Inspection on 26/06/07 for Orchard,The

This inspection was carried out on 26th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 21/02/06

Orchard,The 12/04/05

Orchard,The 14/01/05

Orchard,The 14/09/04

Orchard,The 04/03/04

Similar services:

Hillview Farm

Dalewood Respite Care

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

The Farmhouse

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

CARE HOME ADULTS 18-65 Orchard,The 20 Church Road Wootton Isle Of Wight PO33 4PX Lead Inspector Annie Kentfield Key Unannounced Inspection 26th June 2007 14:30 Orchard,The DS0000012593.V338739.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,The DS0000012593.V338739.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,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard,The Address 20 Church Road Wootton Isle Of Wight PO33 4PX 01983 884092 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 Barbara Winifred Anne Bailey Mrs Barbara Winifred Anne Bailey Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: The Orchard is a small 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 user’s 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 Mrs and Mrs Bailey and managed by Mrs Barbara Bailey. The home is accessible and the service user is fully mobile. The fees are £362.04 per week and the service user makes a small contribution towards transport costs. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report provides an overview of information about the service since the last inspection of 21 February 2006. The service user completed a comment card and the manager provided information in advance of the visit in the form of an Annual Quality Assurance Assessment. The site visit was arranged with limited notice to ensure that the one service user and the manager were at home. The visit took place over 4 hours on a weekday late afternoon. The service user stated that he is very happy and has no worries or concerns. Records kept by the home are in good order and up to date. What the service does well: What has improved since the last inspection? 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,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 6 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,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 7 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 and 2 – Quality in this outcome area is good. The home provides a Statement of Purpose that is specific to the home and the service user they care for. The needs of the service user are regularly reviewed. 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 Statement of Purpose is specific to the home and the needs of the service user and clearly sets out the objectives and philosophy of the service provided to the one service user. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 8 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 – 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service is totally person centred and committed to supporting the service user to lead a purposeful and fulfilling life as independently as possible. EVIDENCE: The service user has been supported to write his own care plan identifying the areas he needs support with, and how he would like that support. The service user confirmed that he had been involved in the care plan and was fully aware of the information written in it. The manager encourages the service user to make choices and take responsibility for his own decisions. The service has a ‘can do’ attitude and risks are recorded and managed positively to help the service user lead the life he wants. The manager spoke knowledgably of the ways this can be done and the progress that has been made in this area. The home does not restrict the service user’s rights and any concerns would be discussed with the service Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 9 user’s care manager who carries out a regular six monthly review of care with the service user and the home. The manager is appointee for the service user and evidence was seen of accounting systems and financial records and the service user makes decisions about how his personal money is spent. The manager is clear about the need for confidentiality and the rights of the service user and would not share information inappropriately. Information within the home is appropriately stored. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 10 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 – 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home understands the importance of enabling a younger adult to achieve their goals, follow their interests and be integrated into the community life and leisure activities in a way that is directed by the person using the service. 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 a holiday he had undertaken with Mr Bailey in October 2006. 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 Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 11 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. Meals were discussed and it is evident that the service user has lots of choice and enjoys a healthy and nutritious diet with access to fruit, snacks and drinks at any time. The service user also enjoys meals out with Mr and Mrs Bailey and their friends and family. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 12 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 and 20 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the service user are met in a way that is person centred, flexible and consistent with the changing needs of the service user. EVIDENCE: The service user is registered with a local GP in East Cowes. 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. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 13 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows the service user to express his views and concerns in a safe and understanding environment. The home has the protection and safety of the service user as a priority. EVIDENCE: There have been no complaints about the service and the service user was clear that he had no complaints but would know what to do if he was unhappy about anything - the service user could speak to his care manager or his day centre key worker if he needed to. The manager is clear about her responsibilities in connection with safeguarding vulnerable adults and has a written policy and procedures and is aware of the Isle of Wight Safeguarding Adults policy. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 14 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, 26, 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The living environment is appropriate for the particular lifestyle and needs of the service user and is homely, clean, safe and comfortable, and very well maintained. EVIDENCE: The home is 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 very keen to show the inspector his new bedroom that is decorated and personalised to a very high standard and provides ample space for the service user to have a bedroom/bed sitting room on the first floor. The adjacent bathroom has a Whirlpool bath, WC and washbasin. The service user Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 15 also has access to the ground floor shower/bath room that has non-slip tiles on the floor. 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 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. There is a separate utility room with tiled floor, sink, washing machine and tumble dryer. The service user is fully mobile and does not require any aids or equipment. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 16 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): 33 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not employ any staff but the service user is supported at all times by the manager and her family. 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. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 17 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, 38, 39, 40, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management arrangements of the home are appropriate to ensure the service user’s needs are met consistently, flexibly and competently. EVIDENCE: The manager, Mrs Bailey, has no formal care qualification, but does have in excess of 35 years practical experience of working within the area of learning disabilities. Mrs Bailey has an NNEB certificate and Mr Bailey is a retired teacher with remedial expertise. Mrs Bailey is leader of the Isle of Wight PHAB club. Mrs Bailey has been presented with an award at the House of Lords in recognition of her work for PHAB. Mrs Bailey has been involved in Person Centred Planning training and regulation related workshops. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 18 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. 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 his or her views. 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 needs of one well-known service user and therefore the policies/procedures are relevant, simple and straightforward. The service user has been involved in the formation of some of the policies such as the fire risk assessment and action plan in which he states what he will do if there is a fire in the home and he is in his bedroom. 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. Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 19 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 4 25 4 26 4 27 4 28 4 29 N/A 30 4 STAFFING Standard No Score 31 N/A 32 N/A 33 3 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 4 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 4 3 3 3 3 3 3 X Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 20 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. 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. Refer to Standard Good Practice Recommendations Orchard,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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,The DS0000012593.V338739.R01.S.doc Version 5.2 Page 22 - 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!