Inspection on 08/07/08 for Orchard Lodge

This inspection was carried out on 8th July 2008.

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

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

Orchard Lodge 09/05/07

Orchard Lodge 21/11/06

Orchard Lodge 02/02/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Orchard Lodge 30/32 Gordon Road Seaforth Liverpool Merseyside L21 1DW Lead Inspector Mrs Margaret Van Schaick Unannounced Inspection 8th July 2008 08:50 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.V363599.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 Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Lodge Address 30/32 Gordon Road Seaforth Liverpool Merseyside L21 1DW 0151 920 9944 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) marglovett@btinternet.com 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.V363599.R01.S.doc Version 5.2 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 9th May 2007 Date of last inspection Brief Description of the Service: Orchard Lodge is a privately owned care home registered for 26 older people personal care only. The home is adjacent to a dual carriageway in a residential area 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. The home was originally two buildings, which have been combined to create a large converted care home. There is a large day room, a separate dinning room and a conservatory overlooking the rear garden. The home has twenty single bedrooms and three shared bedrooms. A passenger lift accesses all floors and a call bell system is fitted throughout the home to include bedrooms and communal areas. There is a small patio area at the front of the house and a garden and patio to the rear. Weekly fees are between £380-£390. Orchard Lodge DS0000063169.V363599.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 2 stars. This means the people who use this service experience good quality outcomes. A site visit took place as part of the unannounced key inspection. It was conducted over one day for the duration of 7.15 hours. Twenty-one residents were accommodated at this time. As part of the inspection process all areas of the home were viewed including resident’s bedrooms. Care records and other associated records were viewed. Discussion took place with residents, staff and visiting relatives. The inspection was conducted with Mrs Margaret Lovett, registered manager. During the inspection two residents were case tracked (their care files were examined and their views of the service were obtained). All of the key standards were inspected and also previous requirements and recommendations from the last inspection in May 2007 were discussed. Satisfaction forms “Have your say about….”were distributed to a number of residents, relatives, visiting health professionals and staff prior to the site visit. A number of comments included in this report are taken from surveys and from interviews. An AQAA (annual quality assurance assessment) was completed by the manager prior to the site visit. The AQAA comprises of two self-assessment questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including staff numbers and training. What the service does well: The information gathered about prospective residents prior to admission is sufficient and ensures that residents’ needs are met. Residents canvassed for their views about the admission process commented, “Margaret the manager invited us and our family to spend time at Orchard Lodge and to have a look around. We could ask any questions and were given time to think about it Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 6 before we made any decisions. They explained all about Orchard Lodge and what care we would get if we decided to come and live there”. Residents care plans evidence that all aspects of their care needs are fully addressed. Residents were interviewed about how the service meets their healthcare needs. All of the residents were complimentary and stated, “the care is first rate and “it couldn’t be better”. A visiting health professional was interviewed and asked for their views on the service. The health professional stated, “Margaret the manager is very good and they all follow instructions that are left, they are quite on the ball”. Residents’ are encouraged to live their lives as they wish with staff support where needed. There is a lot of information recorded on what residents can do for themselves. The emphasis is then on promoting residents independence and empowering them with staff providing support and care only where needed. Residents interviewed were complimentary about the food served and stated, “food, you can’t complain”, “the food I would say is excellent, staff always ask what you would prefer” and “the food is very nice”. Robust procedures are in place to ensure residents are protected. Residents live in a comfortable and well-maintained environment. The front and rear of the building looks well maintained and flowering baskets are in position at the front door to welcome visitors. The rear garden and patio area is very pretty with trellis to support hanging baskets and shrubs and there are flowering plants placed around the rear garden and patio areas. The service continues to provide caring, supportive and friendly staff, which ensures that residents quickly settle in to their new environment. Residents were canvassed for their views about the staff employed in the service and all were complimentary. Residents commented, “the staff are very kind and hard working” and “staff are always here when we need them. One resident interviewed stated, “staff are lovely, you just ask and they will do it for you”. Residents live in a home, which promotes their best interests and is well managed. Through discussion with the inspector it is clear that the manager is knowledgeable about the conditions that affect the older person. The manager is also keen to improve the service where possible so that she can improve the lives of the residents who live there. What has improved since the last inspection? Oral health care is fully documented in care documentation. This ensures that staff are aware of any dental health problems/issues. Where needed residents Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 7 who may have minor mental health needs are now addressed clearly in care plan documentation. Residents who may be at risk of falls have risk assessments in place. These are regularly reviewed. The management of medication has improved since the last inspection. All records were clear and completed