Inspection on 03/07/07 for Orchard House Nursing Home

This inspection was carried out on 3rd July 2007.

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

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Orchard House Nursing Home 16-18 Riley Cresent Wolverhampton West Midlands WV3 7DS Lead Inspector Joy Hoelzel Key Unannounced Inspection 3rd July 2007 09:15 X10029.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 DS0000068497.V345484.R02.S.doc Version 5.2 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 and Care Homes for Adults 18 – 65*. 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 DS0000068497.V345484.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard House Nursing Home Address 16-18 Riley Cresent Wolverhampton West Midlands WV3 7DS 01902 334318 01902 620125 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) First Care Services Ltd Ruth Butler Ms Narinder Anita Kaur Care Home 38 Category(ies) of Dementia - over 65 years of age (38), Mental registration, with number disorder, excluding learning disability or of places dementia (38), Mental Disorder, excluding learning disability or dementia - over 65 years of age (38) Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection New service, first inspection. Brief Description of the Service: Orchard House Nursing Home provides accommodation, personal and nursing care for up to thirty eight people with mental ill health and/or dementia related illness. In February 2007 the home was registered with First care Services as new providers for the service with Mrs Kaur and Mrs Butler sharing the registered managers position. There are a range of single and double occupancy bedrooms with communal sitting and dining areas. The service is currently identifying a refurbishment plan for the whole building. The home is situated in a residential area of Wolverhampton with shops and local community amenities close by. Weekly fees range from £418.00 - £470.00. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. Commission for Social Care Inspection Reports for this service are available from the provider or can be obtained from www.csci.org.uk Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection is the first of the statutory inspections for this service and took place over five and three quarter hours on Monday 2nd July 2007. It was conducted by one regulation inspector. Twenty three of the thirty eight National Minimum Standards for older people and twenty two standards for younger adults were inspected on this occasion. Twenty six people are currently living at the home and were observed to be accessing all areas of the home throughout the day. Three case files were selected for case tracking, relevant documents and procedures were inspected, together with a selection of staff personnel files. A full tour of the premises was conducted. Discussions were held with people living and working at the home. What the service does well: What has improved since the last inspection? Areas of the home have been redecorated, with further plans for more alterations, refurbishment and redecoration. New beds and mattresses have been purchased and six bedrooms have had the floor covering replaced. Laundry and kitchen equipment has been replaced. The activity room is being equipped with games and craft items, people living at the home state that they enjoy doing embroidery. Training and development needs for staff have been identified Improvements have been made to the dining room, the menus and to providing cultural and dietary preferences for people. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): OP 1,3,6. YA 1,2. Quality in this outcome area is good. The home provides a Statement of Purpose that is specific to the individual home, and the resident group they care for. A pre admission assessment is conducted professionally and sensitively by a senior staff member and involves the individual, and their family or representative, where appropriate. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 9 The home has a statement of purpose and service user guide detailing all aspects of the care provision. Both documents are readily available to current and prospective residents and other interested parties and were reviewed in April 2007. The case file of the person most recently admitted to the home was inspected and included an assessment carried out by a senior staff member prior to the person moving into the home. Other pre admission information was obtained from staff at the previous placement, the social worker and the person’s next of kin. The people interested in a placement at Orchard House are encourage to visit the home to meet the people living and working at the home and to have a look round. The home does not offer an intermediate care service. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): OP 7,8,9,10. YA 6,9,16,18,19,20 Quality in this outcome area is good. The care plans are person centred is written in plain language is easy to understand and looks at all areas of the individual’s life. Management of risk is positive addressing safety issues whilst aiming for better quality of life. Where limitations are in place, the decisions have been made with the person and are recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 11 Three case files were selected for inspection from the information received in the Annual Quality Assessment Audit (AQAA) completed by the home prior to this visit. A basic plan of care is generated at the point of admission to the home based on the information gained from the pre admission assessments and is kept in a file in the individuals bedroom. Following a full review and assessment of a persons holistic care needs within the first month of residency a full plan of care is developed and then reviewed at regular intervals. Risk assessments are carried out for maintaining skin integrity, nutrition, moving and handling, falls and the use of equipment, some had been linked with a specific plan of care. One person was deemed at risk of injury due to falling and decreased mobility a specific plan had been developed to reduce the risk to this person. Nutritional screening is carried out for every one living at the home, there was no record of any cultural preferences a person may have. This was discussed with the cook who offered a reasonable explanation of the dietary needs of all the