Recommendations Orchard House Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Nursing Home DS0000045991.V283803.R01.S.doc Version 5.1 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