correctly. The manager has also included a separate medication sheet that informs and alerts staff of any additional information that is specific to the resident. The resident who self medicates has been assessed to ensure the medication is taken as prescribed. The overall impression of the service is that it provides a light, spacious and comfortable environment for the residents to live in. Bedrooms have been refitted and decorated in light colours with matching bedding and soft furnishings. Most of the bedrooms have had new carpets and vanity units fitted. All bedrooms have a key for the locks and residents who wish to, have their own. Bathrooms are in the process of being redecorated and a new shower room has been fitted to the 3rd floor. One resident had just used the shower room and stated, “I like it, it’s easy to use”. The lift has been completely overhauled this year and new flooring and a mirror have been fitted for the residents benefit. All mandatory training for staff is now up to date including fire training. The manager is clearly motivated as evidenced by the improvement of the service and the management of documentation including residents’ files and staff files all relating to the service. All documentation is clear and easy to follow. The service has sought advice from an advocacy service to assist residents in having their own bank accounts. Receipts for the purchase of cigarettes are now in place. The registered provider produces a written report for the service and this is kept on file. What they could do better: The four weekly menu needs to include the alternative meal at lunchtime so that it is clear that a choice is available. The service should continue with the upgrade of the building to include the sitting room and basement floors as identified in the annual audit. The service needs to ensure that the cleaning solution cupboard is locked at all times to ensure residents safety. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 8 The freezers in the basement storeroom need defrosting regularly. Soap and hand towels need to be provided in the laundry for staff to maintain hygiene. 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 Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 9 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.V363599.R01.S.doc Version 5.2 Page 10 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): OP 3 was assessed OP6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information gathered about prospective residents prior to admission is sufficient and ensures that residents’ needs are met. EVIDENCE: The manager carries out pre admission assessments on residents who would like to live in Orchard Lodge. The manager also encourages proposed residents to visit the service if possible prior to admission. Where it is not possible for prospective residents to visit the service, families do so on their behalf as evidenced on care files. One resident who was case tracked evidences a full assessment was carried out prior to admission with records evidencing this. The other resident was admitted for emergency respite. There was a copy of the social work assessment on file for this resident and their family had already visited the service and given quite a lot of information to the manager prior to their Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 11 admission. This was documented on file. There are also copies of social work assessments on record for other residents. One of the residents canvassed for their views on the admission process commented, “Margaret the manager invited us and our family to spend time at Orchard Lodge and to have a look around. We could ask any questions and were given time to think about it before we made any decisions. They explained all about Orchard Lodge and what care we would get if we decided to come and live there”. Another resident who was interviewed specifically chose to come to Orchard Lodge. They stated, “I know about this place, I have seen the way the residents were looked after so I asked my niece to have a look for me, she looked around and liked it too”. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 12 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): OP7,8,9,10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care plans evidence that all aspects of their care needs are fully addressed. EVIDENCE: Both residents case tracked had a care plan in place. Care plans are set up on admission to the service. The care plans evidence that all areas of residents’ health and social needs have been looked at. Care plans are reviewed monthly or sooner with recorded written notes evidencing this. There is a lot of information recorded on what residents can do for themselves. The emphasis is then on promoting residents independence and empowering them with staff providing support and care only where needed. There is evidence of resident involvement in care planned as both care plans viewed were signed by the resident concerned. Care plans cover all areas of care needs that have been identified through the assessment and include, medication, eating and drinking, mobility, confusion, Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 13 personal care, incontinence, equality and diversity issues, mental capacity, communication, social needs and religious needs. Other areas have also been addressed to include specialist input/advice from health professionals such as the district nurse, GP, dentist, chiropody, ophthalmologist, physiotherapist and clinic visits. There is evidence in care plans and care documentation of the input of these health professional supports. Risk assessments are in place where residents are at risk of falls, skin breakdown and nutritional problems and are reviewed regularly as evidenced. The management of medication has improved since the last inspection. The medication trolley is secured to the wall and other medication is stored separately in a locked facility, which was viewed during the inspection. Medication records are clear and easy to follow. There is written evidence of medication prescribed, dosage and amounts for each resident. Staff signatures evidence residents are given their medication at the correct times. One of the residents who self medicates has a risk assessment in place. The manager has also included a separate medication sheet that informs and alerts staff of any additional information that is specific to the resident such as medication in liquid form as they have a swallowing difficulty. The manager has a good working