Inspection on 17/09/08 for Orchard Lea

This inspection was carried out on 17th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orchard Lea 12/06/09

Orchard Lea 07/08/07

Orchard Lea 16/06/06

Orchard Lea 07/03/06

Orchard Lea 23/11/05

Orchard Lea 30/03/05

Orchard Lea 29/11/04

Orchard Lea 30/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

CARE HOMES FOR OLDER PEOPLE Orchard Lea Orchard Way Cullompton Devon EX15 1EJ Lead Inspector Louise Delacroix Unannounced Inspection 09:20 17 September 2008 th 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 Lea DS0000039280.V365691.R01.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. 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 Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Lea Address Orchard Way Cullompton Devon EX15 1EJ 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) 01884 33375 01884 33375 carol.a.jackson@devon.gov.uk http/www.devon.gov.uk Devon County Council VACANT Care Home 26 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (26), of places Physical disability over 65 years of age (5) Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th August 2007 Brief Description of the Service: Orchard Lea is a local authority (Devon County Council) care home which is currently registered to provide accommodation together with personal care to up to 26 older people, up to five of whom may also have a physical disability and up to five of whom may also have difficulties related to dementia. The home was originally built with thirty-six bedrooms. Ten of them are now either used for office space, visitors’ rooms or storage. There is level access into and throughout the building. There is a shaft lift between the two floors and adapted bathrooms and toilets accessible to people with physical disabilities. Each floor has its own lounge and dining areas. The first floor has a quiet room. The building incorporates a day centre, and has a small but pleasant garden, which is not secure. The weekly cost is a set fee of £570.50. Extra costs include dry cleaning, hairdressing, dentist, optician and chiropodist (unless NHS funded), private telephone lines, pet costs (if pets are agreed) and newspapers/magazines. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at http:/www.oft.gov.uk . The last inspection report is on display in the main entrance hall Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Prior to the inspection, the home completed an Annual Quality Assurance Assessment (AQAA), which provides the commission (CSCI) with current information about the service, staff and people living at the home. Earlier in the year, CSCI also sent surveys to people living or visiting the home. Their anonymous responses have also been included in the report The inspection was unannounced and took place over ten hours. There were twenty-three people living at the home. Time was spent talking individually to six people living at the home and their views on the care they receive have been incorporated into this report. We also spent time observing how care was provided. As part of the inspection, three people were case tracked, this means that where possible the three people were asked about their experience of living at the home, their rooms were visited and the records linked to their care and stay inspected. During the inspection, a tour of the building took place and records including care plans, staff recruitment, training and medication were looked at. As part of the inspection, staff members spoke about their roles and responsibilities, and their views are contained in this report. We also spoke with visitors. What the service does well: There is a friendly atmosphere, and people living at the home appear relaxed with staff and told us that they were ‘wonderful’, ‘good’ and ‘kind’. The home contacts health teams appropriately. People living at the home told us that they feel listened to by staff and felt that privacy and dignity respected. People living at the home appear satisfied with the range of activities on offer and told us that their visitors are welcomed. People told us that they make their own routines in the home and praised the quality of the meals. There have been no complaints since the last inspection, and staff are trained to recognise poor practice and their duty to report it. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 6 The home is generally well maintained and where possible has been made to look homely, and is clean and odour free. There are good infection control measures in place. Staff have a caring approach and are up to date with the care needs of people living at the home. Regular training helps support them in their role and a significant number have completed National Vocational Qualifications in care. People living at the home are able to influence the quality of the service, through surveys and relatives’ meetings, and can have support with managing their finances. The home is a safe place to live in the way equipment is maintained and risks minimised. What has improved since the last inspection? What they could do better: We make requirements to clarify our expectations of providers when a regulation has been broken, and so a timescale for compliance is made. A previous requirement made in 2007 has still not been met regarding staff recruitment. We looked at the records of staff recruited in the last year. We found that in some cases staff have started to work at the home before satisfactory references and criminal records/protection of vulnerable adults checks had been received and we saw that other key information was missing from staff files. (This has also been raised in previous inspections). This practice may result in people living at the home being at risk of harm or abuse. We took copies of records during the inspection but on this occasion will not take legal action. Recommendations are good practice statements or advice and are linked to the relevant National Minimum Standards (NMS) for a service. The home needs to Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 7 improve the recording of handwritten changes to medication, and the recording of medicinal creams. The home should also ensure that all bedrooms contain comfortable seating for two people, two double electric sockets and a table to sit at to promote people’s independence and privacy. The home should have a registered manager to provide clear leadership for the home, and CSCI should be informed about changes within the management of the home. 