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Inspection on 29/12/05 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 29th December 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 responsible individual takes an active role and is present in the home every weekday. This practice compliments the extensive experience of the registered manager in provision of a strong management structure. The home has a long standing reputation for satisfactory delivery of all aspects of the service and for maintaining appropriate links with relatives. The programme of in-house and external activities is varied and extensive. Attention to detail is paid regarding the presentation of meals including likes, dislikes and preferred portion sizes. The registered nurses are allocated dedicated administrative time to complete, update and review care plans. There is a good staffing structure with clear lines of accountability and communications. A well established and comprehensive quality assurance system is in place. Emphasis is placed upon hygiene practices including an extensive cleaning schedule for all areas of the home.

What has improved since the last inspection?

The two requirements generated from the last inspection have been addressed. One of the homes hoists has been replaced. Additional furniture for communal rooms has been purchased and redecoration carried out as per the maintenance programme. An electric organ has been donated to the home for use by staff or residents. A television has been purchased for the conservatory. The amount of domestic style lighting has been increased with the purchase of table lamps. There is an ongoing system of replacement of all curtains.

What the care home could do better:

Dedicated storage space for wheelchairs remains a problem; consideration should be given to this issue.

CARE HOMES FOR OLDER PEOPLE Orchard House Nursing Home 126 Whitehouse Common Road Sutton Coldfield Birmingham West Midlands B75 6DS Lead Inspector Kath Strong Unannounced Inspection 29th December 2005 10:05 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 DS0000024875.V275412.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 DS0000024875.V275412.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Orchard House Nursing Home Address 126 Whitehouse Common Road Sutton Coldfield Birmingham West Midlands B75 6DS 0121 378 0272 0121 378 3220 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) Orchard House (Midlands) Ltd Mrs Deborah Kelly Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (31) of places Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Home is registered for the maximum number of 31 people. Registration category is nursing care for reasons of old age and dementia, over 65 years of age. (N), OP, DE(E). 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 20th July 2005 Date of last inspection 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 by residents and visitors. 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 DS0000024875.V275412.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the visit was to conduct an unannounced inspection, the outcome of which was determined by various means. In depth discussions were held with the registered manager who also assisted with the inspection. Relevant documentation was examined including three care plans, one was case tracked in order to ensure that all identified needs were being met. Four residents were spoken with individually and lunch was observed being served. A partial tour of the premises was carried out and the arrangements for staff recruitment were reviewed. At the conclusion verbal feedback was given to the registered manager. Historically the home has provided a good standard of care therefore both inspections for this year have been unannounced, all of the key standards and any others deemed to be necessary have been examined. It is recommended that to gain a full insight into the home that both reports should be read. What the service does well: What has improved since the last inspection? Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 6 The two requirements generated from the last inspection have been addressed. One of the homes hoists has been replaced. Additional furniture for communal rooms has been purchased and redecoration carried out as per the maintenance programme. An electric organ has been donated to the home for use by staff or residents. A television has been purchased for the conservatory. The amount of domestic style lighting has been increased with the purchase of table lamps. There is an ongoing system of replacement of all curtains. 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 DS0000024875.V275412.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 DS0000024875.V275412.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): None EVIDENCE: Standards 1, 2, 3, 4 and 5 were examined at the last inspection and were fully met. Orchard House Nursing Home DS0000024875.V275412.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): 7, 8, 9, 10 Care plans are comprehensive, provide clear instructions to staff and indicate a proactive approach to the utilisation of external professionals. The arrangements for the administration of medications promote the safety of residents. Staff practices ensure that resident’s privacy and dignity are respected. EVIDENCE: Care plans are based upon activities of daily living and others specific to individuals and are collated within 24 hours of admission. Short term care plans are developed as required for such complications as chest or urinary tract infections. Assessments include physical and mental health status, nutritional, manual handling and skin integrity. Monthly reviews and formal six monthly reviews are carried out with the resident and their relatives invited to attend and agree the care plans. A diverse range of external professionals provide regular input and advice. Positive comments were received from residents, “Staff give good care”, “Staff respond to requests”. The system for medications was examined at the last inspection and found to be satisfactory, this inspection was no exception. The home has a contract for the disposal of medications and has introduced extra safety measures. All Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 10 discarded medications, not only controlled drugs are crushed and neutralised when awaiting collection. This is viewed as good practice. Observations revealed that staff use the preferred term of address and all personal care is delivered in the privacy of a bathroom or the residents own room. Standard 11 was examined at the last inspection and was fully met. