Inspection on 11/07/07 for Orchard Mews

This inspection was carried out on 11th July 2007.

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

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

Other inspections for this house

Orchard Mews 26/07/06

Orchard Mews 28/02/06

Orchard Mews 09/09/05

Orchard Mews 01/12/04

Orchard Mews 28/06/04

Orchard Mews 17/11/03

Orchard Mews 15/05/03

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

CARE HOMES FOR OLDER PEOPLE Orchard Mews Bentinck Road Elswick Newcastle Upon Tyne Tyne & Wear NE4 6UX Lead Inspector Aileen Beatty Unannounced Inspection 11th July 2007 09:30 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 Mews DS0000000450.V344244.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 Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Mews Address Bentinck Road Elswick Newcastle Upon Tyne Tyne & Wear NE4 6UX 0191 273 4297 0191 2734284 orchardmews@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Management Ltd 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 Miriam Pearson Care Home 39 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (15) of places Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named Service Users is in category MD(E). No further admissions are to take place in this category without the prior agreement of CSCI if the Service User leaves, CSCI are to be informed. Date of last inspection 26th July 2006 Brief Description of the Service: Orchard Mews is a residential care home, which may provide permanent accommodation and personal care for up to thirty-six older people, some of whom may have Dementia. The home is located within a residential area in the west end of Newcastle upon Tyne, at the bottom of a steep bank, close to Newcastle General Hospital. Local amenities and shops are situated nearby on the main thoroughfare of Benwell and the area is well served by public transport. The three-storey property is purpose built. External on street parking is available at the front of the home and there is a small car park at the side. There is a sensory garden situated in the internal courtyard with water feature, chimes and scented plants. Residents are provided with information about the home including arrangements for staffing and facilities provided. Fees range from £365 to £475 Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was carried out over 7 hours on two days by one inspector, Aileen Beatty. The manager and deputy were on duty during the visits and assisted the inspector with the process. Eight residents were spoken to individually. There were no visitors present during the inspection. The inspector spent time in the lounge observing the care and activities provided by staff, and also looked around the home. Records looked at included, three care plans, training and staff records and the records for complaints as well as the health and safety, accident and maintenance records. What the service does well: What has improved since the last inspection? A number of areas of the home have been redecorated making it homely and pleasant to live in. The variety and frequency of activities offered continues to improve which means that residents have the chance to feel occupied and enjoy social activities. A new file is available containing all policies and procedures and linking them to the care standards. This makes the policies easier to apply to practice and the system is well organised. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 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 Mews DS0000000450.V344244.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5,and 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a detailed statement of purpose and service user guide. Residents and their representatives are given good information on which to base the decision to move into the home. There is a comprehensive assessment undertaken by the staff prior to admission, which forms the basis for the development of the care plan. The home does not offer intermediate care. EVIDENCE: Staff carry out a detailed pre admission assessment before admitting residents to the home. This assessment takes place in a location that the resident feels Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 9 most relaxed in as staff are aware that carrying out an assessment in an office may cause the resident some anxiety. This may also affect the result of the assessment. A new assessment is now in use to assess residents with dementia, which focuses more on the specific needs of people with memory problems. Comprehensive assessment information is also available from other sources such as nurses, social workers or psychiatrist referring the resident. Files of three residents were checked and contained such assessments. New residents are given the opportunity to have short visits such as two hours then stay for a meal then perhaps overnight or for a longer spell during the day. Relatives may also visit the home. A married couple may be admitted to the home and the deputy described arrangements to make sure they have suitable accommodation including a private sitting area in one room. Each resident is given an information pack upon admission. These are usually placed in bedrooms or given to relatives too. Fresh flowers are placed in bedrooms upon admission with a welcome card. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good individual care planning and the care is being delivered in line with these plans. The residents have their healthcare needs met effectively. Staff treat residents with respect and maintain their privacy so far as possible both when delivering care and throughout their daily life. The residents receive their prescribed medication in line with safe working practices. The medicines in the home are well managed and safely disposed of as necessary. Staff are adequately trained to enable them to treat residents and their families with respect care and sensitivity at the time of their death. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 11 EVIDENCE: Care plans of three residents were checked. They are well written and files are organised in the Southern Cross house style, which makes information easy to find. A requirement set at the last inspection that all residents must have a moving and handling assessment has been met. These are also pinned to the back of wardrobe doors to remind staff of the needs of residents when assisting them with personal care. Care plans read are well written, demonstrate sensitivity and comply with the person centred philosophy in the home. For example, one care plan regarding assisting with washing and dressing instructs staff to help the resident to choose their own clothes while also discreetly checking the wardrobe for dirty clothes. Social care plans contain reference the individual interests of the resident for example that they are a keen gardener or enjoy listening to particular types of music. Care plans are audited on a regular basis to ensure they are kept up to date. The health needs of residents are met. There are currently no residents with pressure sores and health care professionals continue to visit the home. The optician visits the home and they have provided staff with a training DVD to demonstrate how changes to eyesight affects residents and enables them to see what the resident sees. Specialist support and advice continues to be provided by the Castleside unit at Newcastle General Hospital and they maintain close links with the home. Procedures for the receipt of medication have been tightened up since the last inspection. The treatment room is clean and tidy and room and fridge temperatures are checked daily to ensure stock is controlled at the correct temperature. Staff on duty are able to describe the procedures for ordering, receiving, administering and keeping safe records. Records checked have been completed fully. One resident is supported to take their own medicine. Residents spoken to say that they feel well cared for. All residents are dressed in their own clothes and are discreetly helped to maintain a smart appearance. The staff could describe the way they maintain residents privacy and were seen doing so when delivering care. The induction procedure instructs all staff to respect privacy by knocking on doors and to preserve dignity for example by covering parts of the body when assisting with personal hygiene. Staff have been provided with palliative care training (care of the dying) by City and Guilds. This helps staff to deal with the dying resident, change and loss, bereavement, coping strategies and provides a guide to cultural and spiritual awareness. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 12 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): 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. Residents are satisfied with the flexibility of their routines and social activities, which meet their cultural, social, religious and recreational interests and needs. Satisfactory arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly. Residents have a well-balanced nutritious diet, which offers choices. EVIDENCE: The social and recreational interests of all residents are recorded in their social care plan. Using this information, individually tailored activities are offered. On both days of the inspection activities were being enjoyed by residents such as hoopla. Staff support residents to take part in a skilled way and avoid applying any pressure or making people feel inadequate by setting targets that they are Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 13 able to manage. Residents were observed enjoying a sense of achievement and also the fun and joking with staff that accompanied the activity. Some residents who were dozing during the activity were gently wakened to have a drink when the others stopped for refreshments and staff made more juice, as it was a very hot day. One resident was very upset and anxious during one activity. A staff member was observed supporting them very well and made a visible difference to the mood of the resident. Residents are encouraged to make choices about all aspects of their daily lives. Two gentlemen were sitting in the garden on both days of the inspection watching cars and people passing by. Other residents preferred to be in their own room or sitting in the lounges. Notices are displayed to advertise forthcoming activities and residents are encouraged to invite friends and family to the home. The manager advised that residents can invite family members for a meal especially for special occasions such as birthdays. Bedrooms are nicely personalised and reflect the individual style and tastes of the residents in the home. A monthly newsletter is available to residents and visitors to help people to keep up with news in the home. The home has also forged new links with a charity who are going to do some activity work, and also a local school. This helps residents to maintain contact with the community outside the home. The home is now using the “Nutmeg” computerised system for menu planning to ensure meals are nutritionally balanced and varied. It is in the early stages with some changes still being made to menus. The dining areas are clean and tidy and tables are fully set with napkins and condiments. The kitchen was inspected and was found to be clean and tidy. Kitchen cleaning schedules were checked and found to be up to date. Food temperatures and fridge and freezer temperatures are recorded. Opened food is wrapped and dated and kept in the fridge. There were adequate supplies of fresh fruit and vegetables. On the day of the inspection the choices from the new menu were Chinese chicken or ratatouille. The cook said that staff are monitoring which meals are popular, as some choices may not suit some residents who prefer very plain meals. New pans and tins have been ordered. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 14 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and are acted upon promptly. The training and procedures in place ensure that residents are adequately protected from abuse. EVIDENCE: There have been three complaints since the last inspection. One was withdrawn, one was investigated and responded to by the manager, and the other one was investigated by the home and social services. The home is now using standard documentation but some entries could contain more detail. The deputy is aware of this and confirmed that work towards improving the recording of complaints is ongoing. Complaints procedures are displayed and the manager stated that she operates an open door policy for resident’s visitors and staff so that they can speak to her whenever they have a concern. There have been no adult protection issues since the last inspection. Staff receive safeguarding adults training. A check of recruitment procedures found that staff are vetted to ensure they are safe to work with residents. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 15 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): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean and well maintained. EVIDENCE: All communal areas in the home, and most bedroom areas were inspected. The vast majority of the home is maintained to a high standard. There is a lovely sensory courtyard garden, and the home are well on their way to winning another hanging basket competition. Residents are involved in light housework and gardening if they wish to be. Most areas of the home are freshly decorated and bedrooms are nicely personalised and homely. There is good signage to remind residents the way to the lounge and bathrooms. One resident showed the inspector around the ground floor including his own bedroom. He said that he was happy with the facilities provided and that he had everything he needed. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 16 There is a separate smoking lounge in line with new legislation and appropriate signage is in place. Bathrooms have been decorated to make them feel more homely and less clinical. One bathroom appeared to be used for storage as it had staff uniforms and other items in. New dining room furniture has been ordered for the top floor, which is due to arrive after the inspection. Some new dining furniture has already been provided including slide and glide chairs. The “Hollywood” room on the middle floor also has new chairs. The manager advised that all new residents will be going into a newly decorated bedroom with matching curtains and bedding. This is an opportunity for the resident to select the colour of their room if possible. Tactile wall panels remain in place although it was reported that not many residents appear to show interest in these. Staff are therefore experimenting with other items such as dolls and tactile scarves that are left lying around the home for residents to explore. There is some mild malodour on the middle floor compared to the ground floor. There are plans to replace some carpets in the home during ongoing refurbishment. The assisted bath that was out of use at the last inspection has been repaired. The home is satisfactorily clean. New plastic cord covers have been put on pull cords in bathrooms to enable them to be kept clean. Some en suites have a very small area to store toothbrushes etc but some items are being stored on the boxed in pipes below the toilet area. This is not very hygienic. Good infection control measures are in place such as the use of foot operated pedal bins. Clinical waste is safely disposed of. The laundry was clean, organised and well equipped. Residents spoken to say that they are happy with the standard of décor and cleanliness in the home. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 17 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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff are recruited and selected using a robust system, which ensures that they do not present a risk to the residents and have the necessary skills and qualifications to care for them. All staff receive a comprehensive induction. EVIDENCE: The home currently has a full complement of staff and there continues to be a core group of staff who have worked in the home for a long time. Two members of staff received awards after being nominated through “Care Choices” magazine. Awards were presented by Dame Vera Lynne. There were sufficient staff on duty on both days of the inspection. A new member of staff confirmed that they had received a thorough induction since starting work in the home. Files of two staff members were checked and contain all of the required information including police and health checks and two references. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 18 75 of staff have NVQ level 2 or above. Staff training plans are available and there are individual staff training records. All statutory training has been carried out and training is booked at regular intervals. Specialist training is sourced externally, for example in challenging behaviour which is provided by specialist staff from Newcastle General Hospital. Domestic staff confirmed that they had received training to help them work safely with chemicals. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 19 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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager in cooperation with Southern Cross ensures that there are systems in place to make sure that the home is managed effectively taking into account the needs and wishes of the residents. Clear safe working practices are used in the home in line with the company policies and procedures. Personal allowance management is good and the systems and records are in place to allow audit to be effective. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home is managed by an experienced manager and deputy. There are clear lines of accountability and a representative from the company visits regularly to carry out checks that the home is operating satisfactorily (regulation 26 visits). The home continues to be run in the best interests of residents. The newsletter keeps residents and visitors up to date with events and there is evidence through discussions with staff, of self monitoring. The deputy described a number of exciting projects that they hope to start in the near future, including continuing to build links with the community. Residents funds are now all held communally. This does not enable individual residents to accrue their own interest but the company is reviewing the way that residents funds are held. The communal fund does not accrue interest. They are regularly audited and there is a clear audit trail. Receipts for all purchases are held. Regular safety checks are carried out in the home. These include fire safety checks, water temperatures, and electrical checks. The handyman carries out these checks. Some checks are carried out monthly and others are weekly. The handyman had been on leave for three weeks so some weekly checks were out of date, although monthly checks were up to date. Risk assessments requested at the last inspection have been provided. These relate to residents wishing to leave the home unsupervised. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 21 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 4 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 2 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 Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 22 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. 2. 3. Standard OP19 OP21 OP19 Regulation 23(2) (d) 23 (2) (j) 23 (2) (m) Requirement Monitor and address mild malodour on middle floor. All bathrooms must be available for use and not used for storage. Provide additional storage in some en suite bathrooms. Timescale for action 17/09/07 17/09/07 17/09/07 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 OP7 Good Practice Recommendations Where residents are unable to sign care plans this should be noted. Orchard Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Mews DS0000000450.V344244.R01.S.doc Version 5.2 Page 24 - 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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