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 Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 8 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 Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standard 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from good admission and assessment practice, which ensures the home can meet their needs. EVIDENCE: The home’s AQAA states that people will only move to the home after they’ve been assessed by one of the management team. We saw from people’s care files that this was the case and that information is also gathered from health and social care assessments. One person who lives at the home told us that they had visited before moving to the home, and that they had appreciated a member of staff introducing them to people working and living at the home. Another person was unable to remember whether they visited before moving in but they told us that Orchard Lea felt like a ‘second home’ and that when they moved in it felt ‘familiar’. The home’s admission process has improved since the last inspection to help Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 10 ensure that people’s care needs can be met by the home. The home does not provide intermediate care. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans have improved so that they provide clearer guidance to enable staff to meet the health and social care needs of individuals. Medicines are stored securely and administered appropriately to help keep people safe. Individuals are treated with dignity and respect and there are good relationships between those living and working at the home. EVIDENCE: We looked at the care plans of three people living at the home and we could see that they reflected people’s individual care needs. They were up to date, reviewed on a regular basis, and generally provided staff with guidance. For example, risk assessments and moving and handling plans were in place. This is a noticeable improvement since the last inspection. Staff that we spoke to were clear about people’s individual needs. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 12 We looked at how people’s health needs are met, both physical and mental. People told us that they received the medical support they needed and this view was supported by information in care plans. The manager said in the home’s AQAA that the home had an excellent relationship with local health care professionals. A visiting health professional confirmed that the home contacted the district nursing team appropriately and that advice was followed. Care plans evidence health concerns being followed up i.e. referrals to health professionals. We were told that there were less emergency admissions although staff were able to meet the needs of people at the end of their life. Medication is administered in a safe and unrushed manner, which people seemed to appreciate. We saw that people’s pain relief is monitored, and one person told us ‘they give you things to take away the pain’. We looked at medication records, which were generally well completed, although some handwritten amendments are not always double signed, which is not safe practice. Fridge temperatures for the medication fridge are clear to enable staff to monitor that medication is stored appropriately. The home also has risk assessments in place for people who want to self medicate. A staff member told us that the management team are trying to promote better completion of cream charts, which are currently filled in intermittently. Medication is stored safely. People living at the home told us that they felt listened to by staff, and we saw this on the day of the inspection. They told us that they are called by their preferred name and that when staff help them with intimate care tasks i.e. bathing that they do not feel embarrassed because of the staff’s skilful approach. We noticed that staff knocked on people’s door and asked discreetly if people needed help i.e. with eating their food. A relative commented that ‘in addition to looking after residents basic needs, the carers treat then with patience, gentleness and compassion.’ One person was supported to eat their meals, and the staff member supporting them was attentive and took their cues from the person rather than rushing them. They sat by their side and ensured the person’s dignity was maintained. People told us that their clothes were well cared and that the laundry was well managed. One person told us that when they moved in, staff asked what food they liked and when they liked to have a bath, which helped them maintain their sense of identity. The tables in the dining room are attractively set with tablecloths, flowers and condiments and staff served food in a friendly and helpful manner to make the meal an enjoyable occasion. When we spoke to staff working at the home, they all showed respect for the people living at the home and understood their individual needs. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home recognises the importance of people’s social lives and welcomes visitors. Meals are varied and provided in a helpful and friendly manner. People are encouraged to exercise choice. EVIDENCE: We talked to people to see how they spent their time. People generally seemed content with how they spent their day, some people told us they liked their own company and that as long as they had the newspaper and were visited by family they were happy. People told us that in the better weather they liked to use the garden. Since the last inspection, the garden has been made secure. We looked in detail at the social records for two people, which showed that they were encouraged to join in activities and that they had chosen to participate in some sessions, such as scrabble, flower arranging, bingo, singing and quizzes. The home also has visits from external entertainers and has its own activities co-ordinator. Recently four people went to the circus. The home’s AQAA states that there is ‘a greater understanding from all staff of the importance of social care as well as personal care’ which came across during Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 14 the inspection. The manager has identified that activities information could be improved and has ideas how to achieve this. People told us that their visitors are welcomed and the home has a visitors’ lounge, which is helpful, as some bedrooms have limited space. There are also several lounges, which means there is more choice of where people can entertain guests. One person told us they appreciated the help of staff to keep them in notelets and to use the phone so that they can keep in contact with friends and relations, which was important to them. A relative said that staff also supported them ‘they are sympathetic to how I feel about my relative’s condition and I find this immensely comforting’. Throughout the inspection, we saw that people were offered choice by staff and people told us that this was always the case. For example, choice of drink, meals, where to sit and when they got up and went to bed. Care files also showed that choice was offered and promoted. People living at the home benefit from an experienced catering team, who clearly demonstrated their knowledge of people’s individual likes and dislikes, and the way in which people need their meals prepared and presented. People that we spoke to praised the food with one person saying it was ‘marvellous’ and another said that the portions were generous. People were clear that there were choices on the menu and said that it was ‘nicely set out’. Catering staff speak to people on an individual daily basis and they told us this helped gather feedback and to get to know peoples likes and dislikes. We saw people’s individual preferences being met during a lunchtime meal. We saw that meals are served in a calm and friendly manner. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are confident about who to approach if they have a problem and the home has a clear complaints policy. Staff are clear in their understanding of their duty to report poor practice if seen, which helps create a safe environment for people living at the home. EVIDENCE: The Devon County Council complaints procedure is clearly displayed around the home. The procedure is also contained within the Service User Guide and CSCI contact details are displayed on the main entrance hall notice board. People told us that they knew who to go to if they had any concerns. Since the last inspection, we have received no complaints about the home, although an anonymous concern was raised about staffing levels on one shift. However, a lack of detail i.e. no date, meant this could not be confirmed. Nobody that we spoke to during the inspection, raised any concerns, and we checked that they were happy with staffing levels. The home’s AQAA states the home has not received any complaints in the last twelve months. Staff records show that staff receive regular training in recognising and dealing with safeguarding (i.e. protection of vulnerable adults) issues. Staff were able to describe differing types of abuse and were clear about their responsibilities and who concerns should be raised with, both within and outside the home. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 16 Staff at the home said they had feedback concerns about the lack of experience of one agency worker and that the management team have listened to them. The management team said that they had given this feedback to the agency and that alternative staff had been provided. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection states that in order to improve the service, the home intends to have the topic of POVA as a standing item at staff meetings to ensure staff are kept up to date on the topic. Also to have the complaints procedure on the agenda of all the meetings for people living at the home and their representatives, so that everyone is aware of the procedure and that the home encourages people to complain if they are not satisfied. This was also stated on the last AQAA submitted in 2007. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 19, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home generally provides individuals with a clean, safe, comfortable and homely place to live. EVIDENCE: Orchard Lea is a purpose built home and therefore has the advantage of level access on both floors, a large garden, a passenger lift, and a variety of communal and private spaces and several pieces of specialist equipment. The home’s AQAA states that since the last inspection some carpets have been replaced and that there has been general redecoration. There is a large and pleasant bathroom with a modern accessible bath. Seated scales have recently been purchased to enable those who cannot stand to be weighed more easily. There are several mobile hoists around the home, and each person who needs to use the hoist has their own separate sling. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 18 The home has a pleasant garden, which has been made secure, which means that vulnerable people do not have to be accompanied if they wish to go outside. Most of the bedrooms are small by current standards and this affects the amount of furnishings and fittings that can be accommodated. Therefore there is not enough space to provide comfortable seating for two people, at least two accessible double electric sockets and a table to sit at. Rooms are clean and odour free. Some appeared homely and personalised but generally fittings are dated and tired in appearance. Bedroom furniture is utility in style and marked, including fitted wardrobes and sink units. Where possible efforts have been made to brighten rooms with colourful curtains. There are no current plans to refurbish the bedrooms. People were positive about their bedrooms, despite their lack of room, particularly as they had been able to bring in a few things to make their room more homely. We visited many rooms during the visit and saw that the home is kept clean and odour free, which people living there told us that they appreciated. Staff were clear about infection control and could give us examples of good practice. We saw this demonstrated during the inspection. All bathrooms have soap and paper towels, and signs instruct staff to keep bathrooms clean. Infection control has also improved since the installation of a sluice in a former toilet rather than having a sluice sink in the laundry, which a number of staff had raised concerns about. The home’s AQAA states that all staff have received infection control training and that the majority of staff have received training in safe food handling. The selection of staff files we looked at confirmed this. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 27,28,29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff have a caring approach with recognition of individual needs. However, poor staff recruitment practice could put people at risk. Training is encouraged to provide skilled workers, which benefits the people living at the home. EVIDENCE: People that we spoke to seemed happy with the staffing levels at the home and told us that they did not have to wait long for staff to help them. Some people visiting the home expressed concern about the use of agency staff. Staff at the home told us that agency staff are used regularly but that wherever possible agencies supply the same staff to provide consistency. However, there is a stable core staff team, many having worked at the home for a number of years. The staff we talked to clearly enjoy their work and took a pride in providing a good quality of care and services. Staff from the home no longer provide night time cover to the bungalows situated next to the home only day time cover. However, on the day of the inspection a person living in one of the bungalows was anxious and phoned the home on numerous occasions, which took up a significant amount of staff time. In the afternoon, the home was running at a reduced staffing level due to sickness, and yet staff also spent time at the bungalow to offer reassurance to the person who was contacting. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 20 All those living and working at the home felt that the numbers of staff available were sufficient to meet the needs of individuals. People were very complimentary about the staff with people calling staff ‘administering angels’, ‘wonderful’ and ‘friendly’. The home remains committed to training reflected by staff successes in passing NVQ 2 or 3 in care resulting in over half of the staff having this qualification. We were told that two staff are in the process of completing NVQ training, and staff talked about their training in this area and we saw their certificates. Care homes need to be able to show that their recruitment processes protect the people who live there and there is set information that needs to be kept to evidence good practice. The home’s AQAA states that ‘we have a robust recruitment and selection process’. However, we looked at three staff files belonging to people who have been recruited since the home’s last key inspection. These showed that key documents were missing from people’s files when they started at the home and showed that the home’s recruitment process is not robust and has the potential to put people living at the home at risk of being cared for by inappropriate people. Staff said, and records confirmed, that there was a good range of training on offer, including Moving and Handling, POVA, infection control, understanding dementia and safe handling of medications. We were told that the current allocation of training places on internal courses is restricted, which can cause problems with ensuring people’s training is updated. However,the records we checked showed that staff members were up to date with their training. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): We looked at standards 31,33,35,37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People can feel confident that the home is safe, and their opinions will be valued and acted upon. However, people are not fully protected by some administrative processes and would benefit from a registered manager to help provide formal leadership for the home. EVIDENCE: The home does not currently have a registered manager but has an acting manager. For a number of weeks, the home has been operating without an acting manager. Staff told us that the home suffered from a lack of leadership during this period, and that although some support was available this was not enough. There is a management team made up of nine people but some staff told us that because of the size of this group, there was a fragmented Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 22 approach to managing. People have been given specific tasks to complete, and this can mean that others are unclear about the progress of this individual work. One person said that there was ‘nobody with an overview’. However, general feedback from staff was that there were no significant problems with communication about the care needs of the people living at the home. For example, staff told us that they were told about the care needs of people before they move to the home and that they were updated on changes through regular handovers. While many aspects of the management of the home were entirely satisfactory, one aspect of administration was poor. As reported in the Staffing section, recruitment processes are unsatisfactory and place people at risk. There has been uncertainty about the future of the home for some time and a number of people from the staff group expressed concern about the lack of information about the future of the home, which led them to feel unsettled. However, nobody living at the home raised concerns about the home’s future. Staff said, and minutes confirmed that separate meeting are held regularly for all those who live and work at the home, in order to gain feedback about the service. Changes made following these meetings, include revised menus and more activities and entertainment. Devon County Council have now introduced a quality assurance system. An Age Concern advocate visits the home to assist anyone living there with any concerns they may have. A representative of the registered company (Devon County Council) also visits the home and we saw the reports for these unannounced visits. People living at the home who do not wish to manage their own finances are able to have them managed through Devon County Council’s ‘suspense account’ system. Individuals are able to access their money at any time, through a ‘pool’ of money held at the home. Individual records are maintained for each person, and receipts and signatures are obtained as necessary. Interest is allocated in line with people’s savings. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that Orchard Lea complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. Accident and incident records are up to date, and appropriately completed. We were told that the fire risk assessment has been updated. So that the risk of burning from hot surfaces is minimised, all radiators within the home are covered. Windows above ground floor level are fitted with restrictors, in order to minimise the risk of anyone falling from them. Orchard Lea DS0000039280.V365691.R01.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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x 2 x 3 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x 2 3 Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES. 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 OP29 Regulation 19 (1) (a) (b) Schedule 2 Requirement Staff must have a full employment history, two written references, including one from their last care position, proof of identity and POVA/CRB checks before working at Orchard Lea to help protect the people living there. (Previous timescales of 31/05/07 and 31/12/07 not met). Timescale for action 30/11/08 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 Handwritten amendments to medication administration records should be double signed to prevent mistakes and keep people safe. A more robust system should be put in place to document the use of creams. Bedrooms should contain comfortable seating for two people; at least two accessible double electric sockets and a table to sit at to make them a more comfortable place to spend time. DS0000039280.V365691.R01.S.doc Version 5.2 Page 25 2. OP24 Orchard Lea 3. 4. OP27 OP31 5. OP37 Time spent supporting people living in the DCC bungalows should be monitored and reviewed to ensure it is not negatively impacting on people living at the home. The home should have a manager registered with CSCI to help ensure they are competent for this role and to provide clear leadership for the home. CSCI should be informed if the home is running without a manager for over 28 days. There should be a consistent approach to recruitment to ensure all necessary documents are in place before people start working at the home. Orchard Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Lea DS0000039280.V365691.R01.S.doc Version 5.2 Page 27 - 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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