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 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): 12, 13, 14, 15 The home provides an excellent recreational programme, which takes into account resident’s preferences. Residents are consulted and exercise autonomy over their lives. Meals provided are of a good standard offering both choice and variety. EVIDENCE: Standards 12, 13 and 14 were examined at the last inspection and were fully met. The in-house programme continued to provide a varied and interesting range of activities; residents had decorated the dining room for the Christmas period. A further stock of in-house games has recently been purchased. The homes mini bus was no longer available; the registered manager advised that as a result resident’s outings had not been compromised. Popular venues continue to be the Botanical Gardens and Cadburys World. Entertainers regularly visit the home. The content of the recreational programme continues to be influenced from suggestions made at the regular residents meetings. From observations and comments received from resident’s staff respect personal preferences, privacy and dignity. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 12 The home offers a comprehensive menu; breakfast and evening meals provide a good range of choices. The main meal of the day is served at lunchtime with two choices for the main course and up five choices of sweets. A glass of wine is included and specific diets catered for. Residents are encouraged to eat in the dining room but may take meals in the lounge or their bedroom. The meal was attractively presented and staff provided discreet assistance. Kitchen staff maintain details of likes/dislikes and preferred portion sizes. Resident’s comments included, “Staff will help me to eat lunch”, “I look forward to the food, its very nice, we choose what we want”. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 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 the following standard(s): None EVIDENCE: Standards 16, 17 and 18 were examined at the last inspection and were fully met. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 21, 24, 26 The home provides a warm, comfortable and safe environment with a rolling programme of improvements being made. EVIDENCE: All areas of the home are decorated and furnished to a good standard and are well maintained. There is evidence of forward planning and attention to detail. Communal rooms offer a choice of lounge, conservatory, dining room or the reception area, all of which are well appointed. The large attractive rear garden offers a large paved are were residents sit during clement weather. Bedrooms are decorated to a high standard and include all of the required furniture. Each room has a vanity hand basin, a lockable facility and suited door locks. Four bedrooms have en-suite facilities. Residents are encouraged to personalise their room and to take in items of furniture and personal possessions. Communal toilets and assisted bathing facilities are strategically located throughout the home. An assisted bathroom situated on the ground floor has Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 15 had the static chair lift removed resulting in incomplete floor covering. This issue must be addressed. Hygiene practices are exceptionally high within all aspects of the home. There is a comprehensive cleaning schedule in place and staff are supplied with alcohol hand rub dispensers for use when delivering personal care. Standards 21 and 22 were examined at the last inspection and were fully met. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 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 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, 28, 29 Staff morale is high resulting in an enthusiastic workforce that works towards improving the quality of life of residents. The home operates robust recruitment practices ensuring the safety of residents. EVIDENCE: Examination of the duty rota revealed that the home continues to meet the required staffing levels. Each trained nurse is allocated a six hour period every two weeks to complete administration tasks and ensure that care plans are up to date. Of the current staff employed 50 have completed NVQ level 2 training or above and further staff are currently undertaking training. Staff files indicate that all required recruitment checks are carried out including CRB checks prior to a position being filled. Standard 30 was examined at the last inspection and was fully met. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 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 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, 33, 35, 36, 38 The registered individual and registered manager have a clear development plan and vision for the home, which is effectively communicated to others. Health and safety arrangements provide adequate protection for residents and staff. EVIDENCE: The registered manager possesses adequate skills and experience for the day to day management of the home. There are good relationships and clear lines of accountability between all disciplines and evidence of effective team working. The home has a long established and comprehensive quality assurance system. All departments, some clinical practices and documentation are regularly audited. Residents and relatives are issued with questionnaires every six months. A report is collated and any identified action is allocated a timescale for completion. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 18 When requested the home holds residents personal monies. The system in place was found to be satisfactory. Written policies and procedures are reviewed annually or when circumstances change. Staff receive adequate formal supervision, a range of topics are used for this process. When a problem is identified the registered manager develops a supervisory tool for use as a monitoring tool. Accidents are well documented and audited monthly. All servicing of equipment is carried at as required. Weekly fire and monthly emergency lighting and smoke detectors are carried out and documented. Staff fire drills and training are also up to date. The registered manager is an accredited manual handling trainer, staff training is provided regularly and the registered manager carries out spot checks of staff practices. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 19 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 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 2 X X 3 X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 20 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 OP21 Regulation 23(2)b Requirement The floor covering of a ground floor bathroom must be repaired or replaced. Timescale for action 15/03/06 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 OP19 Good Practice Recommendations A review of the storage facilities for wheelchairs should be carried out. Orchard House Nursing Home DS0000024875.V275412.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Birmingham 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 DS0000024875.V275412.R01.S.doc Version 5.1 Page 22 - 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. 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