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Inspection on 28/11/05 for Orchard House Nursing Home

Also see our care home review for Orchard House Nursing Home for more information

This inspection was carried out on 28th November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents were very positive about the care they received, the staff and the food at the home. Some comments included ` lovely staff and good food.` `I like it here because they keep me busy.` and ` No complaints I am very comfortable.` The care plans are particularly detailed and they give useful information about the care each resident needs. The staff said the morale of the whole care team is good and that they are supported to do their jobs.

What has improved since the last inspection?

The manager has addressed the previous requirement to ensure that staff are deployed throughout the home. This enables the residents sitting in the lounges can get assistance when they cannot reach the call bells.

CARE HOMES FOR OLDER PEOPLE Orchard House Nursing Home Grosvenor Road Mablethorpe Lincs LN12 1EL Lead Inspector Unannounced Inspection 28th November 2005 10:00am erland-Dee 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 DS0000061935.V261043.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 Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Orchard House Nursing Home Address Grosvenor Road Mablethorpe Lincs LN12 1EL 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) 01507 472203 Orchard House Nursing Home Ltd Mrs Jean Anne Pemberton Care Home 52 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (46), of places Physical disability (9), Terminally ill (1) Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the registration the following placements are allowed: 7 PD aged 40 years and over accomodated in Rooms 1, 2, 3, 8, 9, 47, and 48. 2 PD (Respite only) aged 25 years and over accomodated in Rooms 6 and 16. 1 TI aged 55 years or over. 3 DE(E) aged 60 years and over. 12th July 2005 Date of last inspection Brief Description of the Service: Orchard House is a large detached residence with a new extension situated in large grounds. The extensive grounds are largely laid to lawn with mature trees and there are pleasant and landscaped seating areas for service users. The home is situated 500 yards from the town centre of Mablethorpe and there is good access to public transport and local community facilities. The home provides nursing and personal care to 52 older people and has nine beds, which may be used for younger adults who have a physical disability. The homes registration also includes 1 bed for a terminally ill service user. Accommodation is provided on ground and first floor levels and there is a passenger lift. There are 44 single and 3 double bedrooms provided, 9 of which are en-suite. There are a variety of lounges, a large dining room and conservatory. The home is appropriately adapted to meet the physical needs of older and disabled people including lifting appliances and assisted bathing. The statement of purpose sates that the home’s aims are to provide an ever improving and caring service within the community that reflects their commitment to treat clients as individuals. Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one morning and consisted of speaking with the residents, the manager and senior nursing staff as well as case tracking by using a sample of 3 residents files. A sample of relevant documents were seen and a partial tour of the home took place. What the service does well: What has improved since the last inspection? What they could do better: Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 6 The home provides a good standard of care. A requirement has been made for the night staff to receive supervision as the day staff already do. It was also discussed with the manager that when bed rails are used there should be a risk assessment to demonstrate whether there should be covered or not. 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 DS0000061935.V261043.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 Nursing Home DS0000061935.V261043.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): 2 The manager provides the information that the residents and prospective residents need about the home. EVIDENCE: A sample of the residents contracts were seen, they included terms and conditions and they had been signed by the resident or their representative. These records are kept securely and the residents receive copy. The home has reviewed the statement of purpose and this is available. Orchard House Nursing Home DS0000061935.V261043.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): 7,8,10 The registered person is meeting people’s personal and health care needs, whilst maintaining the resident’s privacy and dignity. EVIDENCE: A sample of the care plans were seen. They were detailed and the staff said they do use these to inform the care they give. There was evidence of resident involvement, with a number of the documents signed. The care plans included information about people’s preferences and likes and dislikes. Each person’s activities were listed and this corresponded to the activities listed in the hallway. The staff did assess people’s health and ensured that the residents got access to health professionals. People’s medical conditions are monitored and two residents spoke about the ‘excellent medical care’ at the home. Suitable equipment had been provided in consultation with the district nurses. During a talk with one resident they told the inspector that the staff were very kind and they always knocked on his door, even though he likes to keep it open during the day. During lunch several resident’s told the inspector that the staff were very good and helped them in a way that they liked. Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 10 Orchard House Nursing Home DS0000061935.V261043.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): 13,14,15 The manager provides a home where the residents are consulted and able to choose their individual lifestyle. The kitchen staff supply a balanced and interesting menu that meets peoples expectations and needs. EVIDENCE: The residents talked about their relatives visiting and the care plans included a social history and the contacts for family members. The residents said they enjoy the food at the home. A daily menu is displayed and people are able to choose alternatives. Specialist diets are catered for and the kitchen staff were well aware of the residents needs. It was observed that the staff were helping the residents with their meals if this was needed. The kitchen had good stocks of fresh and dry goods. The home holds regular residents meetings and people are consulted and able to make choices about their daily lives. Orchard House Nursing Home DS0000061935.V261043.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): 16,18 The home takes action to protect the residents and complaints are taken seriously and acted upon. EVIDENCE: The inspector saw the complaints procedure and the forms, although no complaints had been received since the last inspection. When asked the staff knew what they would do if they suspected abuse. The staff have received training as part of their induction and N.V.Q courses and the home had the adult protection procedures. The notice board in the hallway displays a notice giving information about how to gain advocacy services, and some of the residents were aware of this. Orchard House Nursing Home DS0000061935.V261043.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): 20,22,23 The home is well decorated and furnished and the residents do have the equipment they need. The home needs to carry risk assessments when bed rails are used. EVIDENCE: The inspector saw most of the home and it was well furnished and comfortable. The residents had the equipment they needed to maintain their independence and increase their mobility. The resident’s bedrooms were personalised and the residents said they like their rooms and felt comfortable. Several residents require the use of bed rails for their safety. It was noted that the care plans include a consent form for these that is usually signed by a representative. One set of rails did not have covers. This was discussed with the manager. A risk assessment must be carried out to demonstrate whether a cover should be fitted or not. Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 14 Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 15 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 The home provides enough properly recruited staff to meet the residents needs. EVIDENCE: A sample of the staff files were seen and they showed that the home recruits staff in a way that protects the residents as far as possible. All the documents were clear and stored securely. The staff said they work as a team and that morale is good. They added that there are enough staff for them to carry out their duties. It was seen that during lunch there were enough staff in the dining room to help those residents that required assistance. The staff have been redeployed following the last inspection and the person in charge of the shift now identifies a member of staff who regularly checks the lounge areas and they assist anyone who cannot reach a call bell. Orchard House Nursing Home DS0000061935.V261043.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): 35,36 Although the day staff are regularly supervised there was no evidence to demonstrate that the night staff had been. The manager does have systems to protect the financial interests of the residents. EVIDENCE: The manager told the inspector that the training manager does supervise the night staff, however there were no written records. There were records for the day staff, who had received regular supervision. This supervision includes formal one to one meetings and also assessment of their work by more senior staff during their duties. A requirement has been made for the night staff to benefit from this opportunity as well. The manager explained to the inspector that most of the residents either look after their own money or relatives help them. Where the home does take on Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 17 this responsibility there is a safe storage place and accounting procedures. Residents do also have there own lockable facilities. Orchard House Nursing Home DS0000061935.V261043.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 X 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X 3 X 2 3 X X X STAFFING Standard No Score 27 3 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 2 X x Orchard House Nursing Home DS0000061935.V261043.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP36 Regulation 18 Requirement Timescale for action 30/02/06 2 OP22 13(4)(a) The registered person must ensure that all staff working at the home receive formal supervision. The registered person must 30/02/06 conduct a risk assessment to determine whether covers should be used on bed rails and these records must be kept. 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 DS0000061935.V261043.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000061935.V261043.R01.S.doc Version 5.0 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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