Inspection on 12/09/07 for Orchard Manor Transition Service

This inspection was carried out on 12th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Orchard Manor Transition Service 19/10/06

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Orchard Manor Transition Service Manor Road, Fenny Lane Meldreth Royston Hertfordshire SG8 6LG Lead Inspector Andy Green Unannounced Inspection 12th September 2007 10:30 Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 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 Manor Transition Service DS0000067372.V350620.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Manor Transition Service Address Manor Road, Fenny Lane Meldreth Royston Hertfordshire SG8 6LG 01763 268030 01763 268026 chris.callaby@scope.org.uk www.scope.org.uk SCOPE 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) Miss Christine Callaby Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2006 Brief Description of the Service: Orchard Manor provides a service specifically aimed at young adults leaving education. They are registered for 20 residents and there are plans to extend this at a later date. The service offers structured opportunities to learn and develop a variety of skills, as well as taking part in a range of social and leisure activities. The service provides support to a range of residents with complex health and physical care needs. Residents usually stay in the home for a period of 3 years or until they reach the age of 26. The service is based in the village of Meldreth, close to the Cambridgeshire/Hertfordshire border, but within easy reach of all amenities. The weekly fees range between £1789 and £2556 depending on the assessed needs of the resident and the level of support that is required. Copies of CSCI inspection reports are made available to residents and their relatives on request. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Andy Green, Regulation Inspector, undertook this key unannounced inspection on 12th September 2007. A number of records were inspected including care plans, training records, health and safety records and staff files. A tour of the building and grounds was also undertaken. The inspector also met five residents to gather their views regarding the services offered in the home. Five members of staff were also interviewed to gather their views regarding the service, training and support they received. Comment cards were also received from residents and relatives. What the service does well: What has improved since the last inspection? What they could do better: It is recommended that a sheet is added in individual care plans which details visits and appointments with healthcare professionals to easily access information and monitor resident’s health. It was also recommended that a sheet is included which staff sign when they have read individual care plans. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 6 It was recommended that an overall training spread sheet is implemented so that dates of the staff’s training and when updates and refreshers are due can be easily viewed. 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 Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed assessments and information is obtained to ensure the resident’s needs can be met. EVIDENCE: The manager stated that the Statement of Purpose has been reviewed this year to ensure that information remains accurate and up to date. The Service User Guide is produced in a comprehensive pictorial format to aid residents understanding of the services and procedures provided in the home. Referrals are received from a variety of sources including parents, care managers and educational agencies. An initial visit usually takes place which involves the prospective resident/family/social worker. Staff confirmed that they met all prospective residents and their relatives during the assessment phase. During this time detailed assessments are carried out by the home’s physiotherapist and an occupational therapist to ensure that needs can be met. Evidence of this was seen in care files. An overnight stay can be arranged where possible so that the prospective resident can ‘test drive’ the home before they move in. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 9 When a decision regarding the care and support needs and funding arrangements have been agreed, a letter of confirmation is sent to the resident with details of when they will move in to the home. Care plans and risk assessments are commenced as soon as possible after admission. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide detailed information to ensure staff are able to support residents in all areas of their lives. EVIDENCE: Care plans are based upon the assessments/reports prepared prior to the resident moving in to the home. Three care plans were inspected and they contained a variety of detailed information regarding health, physical, social and communication needs. Care plans are in a person centred format with clear guidelines for staff regarding the care and support that the individual resident requires. Each of the care plans inspected, contained appropriate information including; Individual activity timetables, moving and handling risk assessments, bathing, behaviour and individual dietary needs and preferences. Each of the care plans has a sheet entitled ‘Identity & Self Esteem’ which clearly explains the residents preferences and important details about themselves. It is recommended that a sheet is added which details visits and appointments with healthcare professionals to easily access information and monitor Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 11 resident’s health. It was also recommended that a sheet is included which staff sign when they have read individual care plans. Residents are clearly involved in the care planning process as much as possible and they have a communication book which presents information about their needs and interests. This is achieved by creative use of photographs of key people and events and clear statements regarding the residents individual preferences. Each resident also has a diary which details events and appointments during the day. There was evidence of regular reviews of care plans and relatives can be involved where appropriate. This was confirmed by a relative spoken to during the day. As part of the care planning, detailed risks assessments are undertaken, and again these were seen during the visit. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service promotes personal and community development in all areas. EVIDENCE: The service continues to provide activities and facilities for residents with profound levels of disability to maximise their independence and skills. Residents are encouraged to learn and develop new skills through a daily programme which is a central focus of the service. Residents have access to a wide choice of both vocational and leisure activities, and in addition a range of leisure pursuits are available at weekend and during the evening. Residents regularly access the Skills Development Centre adjacent to the home which provides a wide variety of activities including mobility sessions, communication, computer, hydro pool and film work projects. There is a senior Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 13 skills tutor/ coordinator and two new tutors have recently been recruited who have particular skills in drama, media and music therapy. Residents also have access to the local village and surrounding towns with staff assistance. The home has the use of four vehicles to ensure that residents have frequent trips away from the home including local church events, pubs, cinemas and local shopping trips. There is a