Inspection on 26/07/06 for Orchard Mews

This inspection was carried out on 26th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 11/07/07

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 Key Unannounced Inspection 26th July 2006 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.V295136.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.V295136.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 Healthcare Services Limited 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.V295136.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. 28th February 2006 Date of last inspection 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. Fees range from £355 to £447 Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection involved a tour of the premises, discussions with staff and residents and a review of records. The inspection found that the overall standard of care is good. What the service does well: What has improved since the last inspection? A disused lounge has been turned into a “Hollywood room” for the entertainment and enjoyment of residents. Residents who have dementia have been given the opportunity to have their bedroom door decorated in a colour of their choice, and decorated to look like a front door. Tactile boards are on the walls for people with dementia to enjoy and explore. Staff supervision takes place on a regular basis meaning staff have the opportunity to meet with their line manager in private and discuss concerns or practice issues. Orchard Mews DS0000000450.V295136.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. Orchard Mews DS0000000450.V295136.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.V295136.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Intermediate care is not provided. Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Each service user has his or her needs assessed before moving into the home. The home is not registered for, and therefore does not provide intermediate care. EVIDENCE: Staff carry out a detailed pre admission assessment and speak with the residents and family prior to admission. Care plans have good information to ensure that the home can meet the needs of the prospective resident. Physical care plans are now in place upon admission. This was a requirement set at the last inspection and has been met. Pre admission assessments are obtained from other professionals such as social workers, psychiatrists and health. Intermediate care is not provided. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Health, personal care and social needs are set out in an individual plan of care. Service user health needs are fully met. Residents are protected by the home’s medication policy. Residents feel treated with respect and their right to privacy upheld. EVIDENCE: Care plans are detailed and up to date. They are evaluated on a regular basis. The company documentation says that all residents should have a manual handling care plan, and a falls risk assessment. Not all residents have these. It is also recommended that where someone has been found to be at high risk of developing a pressure sore, a preventative plan be put in place. The company documentation also says that where someone has a falls risk of 4 and above, a care plan must be in place. The manager should consult the company senior management to confirm their expectations with regard to these assessments. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 10 The health needs of residents are met. District nurses visit the home regularly. Records of professional visits are also kept such as GP visits. Residents spoken to felt that they are well looked after. The medication records are up to date and the trolley is clean and tidy and contains only items that should be there. Medication is now supplied by Boots pharmacy. Satisfactory procedures are in place for the disposal of medicines. The temperature of the fridge in the treatment room is taken daily. A random check of controlled drugs was carried out. There were more tablets than there should have been, and this was due to a delivery having been received and not recorded. Records must be completed when medicine arrive in the home. Residents spoken to said they feel they are offered choices most of the time. Staff treat people with respect and demonstrate a genuine affection for residents. Resident are offered choices throughout the day and appeared to be doing things that they enjoy. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The social and recreational needs of service users are met. Service users maintain contact with the local community and family and friends if they wish. Service users are helped to exercise choice and control over their lives. A wholesome and appealing diet is provided. EVIDENCE: A good range of activities is available. There are group activities and organised entertainment evenings on a regular basis. These are advertised on the notice board. A number of people were involved in different activities throughout the home on the day of the inspection. For example, someone was sitting knitting in their room, someone else was feeding pigeons on the courtyard from their window, and some people were involved in group activities with the activity coordinator. A group of people were watching “The Titanic” which they had paused while they were having lunch. The activity Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 12 worker constantly moves around the home, starting people off with various activities and checking they are managing. This makes maximum use of her time and works very well. An aromatherapist visits the home regularly. Residents are encouraged to maintain contact with family and friends and they may meet with them in private. The home also encourages contact with the local community. On the day of the inspection, a luncheon club was arranged. “Friends