Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Penwortham Grange and Lodge Martinfield Road Penwortham Preston Lancashire PR1 9HL The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Marie Cordingley
Date: 0 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home
Name of care home: Address: Penwortham Grange and Lodge Martinfield Road Penwortham Preston Lancashire PR1 9HL 08456035498 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Orchard Care Homes.Com Limited care home 86 Number of places (if applicable): Under 65 Over 65 0 44 dementia old age, not falling within any other category Additional conditions: 42 0 The registered person may provide the following categories of service only: Care Home only - PC, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 44) Dementia - Code DE (maximum number of places: 42) The maximum number of people who can be accommodated is 86. Date of last inspection Brief description of the care home Penwortham Grange and Lodge is a large residential home registered to provide care and accommodation for up to 86 people. The home is arranged in two separate units, one providing accommodation for up to 44 older people and the other providing accommodation for up to 42 people who have Dementia. The home is situated in the Penwortham area of Preston. It is located in a residential area and there are a number of transport links, facilities and amenities close by. All accommodation at the home is provided on a single room basis. Residents bedrooms are well equipped with en-suite facilities including a shower, television, DVD and a mini fridge. There are four large Care Homes for Older People
Page 4 of 31 1 1 0 9 2 0 0 8 Brief description of the care home communal areas as well as four smaller quiet rooms and safe outdoor space for the use of residents. Care is provided on a 24 hour basis including waking watch care throughout the night. At the time of our visit we were advised weekly fees for the home range from £485 to £570. All this information and more can be found in the Service User Guide which is available from the home on request. Care Homes for Older People Page 5 of 31 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating of this home is two star. This means that people using the service experience good quality outcomes. The inspection of this home included an unannounced visit. As the visit was unannounced the manager, staff and residents did not know it would be taking place until the inspector arrived. During our visit we spoke with residents, some relatives, staff and the manager. We also viewed a selection of documents including staff personnel files and residents care plans. We carried out a tour of the home viewing all communal areas and a selection of residents private accommodation. Care Homes for Older People
Page 6 of 31 Prior to our visit we asked the manager to complete a very comprehensive self assessment which looked at all aspects of the service. This was returned to us within agreed time scales and completed to a very good standard. We also wrote to a selection of residents and staff members and asked them to take part in a written survey. We received nine completed surveys in total. What the care home does well: People we consulted in writing and those we spoke with during our visit were very complimentary about all aspects of the service. Comments received in the written surveys included; I feel very lucky to be here, I am very well looked after. We are always impressed by the carers. They are very professional. People we spoke with during our visit told us; The carers are brilliant, everything is brilliant. I have absolutely no complaints about this home, it is excellent. Throughout our visit we observed carers going about their duties in a pleasant and professional manner. Residents appeared relaxed and comfortable in their surroundings and appeared to get along well with their carers. The Service User Guide is an important document that helps people make a decision about whether they want to move to a home. This home provides a comprehensive Service User Guide which is available in a number of formats including audio, so that everyone has equal access to the information. The home has a thorough approach to care planning with all areas of need being carefully assessed and regularly reviewed. Where residents are assessed as being at risk of for example, developing pressure sores or falling, a specific care plan is put in place to help carers minimise these risks. We saw evidence that staff monitor residents health carefully and act promptly when concerns are identified. This was also confirmed by a visiting health care professional. We found that the home have good procedures in place to help ensure that peoples medication is carefully managed. Thorough audit systems are also in place so that any errors can be identified and rectified immediately. We found that people are provided with a varied and nutritious diet and that a number of choices are made available on a daily basis and at each meal time. Peoples nutritional needs are carefully assessed and kept under regular review. One resident told us that she had been very underweight on her admission to the home but had gained a lot of weight because the food was so good! People living at this home are provided with an excellent standard of accommodation. The home is very well maintained and furnished to a high standard. All residents have their own bedrooms with en suite facilities as well as additional facilities such as a DVD player, Sky television and a mini fridge. Additional efforts have been made to enhance the environment on the unit for people with dementia and make it more homely and interesting. Care Homes for Older People Page 8 of 31 Careful processes are followed to ensure that all staff who are recruited are suitable to work with vulnerable people. In addition, staff receive a very thorough induction and in most cases, complete all their mandatory health and safety training within two weeks of their employment. Ongoing training in areas such as working with people with dementia is provided on a regular basis. It was pleasing to see that all staff members including administration and domestic staff are required to completed a training course in safeguarding vulnerable adults within the first two weeks of their employment. The manager and all the staff we spoke with demonstrated a good understanding of safeguarding and whistleblowing procedures. We also found that staff are well supervised by the manager and people told us they felt their managers were very approachable. We noted that supervision was regular and of a good standard. In cases where issues had been identified about a staff members performance, evidence was available to show that the areas had been regularly addressed and monitored through supervision. Processes are in place to assist the manager in monitoring quality and we noted that where possible, residents and relatives are invited to take part in these processes. Residents and relatives meetings take place on a regular basis so that people can express their views and ideas about the running of