CARE HOMES FOR OLDER PEOPLE
Orchard Lodge 30/32 Gordon Road Seaforth Liverpool Merseyside L21 1DW Lead Inspector
Mrs Julie Garrity Unannounced Inspection 2nd February 2006 12:15 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 Lodge DS0000063169.V282291.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 Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Orchard Lodge Address 30/32 Gordon Road Seaforth Liverpool Merseyside L21 1DW 01202 512 500 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) Mrs Miljana Kiss Margaret Elizabeth Lovett Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Physical disability (5) of places Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. The service may accommodate up to 26 service users The service should employ a suitable qualified and experienced manager who is registered with the Commission for Social Care Inspection The service may accommodate up to a maximum of 26 service users within the category of OP The service may accommodate up to a maximum of 5 service users aged 55 years and over, within the category of PD 18/08/06 Date of last inspection Brief Description of the Service: Orchard Lodge is owned privatly owned registered to care home for 26 older people personal care only. The home is adjacent to a dual carriageway in a residential arae of Bootle. The home is close to main bus routes and there are local shops nearby. The main shopping area, library, restaurants and train station are a short ride by car, or alternatively there is regular public transport.Origionally two buildinngs these have been combined to create a large converted care home. There is a large day room, a seperate dinning room and a small tiled smoking room at the rear of the building . There is a patio arae at the front of the house and a small garden to the rear. All bedrooms are single accommodation without ensuite facillities. The is a passenger lift to all floors and emergency call systems to bedrooms and main communal araes. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day The inspector arrived at the home at 12:15 and left at 16.45 .The inspector spoke with 3 staff, the manager and deputy manager, 2 visitors and 6 residents. The inspector completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas that needed covering were done so. Feedback was given to the manager and the deputy manager during and at the end of the inspection. What the service does well: What has improved since the last inspection?
The manager with the support of the owner has reviewed a number of areas within the home and has started to progress these. These have included care plans, staff training, Protection of Vulnerable Adults and staff supervision. A number of areas have been redecorated these include the main corridors, the kitchen has been upgraded, the carpets have been cleaned and residents have been consulted with regards to further redecoration including individual bedrooms. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 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. Orchard Lodge DS0000063169.V282291.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 Lodge DS0000063169.V282291.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 of the standards in this area were fully reviewed at this inspection. EVIDENCE: The home does make sure that it monitors the needs of the residents and works in partnership with Social Services when needed. Several residents spoke very positively of the homes ability to meet their needs, including “the staff are really good, their kind and so nice” and “its very nice living here”. Orchard Lodge DS0000063169.V282291.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): None of the standards in this area were fully reviewed at this inspection. All of the core standards in this area were reviewed in the previous inspection. EVIDENCE: The manager is trying to improve the quality of the care plans in the home. The intention is that eventually all residents needs will be suitably identified and staff will have clear instructions as how to support and care for residents. Information regarding the actions that staff need to take to care for the residents in unclear due to these changes. Although this is a requirement from previous reports the home now has a new owner and new manager who are keen to progress this area. Although medications were not reviewed it was noted, by the manager that there was room for improvement. Advice and guidance was given as to where to obtain appropriate support for the safe administration of medicines. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 10 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): None of the standards in this area were fully reviewed at this inspection. All of the core standards in this area were reviewed in the previous inspection. EVIDENCE: There were two family visitors spoken with. Both spoke positively of the care that their relatives received. One relative said that her relative had “improved, dramatically”, whilst living in the home. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 11 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 of the standards in this area were fully reviewed at this inspection. All the core standards were reviewed at the last inspection. EVIDENCE: A number of staff have received training regarding Protection of Vulnerable Adults. As yet not all the staff have received training and senior staff are still unclear as to their role. Although this is a requirement from previous reports the home has a new owner and manager who are keen to progress this area. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 12 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): None of the standards in this area were fully reviewed at this inspection. All the core standards were reviewed at the last inspection. EVIDENCE: The new owners have invested considerable time and funds in redecorating and refurbishing the home. The kitchen has been completely upgraded. All the carpets in the home have been cleaned, and these are to be particularly those in the corridors and main lounge. The main corridors have been redecorated and several of the bedrooms. There are also plans to redecorate the residents smoking room which is poorly ventilated and of poor appearance. Several of the residents, relatives and staff were critical of the smoking room, which was described as “awful”, “disgusting” and “makes the home smell”. All the residents spoken with are pleased with the changes and some detailed that they had helped choose wallpaper and carpets. One resident said, “it’s going to be lovely”. The home has changed its name however the old name is still at the front of the building.
Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 13 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): None of the standards in this area were fully reviewed at this inspection. All of the core standards were reviewed at the last inspection. EVIDENCE: There are still a number of records relating to staff and their training that are in need of updating, at present it is difficult for the manager to determine what training staff are in need of. A number of training courses have been identified such as medicines, Protection of Vulnerable Adults, National Vocational Qualifications and pressure area care that the manager and owner are eager to put into place for the staff. Residents and relatives where happy with the skills of the staff, two commented that staff were “kind”, “caring” and “lovely”. Staff supervision has commenced in order that the manager can help further develop the staff for the future. A new member of staff did not have a Criminal Records Bureau (Police Check) in place before employment, whilst this acceptable with a full Protection of Vulnerable Adults. The individual must be supervised at all times until a Criminal Records Bureau is received by the home. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 14 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 The new manager and owner are eager to develop a quality service. Both are registered with CSCI and are developing the home to be run in the best interests of the residents in a manner that safeguards all their interests. EVIDENCE: This is the first report with both the new manager and owner now registered with CSCI. Residents spoken with were happy with the change in manager and owner, comments included “brilliant” and “so much has changed for the better”. Relatives and staff also said that the residents were “better cared for” and the home was “much nicer now” and credited the new owner and manager with this positive change. Residents and relatives meetings are held, although minutes were not available at this time. A quality assurance system that allows the home to find out what the resident’s think is in place.
Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 15 The owner has not undertaken her responsibility to make unannounced visits to the home with a report to the manager and CSCI. This is due to a misunderstanding of the regulations. The owner stated via a telephone conversation that this would be addressed. The home managers personal allowances for very few residents and holds funds at the request of families for others. Receipts of residents spending are kept to make sure that a record can be maintained. The manager makes sure that there are some funds available at all times for residents to make sure that if they wish to spend some of their money they can be supported to do so. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 16 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 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X x Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 17 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 OP29 Regulation 19 1)a)b)c) (3 Requirement Timescale for action 01/03/06 2. OP33 26 The registered manager must make sure that Criminal Records Bureau guidance is properly implemented in particular when and how staff can work without a Criminal Records Bureau in place. The registered provider must 01/03/06 undertake monthly unannounced visists that gain the opinions of the residents A report must be produced with a copy sent to the manager and CSCI. 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 *RCN Good Practice Recommendations Continue to progress the good practice already implemented including, care plans, medications, staff training, Protection of Vulnerable Adults training, staff supervision and health and safety within the home. The manager should obtain a copy of the Care Standards
DS0000063169.V282291.R01.S.doc Version 5.1 Page 18 2. *RCN Orchard Lodge including regulations and update all policies and procedures in line with the Care Standards. Orchard Lodge DS0000063169.V282291.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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