Inspection on 12/04/05 for Orchard,The

This inspection was carried out on 12th April 2005.

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,The 26/06/07

Orchard,The 21/02/06

Orchard,The 14/01/05

Orchard,The 14/09/04

Orchard,The 04/03/04

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

CARE HOME ADULTS 18-65 The Orchard 20 Church Road Wootton Isle of Wight PO33 4PX Lead Inspector Janet Ktomi Unannounced 2nd August 2005 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 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 Stationary 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. The Orchard Version 1.10 Page 4 SERVICE INFORMATION Name of service The Orchard Address 20 Church Road, Wootton, Isle of Wight, PO33 4PX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 884092 Mrs Barbara Winifred Anne Bailey Care Home 2 Category(ies) of Learning disability (2) registration, with number of places The Orchard Version 1.10 Page 5 SERVICE INFORMATION Conditions of registration: none Date of last inspection 14/1/2005 Brief Description of the Service: The Orchard is a residential care home providing care and accommodation to one service user with a learning disability. The home is a chalet bungalow situated in a quiet residential area of Wootton, a short walk from local shops and amenities. The property is domestic in every respect with the service users bedroom on the first floor. There is space for off road parking to the front and a large garden to the rear that is available for use by the service user. The home is owned by Mr and Mrs Bailey and managed by Mrs Barbra Bailey. The Orchard Version 1.10 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first inspection of this inspection year, core and additional standards were assessed. Core standards not assessed during this inspection will be assessed during the second inspection. The service was provided with limited notice of the inspection to ensure that the one service user and the manager were at home. The inspection was undertaken on a weekday late afternoon and lasted one and a half hours. Discussions were held with the manager and the service user. The service user stated that he is very happy and has no worries or concerns. Records and documentation identified in the report were viewed. What the service does well: What has improved since the last inspection? What they could do better: The service provided is individual and exceptional. There are no areas that the inspector feels could or should be improved. The Orchard Version 1.10 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Orchard Version 1.10 Page 8 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 Standards Statutory Requirements Identified During the Inspection The Orchard Version 1.10 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The service does not intend to admit any new service users. none EVIDENCE: The manager confirmed that the home does not intend to admit any new service users. The service exists solely to continue to provide a home for the one service user and would cease to exist as a registered home should the service user move to alternative accommodation. The Orchard Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 , 9 and 10. The service user’s physical, social and emotional needs are fully met at the home. EVIDENCE: The service user has been supported to write his own care plan identifying the areas he needs support with. This covers all the necessary areas. The care plan and care manager reviews identify future needs of the service user, as well as current issues and identifies how these will be met. The care plan and review notes were viewed during the inspection and are appropriately stored within the home. The manager encourages the service user to make choices and take responsibility for his own decisions. The manager spoke knowledgeably of the ways this can be done and the progress that has been made in this area such as writing his own plan of care. Discussions with the service user confirmed that he is able to make decisions for himself and is aware of the consequences of these decisions. The home does not restrict the service user’s rights and the The Orchard Version 1.10 Page 11 manager confirmed she would discuss any concerns with the service user’s care manager. The manager is appointee for the service user and there was evidence seen during the inspection that the service user makes decisions as to how his personal money will be spent. The service user confirmed that he is able to make his preferences known and that he is involved in decisions about the home. During the inspection it was evident that the service user felt comfortable with the manager and her family and able to make any suggestions or requests as they occur. The policies and procedures within the home are specific to the needs of the service user. The manager clearly understands the service user, his needs and capabilities. He is encouraged to consider the implications of his actions and to understand any risks involved. The service user attends day services, works daily and is able to use public transport with an escort to get around the Island. The home has an appropriate procedure in place should the service user have any unexplained absences or not return home at the time expected. The manager and her family are well used to working with the rules for confidentiality. The manager was clear about the service user’s right to confidentiality and would not share information inappropriately. The service user attends social services review meetings. Information held within the home is appropriately stored. The Orchard Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15, 16 and 17. 