Inspection on 29/05/07 for Orford House

This inspection was carried out on 29th May 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Orford House 21/06/06

Orford House 13/02/06

Orford House 15/08/05

Orford House 15/07/04

Orford House 15/01/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Orford House Ugley Bishops Stortford Essex CM22 6HP Lead Inspector Sharon Thomas Key Unannounced Inspection 29th May 2007 09:30 Orford House DS0000017899.V341706.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 Orford House DS0000017899.V341706.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. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orford House Address Ugley Bishops Stortford Essex CM22 6HP 01279 816165 01279 816858 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) www.hft.org.uk Home Farm Trust Kerry Louisa Dunne Care Home 26 Category(ies) of Learning disability (26) registration, with number of places Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 26 persons) 21st June 2006 Date of last inspection Brief Description of the Service: Orford House is located in a rural location close to Stanstead Mountfitchet and is registered to provide accommodation for 18 people with varying degrees of learning disabilities. Accommodation is provided in one purpose built bungalow that provides 6 single rooms at ground floor level. While the newly furbished cottages provides 12 single rooms in 3 separate units. All of the accommodation provides en-suite bathrooms and is decorated and furnished to a very high standard. The home is located in large accessible, and extensive grounds. All bedrooms in the home are highly personalised. The communal areas are domestic in nature and well used by the residents. The home aims to provide personal, social and emotional care to the people living there while supporting their independence. The fees on the day of inspection ranged from £1,347. - 1,710. per week. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 29 June 2007; and included a tour of the premises, discussions with the manager and members of staff and with people who live in the home. No visitors were available to speak on the day. Observations of how members of staff interact and communicate with people living in the home have also been taken into account. A range of evidence was looked at when compiling this report. Paperwork used in the home was examined, such as menus, staff rotas, people’s support plans and staff files. Comments received from visitors and people living at the home were positive about the care and support provided by the staff. The home had not completed its pre-inspection document at the time of this visit so the information from this could not be used within this report. Care practices were observed throughout the visit and the relationships between staff and individuals are genuine, sensitive and professional. A total of twenty-two standards were inspected, twenty-one of which were met and one which was nearly met. This inspection visit raised one requirement and one recommendation and these can be found at the end of this report. On the day of the inspector’s visit the atmosphere in the home was relaxed and welcoming and the inspector was given every assistance from the manager and support staff. At the end of the inspection visit, the findings were discussed with the Registered Manager Kerry Dunne, and the Service Manager Sandra Forsyth. What the service does well: All staff have the proper checks carried out before they start work and they have a full range of training to help them do their jobs well. Orford House is a clean, comfortable and homely place, with a stable, family atmosphere. One person who lives there reported, “It is kept clean and always smells lovely” As far as possible, people have a say in how they lived their lives and how they are supported. Staff helped people to be as safe as possible. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 6 People felt comfortable asking staff for advice or talking about the things that mattered to them. One family member reported, “ My relative is very happy at Orford, everyone is very kind”. Staff did the right things to keep people healthy and supported them well when they became ill. 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. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 7 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 Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 8 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): 2: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service benefit from a well managed admission procedure. Overall the home has pre-admission systems in place that ensures that the home can meet the needs of the individual. EVIDENCE: Orford House has admitted a number of new people into the home since the previous inspection. The care plans for these individuals were examined and contained detailed information on the needs, wishes and opinions of the individual. The home’s pre-admission assessment document included information covering all aspects of the physical and personal care needs of the person, both present and future. One of the three files looked at contained all of the required information that would be used to judge whether the home could give the range of care that the person would need. One of the files looked at did not contain a copy of the required social service assessment. The manager confirmed that Home Farm Trust has a dedicated Social Worker who carries out the pre-admission assessments and that the manager is invited along to the pre-assessment visit. After the person has been on a number of trial visits to the home, the manager, staff, service manager and Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 9 people living in the home make the decision as to whether Orford House will be a suitable place for them to live. Staff spoken with confirmed that they were aware of the admission process and were supportive of both residents and relatives during this time. They stated that they received ‘a lot of information before people came to live in the home’. One of the relatives commented that they were fully involved in the preadmission planning process, and stated that the staff had been “very helpful and asked me what I thought he needed before he went to live there”. The care plans are generated by the pre-admission information resulting in the care plans being full of detail, directive to staff and provide a thorough picture of the person they will be caring for. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in Orford House have the benefit of a developing care planning system. People living in the home are fully involved in decisions about their lives and play an active role in deciding what care they get and how that care is given. Risks are identified and well managed. EVIDENCE: Three support plans were examined and contained very detailed information regarding what the person needs, the care that staff are to give, and the longterm aim of the care to be given. These support plans detailed what the person could do and what tasks they needed staff to help them with. They also gave a full account of what may make a person upset and what may make the person happy. Staff are given information on how to treat people in their care and are given clear directions on what care the person would need. The support plans cover all aspects of the person’s physical, mental and social care needs. The care plans are reviewed on a regular basis and are written in plain English. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 11 Staff said that “…support plans are well written and we are accountable for keeping them up to date’ and “…once I read the care plan I more or less know what I am supposed to do”.’ The support plans contained detailed risk and manual handling, Occupational Therapist and Physiotherapy assessments. There was evidence to confirm where individuals had been consulted and involved with developing their support plans. For those people less able to contribute there was evidence of family involvement. Most of the time staff were observed treating residents with care and respect, and were providing care that was written in the care plans. From discussion with staff and from observation of care practices in the home, it was evident that people in the home are supported to make decisions and choices regarding their lives. Promoting people’s independence is key to the aim of the home and staff spoke about this issue during the course of the day. The support plans provide information of how decisions had been made and by whom, and this matter was well recorded. One person said “…I do what I want every day and carers help me go out”. Records seen indicated that the home provides people with a range of opportunities and experiences that builds on their independence, including external activities including: attendance at church, day centre, shops, garden centres, seaside, annual holidays in UK. On the day people living in the home were undertaking a variety of activities and leaving the home at various times. The staff did not interfere with their choice of activity and individuals were asked throughout the day what they wanted to do and how they were going to do it. Staff were observed to be keen to give as much choice as possible through the use of a range of methods of communication. The staff spoken with confirmed that they were provided with information regarding risk throughout the support plan document. Any newly identified risks are bought to the attention of the support staff so that everyone is kept up date with any changes that affects the person. Support plans recorded a variety of risks including self-harm, road safety, fears and phobias, cooking, neglect, personal care, and memory and orientation. General and specialist risk assessments are found on individual support plans. People are able to leave the home alone or are escorted by a member of staff if required. The home’s aims and objectives is to promote independence, and if possible prepare the person for living independently in the community, therefore risk taking is central to the service. The people living in the home are obviously ‘in Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 12 charge’ of their own lives and support staff only provide care and support should it be required. This aspect of care is well planned and hazards are identified and addressed. Staff spoken with state that they discuss the risks around care with senior support staff and the manager on a constant basis. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 and 17: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home have opportunities for personal development. The home provides activities that are appropriate to their needs and they are supported to build and maintain relationships their families. The people living in Orford House benefit from a well-balanced, nutritional and varied diet. EVIDENCE: People at Orford House are supported to enjoy a full and stimulating lifestyle with a variety of options to choose from. Staff members were able to report that residents were supported to attend various clubs, garden centres, cinemas, shops, restaurants, colleges and many other activities. Individuals have opportunities at their meetings to voice their wishes regarding social events. The staff spoken with are aware of the social needs of the people who live at Orford House and work hard to encourage them to have a full range of activities outside the home. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 14 People spoken with confirmed during the conversation that they are ultimately in control of what they do regarding the type and amount of time they spend undertaking activities. The support plans recorded where choices made by individuals are respected and valued and there are flexible routines that meet the likes and dislikes of the person. People who are likely to miss lunch or dinner will plan with their support worker whether they will eat out or have their meal at home at a later time. The home has since the last inspection improved this aspect of care and now supports people to enjoy their free time either in the home or outside in the community. The service sought the views of the residents and their representatives and considered these when planning the routines of daily living and arranging activities. Routines and activities were flexible and focused around individuals’ changing needs and choices. Support plans that were looked at indicated that staff encourage people to continue their relationships with their families and friends. People are able, with the assistance of the staff, to visit their family home and take holidays with their relatives. One person said, “…I go to my Mum’s house and sometimes I stay there for the weekend”. The manager and the people spoken with confirmed that relatives are welcomed into the home at any time, there was evidence that families and friends are invited to events held in the home and people are able to meet others outside the home through the choices that they make. Individuals are encouraged to make their own choices regarding what food they eat on a daily basis, and the people living there confirmed this on the day. The inspector was invited for lunch by some of the people in the home and accepted. The lunchtime meal was made by the support staff and one of the people living in the bungalow. The atmosphere in the dining room was comfortable and had a family type feeling, staff helped one person prepare and serve the meal. Everyone eating the meal reported that they had enjoyed it. The lunch was made from fresh ingredients and was tasty and well presented. The people living in the home are encouraged to have a well-balanced diet and staff write up a weekly menu based on their choices. People in the home report that they each choose two meals a week and that there is a group decision for the Sunday lunchtime meal. Staff also monitor the amounts of food that people eat to make sure that they are eating enough healthy food. The fridges and freezers throughout the home are well stocked and clean, as are individual kitchens. The home has stocks of fresh, frozen and processed Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 15 foods that are used by individuals and staff. Since the refurbishment of the Cottages and the building of the bungalow, mealtimes have been described as “a very nice time” and it appeared that this is a social event enjoyed by all those involved. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 16 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: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service receive well-managed personal and healthcare support that is tailored to meet their changing needs. Staff are trained to provide a quality service that identifies and responds to individual healthcare issues. The home has systems in place that ensures the safe administration of medication and protects the individual. EVIDENCE: People’s health care needs are recorded in individual support plans and they are helped by staff to take decisions regarding their own health care needs. The support plans have been developed to provide more comprehensive and concise healthcare information for staff to follow. The community nurse, Occupational Therapist and physiotherapist are involved in the care of some of the people living in the home and details of this input is found in their support plans. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 17 One of these support plans sets out in plain language in-depth details of the person’s health issues and what to do to prevent deterioration and what to do if their health does deteriorate. Individual’s health care issues are monitored and reviewed and any changes in their health are reported to the GP and or District Nurse team. The home has strong links with the local primary health care team. People living in Orford House require minimal support with their personal care. However as people who live in the home become older, support with personal care from staff has increased. The support plans examined on the day clearly indicate the support and assistance required by the individual for their daily care and small detail such as ‘how to brush teeth’ details of how to ‘help the person have a bath’ and what approach needed, is recorded. The degree of detail is beneficial to both the people getting the care and staff giving the care. One support worker said, “…it is so important that the plans are up to date and give us all of the information we need to look after people properly”. Routines are flexible and take into account the wishes and abilities of the individual. Observations made on the day confirmed that strong, helpful relationships had been formed and that staff treat people in a sensitive and appropriate manner. Staff show patience and appear genuinely interested in the welfare of those living there. All of the people spoken with made positive comments about the support staff and said “…I like the carers, they are kind” and “…the staff help me do the cooking and she tidies my room when I am tired”. Policies and procedures are in place for the administration of medication and all medication is kept locked in secure facilities. The records for the administration, receipt, and disposal of medication are accurate and well maintained with no gaps in recording. All of the support plans examined contained a ‘consent to medicate’ document. The staff that are responsible for administering medication have now received the required training. Staff had a sound working knowledge and clear working practice regarding medication and the systems in operation to provide protection to people. Staff said “…I give medication and have received training” and “…the home is really committed to safety around medication” and “no one is allowed to give medication without being trained first”. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 18 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: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service have access to an understandable complaint procedure that ensures that they are listened to. The home operates robust practices and procedures to protect the people who live there. EVIDENCE: The home has a well-designed pictoral complaint procedure that is placed throughout various parts of the home. People who live in the home were able to explain in great detail how they can make a complaint and who to make a complaint to. Two people living in the home were able to ‘read’ through the document with the inspector, which gave a clear indication that they understood the document and its content. The complaint log was looked at and two new complaints have been entered, both complaints had the issue, the action taken by the manager, and the outcome of the complaint recorded for reference. The support staff working in the home were able to describe what they do when a complaint is made. They spoke of the procedure that they are expected to follow, how important it is to listen to the person making the complaint, and to encourage the person to make the complaint official. Staff are aware of the difficulties that some of the people living in the home may have in expressing themselves and will offer to use the pictoral complaint document with the person. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 19 Staff said “…I had training regarding this issue and know how to implement the complaint procedure should it be needed, I make sure that relatives are aware of the procedure’. The home has maintained its policy and procedures for Safeguarding Adults. All staff, apart from the most recent appointments, have been provided with training on the understanding, recognition and reporting of abuse. The home offers in-house training using the Essex County Council workbook and DVD. Training certificates were available on staff files. Ongoing training has been arranged to take place in 2007. Staff comments included “…I have received POVA training through the home and found it very helpful” and “I have received Adult Abuse training through HFT and found it very useful as it reminded me of my responsibilities and that the Whistle blowing policy is available’ Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 20 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 and 30: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Orford House provides the residents with a new, homely, warm, comfortable and accessible place in which to live. The home has adaptations and equipment that meets the needs of the people living there. The staff maintain an excellent level of hygiene. EVIDENCE: Orford House has had a major investment since the previous inspection visit. The service now has a new purpose built bungalow that has accommodation for six people. The bungalow is airy, spacious, comfortable and homely despite being a brand new building. The kitchen is large and up to date and the is decorated in neutral, calm colours. Visitors are able to meet with residents in the communal areas of the home or in their bedrooms. Two people living in the home showed the inspector their rooms and these were found to be very personalised and reflect the personalities of the person. They also reported “…I picked the colours and the furniture for my room” and “…love living here since the bungalow has been built” and “…we help the carers keep it clean”. The Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 21 staff stated, “…working in such a pleasant environment has changed the mood in which we work”. The building known as the Cottages has had a major refurbishment and this building now accommodates twelve people in three separate units. Each of the bedrooms has a large en-suite bathroom, the cottages units are decorated and furnished to a very high standard but it has maintained a homely atmosphere. The home’s laundry facilities are located away from communal areas and individual bedrooms to reduce the risk of cross infection. The equipment in the laundry is suitable for the needs of the people living there. The home has a sluice facility that is complimented by the sluice wash cycle of the washing machines. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 22 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): 32, 34 and 35: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in Orford House benefit from a skilled and competent staff team. The recruitment procedure in the home is well managed and provides the safeguards to make sure that appropriate staff are employed. The staff are provided with an effective programme of training. EVIDENCE: During the inspection the support workers were observed interacting with the people in their care. It was evident that warm and genuine relationships have been formed and maintained with the individuals. The support workers were observed to be aware of the needs of the individual and the client group as a whole. The home works within a multi-disciplinary framework and benefit from the support of the Occupational Therapists, Physiotherapists, and other professional agency identified within the individual support plan. The relatives commented that “staff are kind and caring and know what they are doing” and that “staff are fantastic, and make the home what it is”. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 23 One member of staff spent an unacceptable amount of time outside the building, smoking, this was reported to the manager as it was felt that by doing this the member of staff was unable to provide the appropriate levels of care to the people in the home. The personnel files of the three most recently employed members of staff were looked at and were found to contain all of the information necessary to ensure the safety of the residents through the recruitment process. The files contained an application form, the two required references, a Criminal Reference Bureau check and three forms of identification. Staff spoken with confirmed that they “… know that new staff are not allowed to start work at the home until all of the checks are in place”. The relatives commented “…I know that my daughter is safe in the home” and “…I trust the staff in the home”. Staff receive key training in the home that includes first aid, fire training, food hygiene and manual handling. Additional training includes: protection of vulnerable adults, medication training, managing challenging situations, and learning disabilities training. The home provides a thorough induction and foundation programme that meets the Skills for Care specifications. Orford House has a training budget and the manager takes the lead role in identifying and planning training for the staff working in the home. Up to date records are available that indicated the variety of training provided by the home. Staff spoken with stated that the training provided by Orford House is “…related to my job’ and “…the training I get is very good and makes me confident”. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 24 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, 39 and 42: People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people in Orford House benefit from living in a well run home. The home has an established system in place that ensures that their views are heard and acted upon. The health and safety of individuals living and working in the home is promoted and well maintained. EVIDENCE: The manager has many years experience working with adults with learning disabilities. The manager confirmed that she regularly undertakes training to update her knowledge and skills and evidence of this is recorded. She is currently undertaking her NVQ Level 4 Registered Managers Award. The manager is currently responsible for managing one unit and the bungalow in the service and is currently overseeing one of Home Farm Trusts supported housing projects. This issue was discussed on the day with both manager and the service manager and it was agreed that the people using the service would Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 25 benefit from the manager not undertaking external responsibilities. From discussion with the staff it was evident that there are clear lines of accountability within the home. The staff made very positive comments regarding the skills and knowledge of the manager. Two staff spoken with confirmed that they “trusted the manager, and I can always go to her with any issue” and that “the manager really knows her job and she knows the residents as well as we do”. The home has a quality assurance programme in place that measures the quality of the care being provided. The home surveys residents, and relatives to gather information about the running of the home and if it is achieving its aims. Once the information is reviewed the manager will work out what needs to be acted upon and make the necessary changes. The home has not sent the results of the latest survey to the CSCI, this issue was discussed on the day and the manager agreed that these would be sent to the CSCI once the results of the latest surveys were published. One relative commented that the home is “always asking us for our views on what we think of the home” while another stated that “…the home could have better administration and organisation in its day to day running”. The manager has a strong commitment to the health and safety of both the people living in the home and the staff team. The home provides Health and safety training for staff, and it has home has a range of policies and procedures relating to health and safety practices. A health and safety audit check was examined and was seen to be undertaken on a monthly basis. Individual resident risk assessment and premises assessments are in place. The manager presented a Health & Safety file that contained a variety of certificates and records that included safety checks for equipment, gas, electricity and water checks. Evidence was available to indicate that every effort was made to ensure the health, welfare and safety of individuals who live in the home, and support workers. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 26 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 X 2 2 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 27 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 YA2 Regulation 13, (4) 14, (2) Timescale for action The support plans created during 31/08/07 the pre-admission process must include all of the relevant professional assessments so that the management and staff can make a clear decision as to whether the home can meet the needs of the person. Requirement 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 YA39 Good Practice Recommendations The service should send the outcomes and action plan of their quality review to the CSCI. Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Orford House DS0000017899.V341706.R01.S.doc Version 5.2 Page 29 - 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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