Inspection on 11/11/05 for Orchardown Rest Home

This inspection was carried out on 11th November 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

Orchardown Rest Home 09/10/07

Orchardown Rest Home 15/08/06

Orchardown Rest Home 01/04/05

Orchardown Rest Home 04/11/04

Orchardown Rest Home 29/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Orchardown 4-6 Old Orchard Road Eastbourne East Sussex BN21 1DB Lead Inspector Gwyneth Bryant Announced Inspection 11th November 2005 09:00 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 Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Orchardown Address 4-6 Old Orchard Road Eastbourne East Sussex BN21 1DB 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) 01323 726829 Mrs Visnja Mazzoli Mrs Linda Clarke Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is seventeen (17) Service users accommodated must be older people aged sixty-five (65) years or over on admission. 1st April 2005 Date of last inspection Brief Description of the Service: Orchardown is registered to provide care and accommodation for up to nineteen older people who must be aged 65 years or over on admission. Both long term and respite care is provided. Nursing care is not provided. The home is situated close to Eastbourne town centre and railway station. The town shops, library, GP and dentist surgeries are within easy walking distance. The home is a large detached Edwardian house on three floors, with the upper floors accessible via a passenger lift. The home provides two lounges, one dining room and a conservatory looking out to the large rear garden that is well maintained and easily accessible to service users. Grab rails and toilet riser seats are provided throughout the home. Thirteen of the bedrooms have full en-suite facilities, however, en-suite baths are not used as risk assessments undertaken by the Manager found that their use is unsafe for staff. There remain sufficient bathing facilities to meet service users needs, including one assisted bath and a walk in shower. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act2000 and Care Homes Regulations`2001 uses the term ‘service users’ to describe those living in care home settings. For the purpose of this report, those living at Orchardown will be referred to as ’residents’ at their own request. This was an announced inspection and there were fourteen residents in residence on the day and one who was in hospital. The inspection took place over 5 ¾ hours and its purpose was to check compliance with requirements from the last inspection and to inspect other standards. Residents were spoken with individually and as a group. All residents spoke very positively about the care received, the quality of meals and all mentioned the kindness and consideration of staff. A range of documentation was viewed including residents care plans, personnel files and medication records. A tour of the premises was carried out. One carer, one relative, the Registered Manager and Registered Provider were spoken with. The Inspector would like to thank the resident who undertook to coordinate the service users link pilot scheme. This scheme was designed to enable residents to complete comment cards and return them to the inspector via another resident. All residents returned the comment cards and the outcome was that all were very satisfied with the services provided. What the service does well: What has improved since the last inspection? All staff have now completed training in adult protection procedures and all residents care plans are compiled using the new format. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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 Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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, 4 and 5 Standard 6 is not applicable Satisfactory pre-admission assessments are carried out prior to residents moving into the home that ensure that their assessed needs can be met. Visitors are made welcome to the home at all reasonable times. EVIDENCE: Pre-admission documentation was viewed for recent admissions and it is evident that these documents are used effectively to ensure the home is able to meet the needs of prospective residents. Residents spoken with confirmed that their family and friends visit regularly and feel welcomed by staff. The one relative spoken with confirmed that she was able to visit whenever she chose and that staff made her welcome. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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, 10 and 11 The care planning system is clear and consistent and provides staff with the information they need to satisfactorily meet residents’ needs. Residents are protected by satisfactory systems for the recording, handling and storing of medication. Residents’ privacy and dignity is protected. EVIDENCE: A sample of care plans were viewed and found to be detailed and clearly outline residents care needs and how they are to be met. They include personal preferences in respect of getting up, going to bed, and whether or not they require tea-making facilities in their rooms. The care plans are reviewed on a regular basis, the manager and staff have a good understanding of residents needs and were able to discuss them and explain the support that is provided. Satisfactory risk assessments are carried out for all activities both within and outside the home. The residents spoke positively about the care they receive and that they felt they could discuss any issues with staff or the manager. Staff were observed to treat residents with respect and it was evident that staff and residents are comfortable with each other. Residents are registered with GP’s and can access other health professionals as required, including chiropodist, district nurses and dentist. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 10 Medication records and storage arrangements were viewed and both aspects were satisfactory. Medication administration charts were up to date, accurate and clear. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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 Residents’ benefit from a wide range of activities both within and outside the home. The routines of the home enable residents to exercise choice and control over their daily lives. The meals in Orchardown are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The home provides a daily programme of in-house activities in addition to outing to local attractions, tearooms and the theatre. The home also organises regular theme based events and residents are encouraged to invite family and friends to these events. Prior to the inspection the inspector joined staff, residents and relatives for a Halloween celebration. This was a very enjoyable event and both residents and relatives said how much they enjoyed the afternoon and that earlier events at Easter and in the Summer were equally delightful. During the inspection a number of cards from relatives were viewed and all were very positive about the various events organised by the home. One carer was seen to be providing a hand massage for one resident who confirmed this is a regular occurrence as she enjoys it very much. The relative spoken with said she was always made welcome and was happy with all aspects of the care given. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 12 The provision of these events and outings demonstrates that the standard is exceeded. Choices are offered at each meal, residents were positive and complementary about the food. Menus were viewed and found to offer more than one choice for the main meal of the day. Residents are encouraged to comment on the menus during the residents meetings. Residents are encouraged to eat in the communal dining room but may eat in their rooms if they wish. Care plans included residents personal preferences and there was evidence to show they are encouraged to exercise choice over all aspects of their daily lives. Satisfactory risk assessments are in place to ensure residents are able to go out into the community at times and days of their choosing. One resident said it was lovely that the home provided so much care when needed but no one interfered in things that she chose to do. The manager has recently subscribed to an organisation that provides a range of information and support to ensure residents’ autonomy is protected and enhanced. This includes information on advocacy to ensure they have to opportunity to have their views listened to. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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 The home has a satisfactory complaints procedure with some evidence that residents feel that their views are listened to and acted upon. Systems are in place to protect service users from all forms of abuse. EVIDENCE: There have been no complaints since the last inspection and residents said they felt they could talk to staff or the manager if they have any concerns. They also said they could discuss things in the residents meetings. The home has policies and procedures in respect of adult protection. Training in Adult Protection and Whistle blowing is provided for all the staff and the manager has a good understanding of the issues regarding adult protection and what action needs to be taken should there be any concerns. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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, 24, 25 and 26 Residents benefit from a safe, attractive and well maintained environment. Resident’s bedrooms are comfortable and they are able to bring in their own possessions. Satisfactory systems of infection control are in place to protect residents and staff. EVIDENCE: A tour of the premises was carried out and all parts of the home are well maintained, including the gardens and décor is also good. All repairs and maintenance is carried out promptly and satisfactorily. Since the last inspection six bedrooms and all communal areas have been redecorated and carpets replaced in the hall and communal areas. Residents are encouraged to personalise their rooms and many have done so with ornaments and pictures. Residents spoken with said they felt their rooms were pleasant, comfortable and that they felt able to treat Orchardown as their home. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 15 All floors of the home are accessible via the passenger lift and aids and adaptations provided as required. The delivery temperatures of hot water in residents’ bedrooms is safe and guards have been fitted to all radiators. The laundry was clean, with washing machines that wash soiled laundry at high temperatures. All staff have been trained in infection control and were observed to put this training into practice. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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 The deployment and number of staff at key times is sufficient to meet residents care needs. Staff are provided with sufficient training to qualify them to meet residents assessed needs. The procedures for the recruitment of staff are appropriate and provide the safeguards to offer protection to residents. EVIDENCE: Staff rotas were viewed and showed there were sufficient staff on duty to meet residents needs. Since the last inspection staff hours have been increased ensuring that residents receive continuity of care from staff they know well. Residents said that staff have time for a chat and that they never felt rushed. Call bells are answered promptly and staff always respond in a positive manner to the bells. In addition to care staff cooks, domestics, maintenance and laundry staff are employed. Five staff have achieved NVQ 2 or above and the home is on target to ensure 50 of staff achieve this qualification by 2007. Personnel documents for the two recently recruited carers were viewed and this documentation showed that appropriate checks were undertaken including two written references and a Criminal Records Bureau check prior to appointment. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 17 Formal induction and foundation training programmes are in place and all new staff undertake this training to ensure they have the skills to meet residents assessed needs. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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, 36 and 38 The manager provides clear leadership throughout the home and residents benefit from a well supported team of staff. The introduction of formal quality monitoring systems would enable the Provider to critically evaluate the service and take action where required. Systems are in place to protect residents’ financial interests. There are systems in place that safeguard all aspects of the health, safety and welfare of service users EVIDENCE: The Manager is in the process of gaining NVQ 4 in care to add to her management qualification and ensure she fully meets the standard within the required timescales. She is experienced in the care industry and is clear on how to achieve the aims and objectives of the home. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 19 The introduction of formal quality assurance and quality monitoring systems would enable the provider to critically evaluate the service and ensure it is run in service users best interests. This was discussed with the registered provider and manager who are both aware of what evidence needs to be gathered to evaluate the service. Residents are encouraged to handle their own finances if appropriate; relatives and solicitors support others, while the home does not handle the financial affairs of residents. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. A written risk assessment of the grounds and premises in respect of safe working practices was available. Certificates to demonstrate that bath hoists, gas appliances, passenger lifts, electrical systems and appliances are safe were provided. Call bells, water temperatures, fire alarms and emergency lighting are regularly tested and action taken should any be faulty. Mandatory training is provided for staff and includes fire training in addition to infection control and first aid. Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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 3 3 N/a 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x 3 3 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 2 x 3 3 x 3 Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 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 OP33 Regulation 24(1ab) (2)(3) Requirement That formal quality monitoring and quality assurance systems be created and implemented. Timescale for action 11/02/06 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 OP31 Good Practice Recommendations That the Manager achieves NVQ 4 or equivalent Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Orchardown DS0000021181.V266185.R01.S.doc Version 5.0 Page 23 - 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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