the home. The manager of the home demonstrated throughout the inspection that she has a good understanding of her role. We found evidence of a number of significant improvements made since the last inspection which are detailed later in this report. What has improved since the last inspection? Following the last inspection of this home we identified a number of concerns and a number of requirements and recommendations were made. We found during this inspection that the home had made excellent progress and a number of significant improvements were noted. The homes approach to the assessment and planning of residents care needs has been greatly improved. We found during this visit that comprehensive care needs assessments had been carried out for all the people we case tracked. Risk assessments in areas such as developing pressure sores and falling were completed accurately and contained all the relevant information. We found that staff were much better at monitoring residents health and took prompt action when concerns were identified. We spoke with some community health care professionals during our visit who told us they thought staff were much more responsive to residents needs and had improved the way in which they recorded and followed through advice they provided. Systems for managing peoples medication have been improved and are now much Care Homes for Older People Page 9 of 31 safer. We also noted that audit processes are much more robust so that any errors are identified and rectified straight away. There has been much effort made to improve the provision of activities for people living at the home. This has resulted in people being provided with more regular opportunities to take part in enjoyable activities both inside and outside the home. The manager continues to develop this area and is currently examining ways that people can be provided with more individual activities on a one to one basis. We found that there was a more thorough approach to receiving complaints and evidence was available to show that all concerns raised had been dealt with appropriately. Work has continued to enhance the environment on the units for people with dementia. Additions include an aquarium and items of interest such as pictures and ornaments that give the area a more homely feel. At the time of our visit we were advised that a multi-sensory area was soon to be made available. A number of people we consulted commented that staffing levels are now much improved. Rotas demonstrated that the home is now fully staffed. In addition, senior staff who were previously office based now work alongside carers providing additional support and guidance. We found evidence that the home has benefited greatly from the input of a competent and experienced manager. The manager, who is currently going through the process of registration with the Commission demonstrated throughout the inspection that she provides strong leadership and clear direction. One staff member told us We now know what is expected of us and everyone is working towards the same goals. The manager shared a number of ideas about how she intends to develop the service further. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 10 of 31 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 11 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 12 of 31 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home can be confident that their needs and personal wishes are understood. Evidence: A Service User Guide is available for anyone considering a move to the home. This is a useful document that provides information such as services available, fees and staffing. We viewed the guide and found that it contained up to date, accurate information and reflected recent management changes at the home. We were also advised that the Service User Guide was available in a number of different formats including large print and audio to ensure that everyone has equal access to the information. We were able to confirm that all the people we case tracked had been visited by a
Care Homes for Older People Page 13 of 31 Evidence: senior member of staff prior to their admission, who had carried out a pre admission assessment. This is an important process which involves gathering information about the prospective residents care needs. The assessment means that people can be sure their needs will be met if they move to the home and also ensures that staff have enough information about a new resident to provide the right level of care. When viewing assessments we noted that time had been taken to include information about the individual residents preferences and their views about how they wanted their care to be provided. This type of information assists staff to provide care which is individualised and person centred. Care Homes for Older People Page 14 of 31 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care and medication is well managed which helps protect their safety and wellbeing. Evidence: We viewed a selection of residents care plans and found these to be very comprehensive. All areas of daily life were addressed and details of peoples needs in relation to each area were clearly stated. Care plans were very well organised and contained a large amount of information. We noted that there was a brief overview at the front of every persons care plan to help ensure that carers could access specific information quickly and efficiently. We noted that peoples care plans contained information about their preferred daily routines such as how they liked to spend their time and the way they wanted their care to be provided. We saw some good examples of person centred information, for instance one residents care plan stated that they liked carers to spend time helping them to coordinate their outfits each morning. Another residents stressed that they
Care Homes for Older People Page 15 of 31 Evidence: liked to have a leisurely bath in the evening. This kind of information helps carers to provide support which is tailored to the individual. Risks to people in areas such as falling or developing pressure sores were carefully assessed and where significant risk was identified, a specific care plan was in place to help ensure peoples safety and wellbeing. We also noted that risk assessments were reviewed on a regular basis and the examples we saw demonstrated that staff took all relevant factors into account when carrying out the reviews. Daily care records demonstrated that carers are now aware of the importance of monitoring peoples health and general well being and take prompt action when problems are identified. We also spoke with some community health care professionals during our visit who told us they felt that staff at the home were responsive to residents needs and followed health care advice carefully. As part of the visit a pharmacist inspector checked how medicines were being handled because previous visits had found some shortfalls. We found some general improvements in the way medicines records and stock were organised. Records of medicines received, given to people and disposed of were clear and accurate that