house meeting each Friday where activities and day trips are discussed with residents which will be organised during the forthcoming week. Detailed minutes of each meeting are taken and a selection were inspected. Menus are chosen by residents on an ongoing weekly basis and individual food preferences are recorded in care plans and communication books. Since the last inspection a large home cinema has been installed in one of the lounges which residents are able to enjoy on a regular basis. This has been particularly beneficial for residents with visual impairment. Relatives and friends of residents are encouraged to visit the home at any time. One relative spoken to confirmed this to be the case and she stated that the staff were courteous and welcoming. Surveys received from residents and their relatives were complimentary about the care and support provided in the home. Comments from relatives included; • • • “The staff deserve great praise for the work they do as does SCOPE for setting up such a pioneering service”. “I feel Orchard treats its residents with great dignity enabling profoundly disabled students to live a fulfilling life as best as possible.” “The atmosphere of Orchard Manor is happy and vibrant”. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans ensure personal support is provided in a way that meets the individual’s needs. EVIDENCE: Personal care and support needs are detailed in the care plans. Care staff all receive detailed guidance and training to ensure that their needs are met. The home continues to use two local GP practices including the services of local district nurses. Dieticians continue to provide support and advice and training. The manager stated that there had not been any significant changes in the provision of healthcare support since the last inspection. At present none of the residents in the home manage or administer their own medication. Staff continue to receive training in the safe handling and administration of medication. The records of administration were accurate and the medication is appropriately stored. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. There is a procedure for ensuring that all complaints and concerns are adequately dealt with. EVIDENCE: The home has a complaints policy and procedure including policies on adult protection and whistle blowing. A pictorial version of the complaints process is also included in the Residents Guide to aid residents understanding of the process. Relatives are encouraged to raise concerns/issues and this was confirmed by a relative during the inspection. There have been no complaints received by the service since the last inspection, and none have been received by CSCI. All staff receive training in adult protection issues, with regular updates. The inspector gave the manager the contact details of the local authority adult protection coordinator to gather details of further training that the home could access. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service offers a clean and homely environment for residents, equipped to a high standard. EVIDENCE: The home provides a well-equipped and comfortable setting for the residents living there. Particular care has been taken to provide a setting that is as domestic as possible, and all the bedrooms have access to large well equipped ensuite facilities. Since the last inspection the downstairs ‘flat’ has been opened and there were seventeen residents in the home. The environment was clean and tidy with no offensive odours, and residents spoken with were happy with their own personal rooms. This was confirmed by relatives. All bedrooms are large and have overhead tracking /hoists to ensure that residents can be safely moved. Staff confirmed that they had received training in the use of hoists. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 17 The home is decorated to a high standard and residents are able to personalise their rooms with pictures, posters, music systems, television, video and DVD. The communal and dining areas are well presented and meet the mobility needs of the residents. The gardens are attractively maintained and accessible for residents. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Training, recruitment and supervision policies ensure that staff are fit for their role and competent, and regular maintains standards. EVIDENCE: The home provides a comprehensive training programme to ensure that staff have the necessary skills to meet the resident’s needs. Staff confirmed that they had received training in mandatory health & safety issues , peg feeding, hoist training, communication and epilepsy. NVQ training is well established and the home has their own assessors and verifiers. It was recommended that an overall training spread sheet is implemented so that dates of the staff’s training and when updates and refreshers are due can be easily viewed. During the inspection, several of the staff on duty demonstrated their high level of commitment to the residents, and were seen to interact in a very appropriate manner. Three staff files were inspected and all the required documents and procedures were in place including application form, references and CRB/POVA checks. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 19 The home has a high level of staffing to ensure that residents have individual care and attention throughout each day and evening. This was evidenced throughout the day with staff actively engaging with residents in a friendly, social and caring manner. Staff confirmed that they regularly received formal recorded supervision usually on a 6-8 weekly basis. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures ensure that the home is well managed to ensure that staff and residents are not placed at risk. EVIDENCE: The home continues to be well managed and staff confirmed that they were well supported and felt able to raise issues or concerns at any time. The home’s line manager is also based in the home and provides ongoing support. The home also benefits from administrative support to ensure that the service runs smoothly. It was clear that the management team interact with the staff, residents and relatives on a daily basis in a friendly and supportive way. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 21 Residents and families are involved in regular reviews, and an annual quality assurance survey undertaken, together with monthly management visits and reports. Relatives confirmed that they felt able to talk/meet with the managers in the home and were kept aware of any changes affecting their relative. All the required health and safety policies and procedures are in place including the maintenance of hoists, wheelchairs and fire safety equipment. Records confirmed this to be the case. There is an on site maintenance team who are available to deal with any that arise quickly. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 23 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 Refer to Standard YA6 YA19 YA35 Good Practice Recommendations It is recommended that a sheet is added in individual care plans which details visits and appointments with healthcare professionals to monitor resident’s health. It is recommended that a sheet is included in residents care files which staff sign when they have read individual care plans. It is recommended that a training spread sheet is implemented so that dates of the staff’s training and when updates and refreshers are due can be easily viewed. Orchard Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Manor Transition Service DS0000067372.V350620.R01.S.doc Version 5.2 Page 25 - 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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