11, 12, 13, 14, The service user has chosen an active lifestyle appropriate for his age. EVIDENCE: Care plans, along with discussions with Mr and Mrs Bailey and the service user, indicated that he is able to maintain and develop social and leisure skills and activities with disabled and non-disabled people. This increases his selfconfidence, self-esteem, independence and communication skills. The service user is supported to develop practical life skills within and outside the home in both formal (college and day services) and informal (social activities) settings. During the inspection the service user talked about external activities he enjoys and about visits from Mr and Mrs Bailey’s extended family. It was clear during discussions that the service user is able to make decisions and is supported appropriately to do this. The service user discussed his day services and leisure activities with the inspector and is supported when necessary. It was clear that the service user has control over what he does and how he spends his time. The Orchard Version 1.10 Page 13 The service user is very much part of the local community and informed the inspector that he knows and likes the people who live in neighbouring houses. The service user is involved in local activities, church events, the PHAB club held in Wootton Youth Centre and he attends local pubs frequently, where he especially enjoys playing pool with the other regulars. The service user is supported to attend activities in other parts of the Island and transport is available via the car owned by Mr and Mrs Bailey. The service user is registered to vote and would be supported to exercise his rights if he wanted to. It was clear during the inspection that the service user is able to choose what he does and how he spends his time. The service user has his own television, video player, DVD player and music centre in his bedroom. The service user also spends time in craft activities. The service user is planning a holiday in October with Mr Bailey. The service user confirmed that he is fully involved in decisions about holidays and where he would like to go. The service user has no contact with his birth family and regards Mr and Mrs Bailey as his family as he has lived with them since the age of 14 months. During the inspection the service user talked about visits from Mr and Mrs Bailey’s daughter and grandchildren that he had clearly enjoyed. Mr and Mrs Bailey’s other daughter is a regular visitor to the home and the service user clearly enjoys her company and social activities with her. The service user is able to invite friends to visit him and is supported by Mr and Mrs Bailey to maintain contact with friends. The service user has many friends, both disabled and non-disabled within the local community. Mrs Bailey confirmed, and the service user agreed, that he has a lot of choice in his daily life. All mail is opened with the service user present and he is assisted to understand its contents and respond appropriately. The service user clearly felt able to express his opinions and thoughts to Mr and Mrs Bailey. The service user enjoys the pets (one dog and two cats) that live at the home and is involved as appropriate in their care. The service user does not smoke and the home has a non-smoking policy. The service user was very complimentary about the food provided at the home and stated that he is involved in family meal choices. The Orchard Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. The service user’s personal and healthcare needs are met. EVIDENCE: The service user is virtually independent in all areas of personal care requiring only some physical support. The service user has a daily routine for getting up, baths, mealtimes and bedtimes. Verbal support is provided tactfully by the manager and she reported that the service user accepts suggestions appropriately. The service user has his own bathroom adjacent to his bedroom and his privacy is respected. The service user does not require any aids or equipment to maximise independence. The service user is registered with a local GP in Wootton. The service user is happy for one of the proprietors to accompany him for medical appointments and will tell them if he has any health concerns. The service user is generally fit and healthy. The service user has regular health checks, Chiropody, Dental and Optician appointments. The manager maintains a record of all visits to health professionals and advice/action taken. The service user has been assessed as being able to self medicate and does this as part of his daily routine. The service user will request Paracetamol from Mrs Bailey should he have a headache or pain. The Orchard Version 1.10 Page 15 The Orchard Version 1.10 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The service user is able to complain and he is protected from abuse. EVIDENCE: There have been no complaints about this service. The service user was clear that he had no complaints and confirmed that he was aware of how to make one. The service user could also make a complaint via his care manager or his day services who would ensure that appropriate action was taken to resolve any complaints. The manager was aware of the need for the service user to feel he could make complaints and would pass on complaints either to his care manager or to the Commission. The home has a copy of the Isle