Inspection on 20/07/05 for Orchard House Nursing Home

This inspection was carried out on 20th July 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.

Other inspections for this house

Orchard House Nursing Home 20/03/07

Orchard House Nursing Home 29/12/05

Orchard House Nursing Home 08/02/05

Orchard House Nursing Home 04/08/04

Orchard House Nursing Home 16/03/04

Orchard House Nursing Home 22/01/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Orchard House Nursing Home 126 Whitehouse Common Road Sutton Coldfield Birmingham B75 6DS Lead Inspector Kath Strong Unannounced 20 July 2005 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 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 E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Orchard House Nursing Home Address 126 Whitehouse Common Road Sutton Coldfield Birmingham B75 6DS 0121 378 0272 0121 378 3220 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Orchard House (Midlands) Ltd Mrs Deborah Kelly Care Home 31 Category(ies) of Older People, Dementia registration, with number of places Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered for the maximum number of 31 people. 2. Registration category is nursing care for reasons of old age and dementia, over 65 years of age. (N), OP, DE(E). 3. Two people who were under 65 years of age at the time of admission can be accommodated and cared for by reason of physical disability. 2PD Date of last inspection 8 February 2005 Brief Description of the Service: Orchard House is an attractive purpose built home situated within a residential area of Sutton Coldfield on the outskirts of Birmingham. The home is registered to provide personal and nursing care for up to 31 persons over the age of 65 years who may suffer from dementia. Communal facilities consist of a main lounge with a large conservatory off, a separate dining room and a large reception area with comfortable seating, which is well frequented. There is a large enclosed rear garden with an extensive paved area where residents can sit during clement weather. There is sufficient off road parking at the front of the premises to accommodate up to nine vehicles. Bedrooms are located on the ground and first floors, they consist mainly of single rooms and some shared rooms are also available. Two single and two shared rooms include en-suite facilities. There are local amenities very close to the home that includes a small row of shops and a public house/restaurant is directly adjacent to the home. Another parade of shops is within a short walking distance. Local public transport is accessible including a regular bus service to the city centre. The home provides a warm, comfortable and homely environment for residents to live in. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the visit was to carry out an unannounced inspection. The registered manager was unavailable, the responsible individual provided information and assistance throughout. The inspection focussed upon the few requirements made from the last inspection and the standards of care provided. The outcome was determined by various methods. In depth discussions were held with the responsible individual, five residents and four relatives and one trained nurse were spoken with. Three staff were observed whilst carrying out their roles. Relevant documentation was examined including three care plans. A partial tour of the premises was carried out. Feedback at the conclusion of the visit was provided to the responsible individual. What the service does well: The home addresses requirements in a positive fashion and on a timely basis. Such actions have resulted in very few requirements being made at the last inspection the majority of which have now been actioned. The responsible individual plays an active role within the home and is present during each weekday. The home has a long standing reputation for delivery of good standards of nursing care and for maintaining appropriate links with relatives. The programme of in-house and external activities is extensive and varied. Meals are well presented with attention to detail in respect of likes, dislikes and preferred portion sizes. The registered nurses are regularly allocated administration time to complete and update care plans and other relevant documentation. There is a good staffing structure with clear lines of accountability and communications. The roles of the responsible individual and the registered manager are well defined. A well established and comprehensive quality assurance system is in place. There is emphasis placed upon hygiene practices with an extensive cleaning schedule in place for all areas of the home. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 6 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 E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4, and 5 Prospective residents are provided with adequate information for them to make informed decisions about the home. Through the process of assessments the home demonstrates its ability to meet residents needs. EVIDENCE: The statement of purpose and service user guide were found to be comprehensive at the last inspection and no changes to the services have been made since the visit. A copy of the service user guide is issued to each resident and a further copy is available in the reception area. Prior to offering a placement a senior member of staff the home carries out a full pre-admission assessment in order to determine that the home has adequate facilities and equipment to meet the identified needs. The assessment may involve the input of other health professionals. A trial period is provided and a contract of the terms and conditions of residency is supplied to each individual. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 9 Where a resident’s condition changes further assessments are conducted to ensure the homes ability to meet the continued needs and when necessary alternative accommodation may be sought. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11 Care plans are comprehensive but require further details in respect of formal reviews. The system in place for the administration of medications is good, clear and comprehensive in ensuring that resident’s needs are met. The health needs of all residents are fully addressed with evidence of multi-agency involvement on a regular basis. Staff practices ensure that resident’s dignity and privacy are well maintained. EVIDENCE: The approach to care planning is comprehensive and includes all aspects of physical and mental health needs, nutritional and manual handling assessments and risk assessments. Staff carry out monthly basic observations and reviews of the care plans. The six monthly formal reviews must clearly state the names of all persons who participated in the review and their designation/relationship. A diverse range of external professionals provides regular assessment and advice to the home. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 11 Observations of the administration of medications revealed that staff practices safe methods in this aspect of care. The home has a sound system in place for the receipt, storage, auditing and disposal of medications. Staff use the preferred term of address when liaising with residents. All personal care is provided in the privacy of the resident’s own room or a bathroom. Without exception residents provided positive feedback, “very satisfied”, “staff are wonderful”, “all staff are very friendly and you can ask them for anything”. The home has a written policy in relation to care of very ill persons. A resident was seen by his GP during the inspection and consultation concerned his preferences in respect of care being provided by the home or by the local hospital. The next of kin had also been consulted and information given was that the home would check with their wishes in order to ensure full compliance is achieved. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14 The home provides an excellent recreational programme; links with the community are good thus enriching resident’s opportunities. Residents are consulted and exercise autonomy over their lives. EVIDENCE: The activities organiser produces a weekly programme that takes into account the preferences of residents. Wheelchair users are assisted by staff and relatives in order to ensure their ability to participate. The relative of a resident commented, “he does participate with floor games”. Some care staff organise themed events. There are systems in place for fund raising for the purchasing of further equipment. Residents are consulted about how the money should be spent. Entertainers regularly visit the home. Outings provided are varied and interesting. The relatives spoken to said that they are able to visit at any time. One relative reported, “ I visit every day and can always have a cup of tea”. Regular residents meetings the minutes of which provide evidence that residents influence the day-to-day running of the home. Input of members of the legal profession are organised by the resident or their relatives. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16, 17 and 18 The home has a satisfactory complaints system and evidence that resident’s opinions are listened to and acted upon. Arrangements for the protection of residents are satisfactory. EVIDENCE: The written complaints procedure is comprehensive, a copy is issued to each resident and a further copy is on display in the reception area. Historically the home receives very few complaints, none have been received since the last inspection. Residents meetings are held regularly, the minutes indicate that they influence the day-to-day running of the home. Two residents had been assisted in voting during the general election and others voted by post or proxy. There was evidence that members of the legal profession hold meetings with residents. The homes written policy in respect of adult protection is satisfactory and the home adheres to the Birmingham multi-agency guidelines. There is a rolling programme for staff training in this aspect of care. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 20, 21, 22, 24 and 26 The home has a maintenance programme in place, which ensures that ongoing improvements are made. The overall quality of the furnishings and fittings are of a good standard. EVIDENCE: All areas of the home are furnished and decorated to a good standard and are well maintained. There was evidence of forward planning of works in order to maintain the aesthetic appearance and a homely atmosphere. The reception and stair carpet has recently been replaced and curtains were also being replaced. Communal rooms provided a choice of lounge, conservatory, dining room or garden, all of which are spacious and well appointed. Four bedrooms include en-suite facilities and there are adequate communal toilet and assisted bathing facilities on each floor. Bedrooms are decorated to a high standard and advice was given regarding the plans to renew the vanity units in each bedroom. A lockable facility is supplied to each bedroom. Bedrooms are personalised to Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 15 the extent of the occupant’s preference. Work has commenced in the fitting of suited door locks and where completed residents have been offered a key to their room. The home has a good supply of adaptations and equipment including pressure relieving equipment. Hygiene practices are of an exceptionally high standard. The cleaning programme for all areas of the home was noted to be very comprehensive and adhered to. A further improvement since the last inspection was the issue to staff of alcohol hand rub dispensers for use when delivering personal care. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Staff morale is high resulting in an enthusiastic workforce that works positively to improve the quality of life of residents. Staff are provided with the knowledge and skills to meet the health care needs of the current client group. EVIDENCE: As with previous inspections the home was meeting the required staffing levels. Every trained nurse is allocated six hours every two weeks to complete administration duties and to ensure that care plans are up to date. This is viewed as being good practice. Staff receive all mandatory and refresher training to carry out their roles effectively. There was evidence of further training being supplied when staff have displayed an interest and it is determined that residents would benefit from such knowledge. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 37 There is a clear development plan and vision for the home, which has been effectively communicated to staff. Resident’s files are stored safely whilst ensuring staff access at all times. EVIDENCE: Although the registered manager was on leave the responsible individuals presence in the home every weekday ensures continuity and smooth running of the home. Staff were observed readily discussing various issues with the responsible individual. There appeared to be an open and transparent relationship between the responsible individual, staff, residents and residents. Resident’s files were maintained in a logical sequence to ensure ease of access and stored within the nurse’s office. Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 x COMPLAINTS AND PROTECTION 3 3 3 3 x 2 x 4 STAFFING Standard No Score 27 4 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x 3 x x x x 3 x Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 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. 1. Standard OP7 Regulation 15(2)c Requirement Formal care plan reviews must include details of persons present and their designation/relationship. The home must complete the already commenced work in the fitting of suited bedroom door locks. Timescale for action 31st August 2005 31st October 2005 2. OP24 16(2)c 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 Good Practice Recommendations Orchard House Nursing Home E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 E54 S24875 Orchard House NH V240606 200705 Stage 4.doc Version 1.40 Page 21 - 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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