people and explained that as many people have lived in the home for a considerable period ‘you get to know their likes and dislikes’. A person attends a local day centre each week and has overnight stays with family at weekends. A risk assessment has been carried out for safety whilst out of the building and for budgeting finances. Both issues have been fully discussed with the action agreed by the person. A record is made of visits to and from specialist healthcare professionals and includes the continence advisor, community mental health nurses, social workers, GP’s etc. The home operates a twenty eight day regime for the administration of medication using a monitored dose system with the additional use of bottles and boxes. The registered manager, with clinical responsibilities, is carrying out monthly audits and has identified a problem with maintaining the optimum temperatures of the medication fridge. The Medication Administration Record appears to be correctly completed no gaps in the record were observed. The nurse in charge of the administration of medication explained that some people find it difficult to swallow tablets; the manager confirmed that when this has been identified an alternative form is requested from the G.P. Some tubes of external preparations were without a prescribing label and some were in use but the opening date had not been noted. The manager took action to ensure that all preparations were adequately labelled. Staff appeared to have developed good relationships with people at the home and were observed to be discussing options and guiding people with daily activities. However some people looked a little unkempt with their appearance and is was obvious that they are reliant on staff to assist them with personal hygiene and grooming. There appeared to be a lack of attention to detail, for example seven men had not had a shave, some people were wearing slippers that were a size too big, and there were some food stains on clothing. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 12 It is acknowledged that some difficulties may arise from time to time during the course of the day, and it may be a persons choice not to shave that particular day, nevertheless staff should be supporting and encouraging people to maintain basic standards of hygiene. This was discussed with both managers and partly acknowledged. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 12,13,14,15. YA 12,13,15,17 Quality in this outcome area is adequate. Some people using the service are given the opportunity to take part in a variety of activities both within the home and in the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A social activity coordinator is employed for three hours a day three days a week. The activity room is being developed and supplied with games, embroidery and craft items. Three ladies were embroidering items and stated Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 14 that they enjoyed doing this. One lady stated that she had embroidered table runners, which she was then able to give as gifts. Regular activities organised include movement to music, musical evenings, trips to local places of interests and supermarkets. One lady stated that she recently went to Asda and as she hadn’t been ‘for ages’ she was astonished at how big it was. One person who doesn’t go out very much went to the Express café and thoroughly enjoyed this and has asked if it could be a regular occurrence. A minister from the local church visits each month for a short service and Holy Communion. Newspapers in English and Punjabi are available and there are plans for an area to be developed for people to prepare their own snacks and drinks. Community contact is maintained with family and friends whenever possible although some people have very few relatives and friends. One person goes and spends the weekends with family. The more frail people tend to sit in an area in the front lounge, staff are available in this area at all times to ensure their safety and welfare is upheld. Little other activity throughout the day in this area was observed. The AQAA indicates that a sensory garden, particular for the people with dementia is being considered for development within the next twelve months. Some bedrooms have been highly personalised but others have very few personal possessions. The manager explained that the lack of personal possessions may be a consequence of prolonged institutional life for some people prior to coming to live at Orchard House. Meals are prepared and served by the staff mainly in the dining room. The daily menu is displayed on a notice board in the dining room. Alternatives are offered required. The main meal today was turkey burgers, potatoes and vegetables with alternative requests of egg and bacon sandwich, jacket potato and cheese. The cook spoke of the preferences of the individuals, with cultural dietary needs provided on request. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 16,18. YA 22,23 Quality in this outcome area is good. The service has a complaints procedure that is clearly written and easy to understand, it is included in the statement of purpose and service user guide and a copy is displayed in the entrance of the home. The policies and procedures for Safeguarding Adults are available and give clear specific guidance to those using them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user guide contains information of the home procedures for dealing with concerns and complaints. A copy of the procedure is displayed at the entrance of the home. A complaint log is maintained for the auditing of complaints, the manager stating that no formal complaints have been received since February 2007. Policies and procedures in the protection of vulnerable adults are readily available for staff reference if required. The manager demonstrated a good awareness and sound knowledge of the multi agency adult protection procedures. The home offers a facility for residents to deposit personal monies for safekeeping, the procedures have recently been revised with allocated key Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 16 holders to the safe. Records and receipts are kept of each transaction with the service users signing whenever possible. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 19, 26. YA 24,30 Quality in this outcome area is adequate. The home is comfortable, and has a programme to improve the decoration, fixtures and fittings. The planned alterations will enhance and improve the living and working conditions for people. This judgement has been made using available evidence including a visit to this service. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 18 EVIDENCE: A plan for the renewal of fabric and decoration of the whole building is being developed with the replacement of the beds and mattresses planned for this year. The main corridor on the ground floor is currently being redecorated and the bedroom of a person coming to stay at the home has been redecorated with the colour scheme being chosen by the person. Six bedrooms have benefited from new flooring and laundry and kitchen equipment has been replaced. Other areas were clean but the decoration is old and tried looking the manager explained that it is the intention to refurbish the whole home in due course. The AQAA details further plans for the next twelve months for the garden to be made more accessible for people with consideration to include a sensory garden. Good systems of control appear to be in place for the prevention of cross infections with appropriate hand wash facilities provided in all communal and private areas. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 27,28,29,30. YA 32,34,35 Quality in this outcome area is adequate. The service recognises the importance of a robust recruitment procedure and the importance of staff training both areas meeting the regulations and National Minimum Standards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection a registered nurse was in charge of the building supported by four care staff with additional catering and domestic personnel. Both registered managers arrived at the home during the morning. A rota is maintained to show which staff are on duty at any given time of the day or night. The manager stated that minimal agency staff are now used to cover shortfalls in the staffing levels. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 20 The care staff were observed to be busy attending to the needs of individuals, but as stated earlier in this report some peoples appearance looked unkempt and not cared for. It is acknowledged that due to people’s mental health problems, personal preferences and complications arising throughout the day some difficulties may arise nevertheless staff should be in sufficient numbers to assist with personal hygiene needs on a daily basis to ensure certain standards are maintained. Mandatory and specialist training continues for staff and includes moving and handling, fire safety, dementia awareness. National Vocational Qualification training at levels 2 and 3 continues with the AQAA indicating 60 care staff are qualified at NVQ level 2 or above. Staff commented of enjoying the course although they found it at times hard. The cook explained that she had been on Nutrition for Life training recently and thoroughly enjoyed it. Two staff personnel files were selected for inspection and contain all documents relating to a robust recruitment procedure. Certificates and records of achievement are retained to evidence the training undertaken by each individual. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 31,33,35,38. YA 37,39,42. Quality in this outcome area is good. The managers have a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve services and provide an increased quality of life for residents with a strong focus on equality and diversity issues. This judgement has been made using available evidence including a visit to this service. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 22 EVIDENCE: The home is managed by two people Anita Kaur owner/manager and Ruth Butler clinical manager. Both ladies appear to be working and managing the home well and have identified areas for improvement. People living and working at the home commented positively about their style of management and stated that they would speak with either of the ladies if they had any concerns or problems. Mrs Kaur is owner of another care home and has the experience with the general management of running a care home. Ruth Butler has been at Orchard House for a considerable period of time. She is a registered mental nurse, has recently completed the Registered Managers Award and is planning further studying in dementia care mapping. The statement of purpose informs of the experience and qualifications of both managers. Quality assurance monitoring continues with satisfaction questionnaires and monthly audits in various areas conducted by the managers. Residents and staff meetings are arranged regularly with records kept. The AQAA informs of a recent visit by the Environmental Health Officer, with the home awarded 3 stars for a good level of legal compliance. The home offers a facility for residents to deposit personal monies for safekeeping; the procedures for the safe keeping of personal monies has recently been revised with allocated key holders to the safe. Records and receipts are kept of each transaction with the service users signing whenever possible. Documentary evidence is available for promoting and protecting the health, safety and welfare of service users, staff and visitors. Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 23 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 3 2 X 3 3 4 X 5 X 6 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 3 36 X 37 X 38 3 Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 24 No 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 Refer to Standard OP9 Good Practice Recommendations It is recommended that consideration be given to providing opportunities for stimulation through leisure and recreational activities for people with dementia and other cognitive impairments. It is recommended that the schedule for the renewal of fabric and decoration be expanded to identify the dates and timescales to ensure that the improvements are planned in a timely way. It is recommended that consideration be given to having additional staff on duty at peak times of activity during the day. 2 OP19 3 OP27 Orchard House Nursing Home DS0000068497.V345484.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000068497.V345484.R02.S.doc Version 5.2 Page 26 - 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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