of Wight adult protection policy. The manager was clear about her responsibilities in connection with adult protection and the action she should take should she have any concerns. The Orchard Version 1.10 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 and 30. The accommodation provided is to a high standard and meets the service user’s needs appropriately. EVIDENCE: The premises are domestic in nature, very clean and comfortable with a homely atmosphere. There is a very good standard of decoration throughout and the service user has access to all parts of the building and the garden to the rear. The home is within easy walking distance of the shops and amenities and close to a bus route that provides services to other parts of the Island. Mr and Mrs Bailey have a car that is used for the service user when required. The service user was happy to show the inspector his bedroom and bathroom that are decorated and personalised to a high standard. There is central heating and natural ventilation, and the room contains all required furniture, fixtures and fittings. The adjacent bathroom has a Whirlpool bath, WC and wash-basin. The service user also has access to the ground floor shower/bath room that has non-slip tiles on the floor. The Orchard Version 1.10 Page 18 The home has accessible indoor and outdoor communal space that exceeds the standards required. There is a large Kitchen/dining room, separate dining room, lounge, conservatory and a sitting/computer area on the landing close to the service user’s bedroom. All areas of the home are decorated to a high standard, well maintained, clean and tidy. The service user is fully mobile and does not require any aids or equipment. There is a separate utility room with tiled floor, sink, washing machine and tumble dryer. Mrs Bailey confirmed that the washing is done to the recommended temperatures. No sluicing facility is required and the home has been inspected by Environmental Health and found to comply with all the required legislation. At the time of this inspection the home was found to be clean, tidy, and free from offensive odours. The Orchard Version 1.10 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The service user is appropriately supported at all times. EVIDENCE: The home does not employ staff and therefore the standards within this section are not applicable. The service user does not require physical care, his needs relate to emotional and organisational support. He is quite independent and does not need constant supervision. The family is aware of the service user’s needs and ensure these are met. The extended family provide care and support if the proprietors are unavailable and are appropriately trained via their care related employment. The Orchard Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 and 43. The management arrangements of the home are appropriate to ensure the service user’s needs are met. EVIDENCE: The manager, Mrs Bailey, has no formal care qualification, but does have in excess of 35 years practical experience of working with learning disabilities. Mrs Bailey has an NNEB certificate and Mr Bailey is a retired teacher with remedial expertise. Mrs Bailey is the chairperson of Friends of Medina Centre and leader of the Isle of Wight PHAB club. Mrs Bailey has been involved in Person Centred Planning training and regulation related workshops. Evidence of training attended was seen during the inspection. The home is a family home and the atmosphere is one of warmth and caring with each member sharing views and desires. The manager shares her role with her husband, but takes most of the responsibility for the paperwork. The Orchard Version 1.10 Page 21 During the inspection the interaction between the service user and the manager was positive and he clearly felt able to state his views and opinions. Although there are no formal quality assurance processes in place there are regular reviews of the placement by Social Services. This gives everyone an opportunity to voice their views on the care given. These reviews are detailed and written records were seen during the inspection. There is a range of policies and procedures in place. These are appropriately stored together with other paperwork relating to the placement. The family is aware of the information kept and how to access it. The care is tailored to the one well known service user and therefore the policies/procedures are relevant, simple and straightforward. The records kept by the manager are sufficient to cover the nature of the service offered. As previously stated records are held in a lockable facility. The home has the relevant insurance certificates that were seen during the inspection. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 The Orchard Score N/A N/A N/A Standard No 22 23 Score 3 3 Version 1.10 Page 22 4 5 N/A N/A ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 4 N/A 4 Standard No 11 12 13 14 15 16 17 4 4 4 4 3 4 4 Standard No 31 32 33 34 35 36 Score N/A N/A 3 N/A N/A N/A CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 The Orchard Version 1.10 Page 23 no Are there any outstanding requirements from the last inspection? 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 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. Refer to Standard Good Practice Recommendations The Orchard Version 1.10 Page 24 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, PO30 2AA 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 The Orchard Version 1.10 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!