of Orchard Mews” continue to be active, and a regular newsletter is provided. Choices of meals and drinks are offered to residents. Staff supported the choice of one resident to keep her own pharmacist as she had used them for many years. This was despite the corporate contract changing to another provider. Another resident said he would like the opportunity to go out and buy his own newspaper accompanied by staff. Staff agreed that he could do this, and said that he already does so, but would ensure he is offered this opportunity on a regular basis. Some residents wander freely around the grounds or sit at the front door. It is recommended that a risk assessment be carried out and recorded in their file to confirm that this is safe. One person administers their own medication. Another manages their own finances and has a safe in their bedroom. The kitchen was not fully inspected during this inspection, as staff were very busy preparing for lunch and a buffet for the luncheon club. At the last inspection, it was found that kitchen staff were frequently changing the menus. The manager confirmed that staff no longer change the menus except when it is unavoidable. This is checked daily and they must write down occasions when it has been changed and why. Residents spoken to say that they enjoy the food. Dining rooms are pleasantly decorated and tables have tablecloths and napkins. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Complaints procedures ensure that service users and relatives are confident that their complaints are listened to and acted upon. Service users are protected from abuse. EVIDENCE: There has been one complaint to the home since the last inspection, and one anonymous letter expressing a concern sent to CSCI. The complaint was recorded in a complaint book and the outcome also recorded. There is a file containing company standard documentation, including complaints forms. It is recommended that these are used instead of the book. They are more detailed and professional in style. There has been one adult protection allegation since the last inspection. This was unsubstantiated. All staff in the home did a three-month distance learning POVA training course ending in August 2005. Another course must be provided for new staff that have started work in the home since then. It is also recommended that a short in house refresher training course be carried out for those who attended the course last year. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users live in a safe well-maintained environment. There are suitable and sufficient lavatories and wash facilities but one bath is out of use. The home is clean, pleasant and hygienic. EVIDENCE: The home has benefited from a number of rooms being decorated since the last inspection. Some carpets have also been replaced. The corridors upstairs have been repainted. The colour does not go all the way to the top of the walls, a border of white at the top, matching the white ceiling, gives the illusion that the ceiling is higher. Previously it felt quite claustrophobic, so this is an improvement. Residents with dementia live on this floor so this attention Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 15 to the surroundings is very beneficial to their well-being. The residents have been offered the opportunity to have their bedroom door decorated like a front door and painted in a colour of their own choice. There is a brass doorknocker, nameplate and fake letterbox. Some relatives have remarked that the residents have often chosen the colour door they used to have. It is hoped that this will assist people to locate their own room more easily. Some tactile boards have been placed on the walls in the upstairs corridor. These provide an interesting feature and consist of a wooden board with items of interest attached to them. They can be simply regarded as three-dimensional art or residents with dementia may touch them. One board for example has door bolts and door chains on which can be opened and closed, attached and unattached. The boards can also be removed and taken to show people. A disused lounge has been converted into a “Hollywood” room, with black and white pictures of film stars in frames secured to the walls, and a miniature Jukebox. Staff report that residents enjoy looking at the pictures and can remember old films. There is a very pleasant sensory garden, which contains scented plans, wind chimes and water feature. There is a miniature “pond”, and it must be confirmed that this is a safe depth, and has been risk assessed. One resident spoken to has a bedroom overlooking the courtyard sensory garden. He was enjoying watching birds that had been fed bread on the patio, and the bees on the lavender. He explained that residents had been doing hanging baskets. The home has won a regional final in a Southern Cross Health Care competition. Residents plant the baskets, which they did with a world peace theme including different coloured plants and flags, and a sensory basket with herbs. It is disappointing to note that there continues to be a tendency to place chairs against the wall in rows in lounges. This was the only criticism in what is otherwise a very well planned environment, especially for people with dementia. There are suitable and sufficient lavatories in the home. Bathrooms have been decorated to make them homely and inviting. An anonymous letter was sent to CSCI stating that one of the assisted baths on the ground floor was broken for a long period. The manager confirmed that this was the case but that they were still able to use the bath but not tilt it. Residents who wished to be tilted back have been using the bath upstairs. There has been a delay in receiving repairs and this bath must be quickly repaired to full working order. The home is clean, pleasant and hygienic. There were no odour problems encountered during the inspection. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users needs are met by the number and skill mix of staff and are in safe hands at all times. Satisfactory recruitment procedures are in place to protect service users. Staff are trained and competent to do their jobs. EVIDENCE: The manager reports that there is a very stable staff team at present who are working well together. There are sufficient staff on duty. Most staff have worked in the home for a long time. New staff complete an induction programme. Orchard mews does not provide nursing care, there are therefore no nurses employed. There is a manager and deputy manager, who are supported by senior care and care staff. There is a head cook and assistant cook, a head housekeeper and two domestic staff. There is a maintenance man and separate laundry assistant. The activity assistant is employed for 20 hours per week. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 17 Staff files contain all of the correct information for the recruitment of staff. There include two references, and appropriate identification records including criminal records checks. Staff have received training in Fire safety, food hygiene, moving and handling, first aid, medication, palliative care (care of dying), dementia and NVQ training. The manager has completed the Registered Manager’s Award, and the deputy is close to completing it. Further dementia training and NVQ training is planned. Additional POVA training must also be arranged. Regular supervision and appraisal now takes place to monitor staff competence. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,and 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users live in a home that is well managed by a person fit to be in charge. The home is run in the best interests of service users. Service users financial interests are safeguarded. The health, safety and welfare of service users are promoted and protected. EVIDENCE: The manager has many years experience working at Orchard Mews. The manager and deputy have worked hard over the past six months to meet all Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 19 the requirements set at the last inspection. Standards of record keeping, the environment and the activities available in the home are continuing to improve. Systems of monitoring staff compliance with procedures (such as menus) have proven effective. The home is run in the best interests of residents. The residents on the ground floor require personal care and do not suffer from dementia. It is evident that people are encouraged to remain as independent as possible. The middle and top floors care for people with various forms of dementia. There is evidence that in addition to personal care, the home is striving to deliver a truly specialist standard of care to meet the psychological needs of these residents. The environment has been carefully planned and management and staff must be commended for their efforts. A random check of residents funds found that accounts were correct. One resident is reluctant to allow the home to hold their money and has, on occasion, lost some large sums of money. They have been provided with a safe in their bedroom, and they also keep their room locked. The social worker and family are aware of this arrangement and are monitoring how effective this is. There are satisfactory safety procedures in place. Water temperatures of two baths were checked and found to be satisfactory. Maintenance records are up to date, and are reviewed monthly by the manager. Water temperatures, window restrictors and wheelchairs are regularly checked. Shower heads are cleaned and disinfected on a regular basis. It is recommended, as previously mentioned, that risk assessments are carried out to asses those residents who may safely leave the home unsupervised. The front door is left open at times, usually at the request of residents. This should also be considered as part of the general risk assessment in the home, including the risk of intruders. It is recommended that general health and safety training is provided, in particular to managers and senior care staff. Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 20 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X 2 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 2 Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (2) (c) Requirement Care plans for falls risk and moving and handling must be in place in line with company policy. Where a service user is identified as being at high risk of developing pressure sores, a preventative plan must be in place. Controlled drugs must be recorded upon receipt. Agreed immediate compliance. POVA training must be arranged for new staff. The assisted bath must be brought back into use. Individual risk assessments must be completed regarding unsupervised access to grounds and community. The risk of the open door must be included in general risk assessment for the home, including intruder risk. A risk assessment must be provided for the pond area in the Orchard Mews DS0000000450.V295136.R01.S.doc Version 5.2 Page 22 Timescale for action 26/08/06 2. 3. 4. 5. OP9 OP18 OP21 OP38 13 (2) 13 (6) 23 (2) (c) 13 (4) (a, b) 26/07/06 26/09/06 09/08/06 26/08/06 garden. 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 OP16 OP19 OP38 Good Practice Recommendations It is recommended that formal complaints documentation be used. It is recommended that chairs are not placed around walls in an institutionalised fashion. It is recommended that general health and safety training is provided. Orchard Mews DS0000000450.V295136.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: 0845 015 0120 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.V295136.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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