relationship with the pharmacist who visits the service three monthly and is available when needed for advice. The medication file also holds medication information leaflets that can be viewed for further advice. Staff was observed to provide residents with assistance discretely and with patience. Residents were observed to be communicating with staff in a friendly and respectful manner. Where agreed staff were calling residents by their preferred name. Residents canvassed for their views commented, “staff are very kind, they give me a lot of attention and the support I need”, “we get a lot of care and support when we need it and privacy if we want to be alone”. Staff canvassed for their views were satisfied that they were given sufficient information to enable them to care for residents and commented; “we have a verbal handover of the days and nights events and use the information in the care plan and daily communication book” and “care plans are reviewed every month”. Residents were interviewed about how the service meets their healthcare needs. All of the residents were complimentary and stated, “the care is first rate, it couldn’t be better, I have seen the Dr and I get my medicines on time”. A visiting health professional was interviewed and asked for their views on the service. The health professional stated, “Margaret the manager is very good and they all follow instructions that are left, they are quite on the ball, Margaret always follows things through with the GP if need be”. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 14 A relative interviewed about their views on how the service care for her family member stated, “It is brilliant, if it wasn’t for Margaret and all the staff, my relative would not be here, we can’t thank them enough and the other residents are well looked after”. Couples who share bedrooms prefer not to have a screen but they are available. Residents see health professionals in their rooms as confirmed by a district nurse who was visiting a resident. Residents were noted to be suitably dressed. Families and visitors are encouraged to visit the service when they wish with relatives and residents confirming this. One or two of the residents have mobile phones to enable them to have constant contact with their families if wished. Daily newspapers are delivered to residents who request them. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 15 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): OP12,13,14,15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ are encouraged to live their lives as they wish with staff support where needed. EVIDENCE: Throughout the visit it was clear that the service was being run to suit the needs of the residents. The residents who were interviewed were happy with the lifestyle the service offered including them being encouraged to spend their day as they wished with support from the staff were agreed. Residents interviewed stated, “It’s lovely, I couldn’t find anywhere better”, “of course I’m happy” and “I’m happy and settled and I’m happy staying here”. Activities for the day are recorded on the residents’ notice board. Records of activities are held on file to show which residents have attended. The popular choices are film shows, musical afternoons, board games, bingo, darts and watching a DVD on the large plasma screen television. Many of the residents go out also either independently or with their families. One or two of the residents may also go out with a member of staff to do some shopping. Staff and residents confirmed this. One of the residents interviewed stated, “on a Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 16 fine day I just let them know I’m going out and when I’ll be back, I go to the café and have my dinner out”. One of the residents also likes to help staff by laying the tables and informed the inspector that it made her feel useful. Residents were interviewed about their views on activities. Residents stated, “I don’t get involved much with the activities, whatever is going on I just go along with it, “I like to join in with the activities and play bingo, watch TV, videos, music days and sometimes we have parties”, “we love music and bingo, we always look forward to our bingo here and our sing a longs”. A relative interviewed about their family member stated, “they mix better with other residents now and enjoy the entertainment in the afternoon”. Residents are also encouraged to continue with their friends and family relationships whilst living in the service. There are no restrictions on visiting. Residents can see their visitors in the privacy of their rooms or in the public rooms if wished. Residents interviewed stated, “my nieces and nephew visit once or twice a week” and “visitors come at any time there are no problems”. A relative interviewed stated, “I have been visiting regularly since their admission, I can come at any time, I have visited late at night or early in the morning”. Holy Communion is offered to residents once a fortnight with many residents participating. One resident confirmed that they had communion and stated, “I don’t go to Church but they come here and visit us for anyone who wishes them to”. Some of the residents manage their own finances or with family input where needed. Advocacy services are available for residents who may need it. Through observation it is apparent that residents are able to personalise their bedrooms with their personal belongings. Residents’ rights are promoted in this service and this has been evidenced through discussion with residents, relatives, staff and care documentation. Residents canvassed for their views commented, “Margaret and the other staff always listen to us. Sometimes if we feel a little down they will sit down and talk to us or if we have any problems they always try to help”, “Margaret and all the staff make us feel like this is our home, we have good support here” and “I get myself up when I want to no one bothers us to get up, same at night I go when I want”. One staff canvassed for their views commented, “staff are always aware of and put into practice residents personal beliefs and preferences”. The service holds a list of residents who are on special diets and the cook ensures that these are followed. One resident canvassed about their meals stated, “we get a good choice of meals here and with me being diabetic I get a good choice of puddings”. The general menu is on a four-week rota therefore offering residents a change in their daily meals. Breakfasts are varied and are provided between 8-10am to suit the residents. Lunch is served at 12 noon. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 17 Tea is served at 4.30pm and supper between 8-8.30pm. Residents recently decided themselves to change the mealtimes at a residents meeting. Residents preferred to have their main meal earlier in the day at 12 noon rather than the evening and this was accommodated. At suppertime (8pm) residents have the choice of cheese and biscuits, toast, teacakes or pancakes to eat with their drink. The daily menu is displayed on the breakfast tables for residents to view. Their choice is then passed to the cook. Residents confirmed through discussion that they could have an alternative to the menu if wished. The four weekly menu needs to have the alternative choice for lunchtime recorded. Residents interviewed were complimentary about the food served and stated, “food, you can’t complain”, “the food I would say is excellent, staff always ask what you would prefer” and “the food is very nice”. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 18 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): OP 16, 17 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust procedures are in place to ensure residents are protected. EVIDENCE: A complaints procedure and a copy of the Sefton Adult Protection Procedure are in place. The manager stated, “I like to see the residents every day so that they can talk to me and tell me anything that is worrying them and I can sort it out for them”. Residents confirmed that they spoke with the manager each day she was on duty. A resident canvassed for their views commented, “Margaret has always told us that if we are not happy with anything she is always there or if we need to complain she or the staff will always listen and if we make a complaint it will be acted on”. The complaints log evidences complaints made, the investigation, the action taken and the outcomes for residents. The records are clear and easy to follow with evidence of a full investigation recorded. Residents who spoke with the inspector were aware they could complain but none had reason to at present. Surveys returned to the commission confirm that relatives and residents are familiar with the complaints procedure. Most of the residents vote by the posting system and some attend the voting stations. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 19 All of the residents have a locked facility in their bedrooms. Staff has attended adult protection training through Sefton and the manager is aware of the alert procedure. There have been no allegations of abuse. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 20 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): OP19, 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and well-maintained environment. EVIDENCE: As part of the inspection process a tour of the service took place to include most of the residents bedrooms. The service has one or two areas that still need to be updated including the sitting room but the overall impression of the service is that it provides a light, spacious and comfortable environment for the residents to live in. Bedrooms have been refitted with light oak style furniture and decorated in light colours with matching bedding and soft furnishings. Residents who prefer other colours can request a change if wished. Most of the bedrooms have had new carpets and vanity units fitted. All bedrooms have a key for the locks and residents who wish to, have their own. Hallways are fitted throughout with handrails to aid resident mobility. Bathrooms are in the process of being redecorated and a new shower room has been fitted to Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 21 the 3rd floor. One resident had just used the shower room and stated, “I like it, it’s easy to use”. Basement rooms are tidy and act as food stores, laundry services and medication storage. Freezers in the storerooms need defrosting. The storage cupboard for cleaning materials was unlocked. The manager locked it. The flooring in the basement is uneven and difficult to maintain. There were no soap or hand towels for staff in the laundry room. The lift has been completely overhauled this year and new flooring and a mirror was been fitted. The external fire escape is well maintained and easily accessed. The manager has carried out an annual audit of the service with the registered provider and identified areas that require refurbishment over the next year. A maintenance person is employed and maintenance records are kept to evidence jobs that are done and other records also evidence that safety checks with regard to the building are carried out. The front and rear of the building looks well maintained and flowering baskets are in position at the front door to welcome visitors. The rear garden and patio area is very pretty with trellis to support hanging baskets and shrubs and flowering plants placed around the rear garden and patio areas. Suitable garden furniture is in place for residents use. The conservatory overlooks the rear garden and provides residents ramp access to the rear patio, barbecue and garden. The dining room is pleasantly decorated with tables and chairs at suitable heights for residents. Residents who use wheelchairs have easy access to the tables as observed during the visit. The kitchen is clean and organised. All areas of the service including the residents bedrooms were clean and odour free. One of the residents canvassed for their views commented, “they are always cleaning here, our room is always kept lovely as well as the home, our room is quite good, it’s comfy”. Residents interviewed were complimentary about the service and stated, “I like my bedroom, I have no problems, I’m made up here I couldn’t go anywhere else”. A relative interviewed stated, “my dad is made up with the room it’s spacious, the home is like a community”. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 22 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): OP27,28,29,30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service continues to provide caring, supportive and friendly staff, which ensures that residents quickly settle in to their new environment. EVIDENCE: The staffing rota was viewed and evidenced sufficient staff was on duty to care for the residents. The manager is supernumerary therefore ensuring she is able to supervise residents and staff. Domestic and kitchen staff is on duty also. Seven care staff has the NVQ qualification at Level 2 and two staff have commenced it. Three care staff has the Level 3 NVQ and two have commenced it. Residents were canvassed for their views about the staff employed in the service and all were complimentary. Residents commented, “the staff are very kind and hard working”, “staff are always here when we need them, and they give us support when we need it”. Residents interviewed stated, “staff are lovely, you just ask and they will do it for you, “staff are very good to us” and “staff are nice and night staff too”. Full pre employment checks are carried out for any new staff being employed in the service. Documentation included in staff files evidences this. Two staff Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 23 files were examined at random. Both files were well organised and it was easy to find information. Information contained in staff files included, staff photo, personal information, completed application form, two written references, contract, copies of birth certificates and training/induction certificates/qualifications, enhanced police checks, pova first (Protection of Vulnerable Adults) and staff supervision/ appraisals. Training records evidence that all mandatory training is up to date including, fire, health and safety, first aid, basic food hygiene, manual handling, equality and diversity, dementia, induction, challenging behaviour, diabetes, infection control, nutrition, epilepsy, medication and NVQ Level 2 and 3. All of the staff including night staff has up to date fire training. Every staff member now has to sign the fire-training manual to confirm they are competent. Staff canvassed for their views about working in the service commented, “staff supervisions are in place to give staff and management the chance to discuss any problems, I find this very helpful as problems are resolved and opinions are taken into account”, I found my induction very helpful and informative”, and “the service provides care and supports the needs of the residents and gives them a healthy and happy home”. One health professional interviewed stated, “I have been coming to this service for a long time and I find the staff are friendly and helpful”. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 24 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): OP31,33,35,38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which promotes their best interests and is well managed. EVIDENCE: The registered manager has been employed in this post for approximately 3 years. The manager gained the RMA (registered managers award) in 2004. The manager continues to update herself to ensure she is knowledgeable about the residents that she is caring for and has attended training recently including, equality and diversity, manual handling, dementia, fire, first aid, medication administration, nutrition, epilepsy, challenging behaviour and pova. The manager has also commenced the A1 City and Guilds Assessor/Verifier course last month. Through discussion with the inspector it is clear that she is Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 25 knowledgeable about the conditions that affect the older person. The manager is also keen to improve the service where possible so that she can improve the lives of the residents who live there. The manager is clearly motivated as evidenced by the improvement of the service and the management of documentation including residents’ files and staff files all relating to the service. Through discussion with staff, residents and relatives all feel that the manager is approachable and confirmed that she listens to them. Staff canvassed for their views commented, “the manager is very supportive”. The manager has commenced feedback forms for relatives, visitors and health professionals following any visits to the service. These were viewed during the visit. All of the feedback was positive. An external quality assurance award was given to the service in November 2007. The inspector viewed the summary of completed resident, relative and staff questionnaires, all of which were positive. Residents meetings are held two monthly with minutes published. Staff meetings are held three monthly. Minutes of both were viewed. Monthly provider visits are carried out and recorded. Policies and procedures have been updated at the end of 2007 and this year also. Financial records of two of the residents were viewed. The record keeping for these has improved to include all receipts including ones for cigarettes. Individual records are kept for each resident. Documentation evidence that residents sign all financial transactions and the records are audited three times each year with the registered provider and manager. The manager has also accessed advocates on behalf of the residents to provide support whilst opening their individual bank accounts. A fire risk assessment was carried out in January this year. Two weekly fire checks with regard to fire equipment are carried out to include emergency lighting, smoke detectors and fire doors. The annual fire safety-check contractors are due to come in again this month. All servicing and equipment checks to do with lifts, gas and electric are in date. The annual checks on small electric appliances (PAT) were carried out in November 2007. Care staff checks hot water temperatures and fortnightly checks are carried out by the maintenance person. The nurse call system is checked monthly and was checked at random by the inspector. The system worked. Accident records are in place and recorded clearly. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 26 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 3 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 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 27 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. 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. 2. 3. 4. Refer to Standard OP15 OP19 OP19 OP26 Good Practice Recommendations It is recommended that the four weekly menus should show the alternative meal available for lunchtime. It is recommended that the freezers in the storage rooms be defrosted on a regular basis. It is recommended that the refurbishment of the sitting room and basement floors should be carried out as planned. It is recommended that soap and hand towels should be made available for staff in the laundry area. Orchard Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG 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 Lodge DS0000063169.V363599.R01.S.doc Version 5.2 Page 29 - 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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