made accounting for medicines simple to do. Care plans and supporting paperwork were detailed with medicines information and when medicines were prescribed as when required there was good information to support their use to help make sure they are given to people correctly. We checked a sample of medicines and found they usually added up showing they had been given to people correctly. We found some minor recording mistakes but regular checks made by the home were finding these mistakes and immediate action was taken to help prevent them happening again. We looked at the times medicines were given and found continued improvements so that they were given at the right and best time for people. Giving medicines at the right time helps make sure they work correctly. We checked how controlled drugs (medicines that can be misused) were stored and recorded. Records of handling were made in a special book and suitable cupboards were used for storing them. Secure storage and detailed records help make sure controlled drugs are not mishandled or misused. We looked at how medicines were stored and found the arrangements to be clean, tidy and secure. Stock was well organised and medicines were promptly disposed of when
Care Homes for Older People Page 16 of 31 Evidence: no longer required. We looked at how staff were trained to give medicines safely. All staff had received medicines handling training and their competence was regularly assessed to help make sure they have they necessary skills. Care Homes for Older People Page 17 of 31 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with regular opportunities to take part in various activities. Some residents would benefit from the opportunity to enjoy a more individual programme. Evidence: A number of people we consulted both in writing and during our visits told us that they felt the home had improved the provision of activities in recent months. One relative said It seems as though there is much more going on now and staff seem to have a bit more time to spend with people. All the care plans we viewed contained information about peoples individual needs and preferences in relation to areas such as social activities and maintaining relationships. In addition, peoples care plans stated their preferred daily routines and included information about how they liked to spend their time. We noted that there was an activities programme in place which included a different activity on each day of the week. Activities varied between the residential unit and the unit for people with dementia ensuring that they were suitable for people with different needs. We also noted that residents were able to access services from visiting
Care Homes for Older People Page 18 of 31 Evidence: hairdressers and beauty therapists. In discussion, the manager explained that the area of activities was still being developed to ensure that all residents individual needs were met. Records showed that some residents preferred not to take part in group activities and the manager was looking at ways to ensure that one to one activities were made available on a regular basis. We noted that there had been an increase in opportunities for residents to participate in the local community with several people enjoying regular visits to events such as luncheon clubs. The manager told us that this was also an area she was hoping to develop further. Throughout our visit we noticed a number of people arriving to see their relatives. Residents we consulted confirmed that they were able to have visitors at any time of the day and one relative we spoke to said I am always made to feel welcome, I know I can drop in at any time. On all the care plans we viewed we found thorough nutritional risk assessments and specific nutritional care plans for those identified as being at risk in this area. One resident told us that when she had moved to the home just a few months previous, she had been very underweight. She explained that she had gained weight steadily throughout her stay and felt much better as a result. Menus demonstrated that a varied and nutritious diet is offered to people living at the home. We were also able to confirm that people are offered several choices at each meal time. During our visit we observed staff discussing the options available with residents and recording their choices. People we spoke with and those who took part in our written survey told us that they were happy with the quality of food provided. One resident said Its always of a very good standard, I have never had cause for complaint. Care Homes for Older People Page 19 of 31 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that their concerns will be listened to and dealt with properly. More careful recording of complaints and their outcomes will assist the manager in assuring quality. Evidence: The home has a complaints procedure in place which is clearly written and includes advice for people to follow in the event that they are unhappy with the way their complaint has been managed. We were also able to confirm that the complaints procedure is available in a number of different formats including large print and audio so that everyone has equal access to the information. A record is maintained within the home of all complaints received and action taken. In addition to an individual record, a brief overview is also kept and regularly monitored. This is a useful system which enables the manager to identify any patterns or recurring issues easily. We were also advised that all complaints are reviewed at senior managers meetings on a monthly basis, as part of the homes quality assurance processes. In viewing the records of complaints we did note that there was some information missing in relation to one complaint that had been received several months previously. However, after further investigation we were able to confirm that the complaint had
Care Homes for Older People Page 20 of 31 Evidence: been dealt with through the homes head office. We discussed this with the manager and advised that all information relating to complaints needed to be kept within the home. There are robust procedures in place in relation to the prevention of abuse (safeguarding procedures). The manager and all the staff consulted demonstrated a good understanding of these procedures. Records showed that all staff including those not in direct contact with residents, for example, admin staff, are provided with training in safeguarding as part of their induction. Care Homes for Older People Page 21 of 31 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home are provided with an excellent standard of accommodation. Evidence: Penwortham Grange is a spacious home with all accommodation provided on a single room basis with en suite facilities. Peoples private accommodation is very well equipped and includes Sky television and a mini fridge. There are a variety of communal areas for people to access including safe outdoor space and several lounges on each unit. The home is maintained and furnished to a very high standard and since the last inspection the units for people with dementia have been improved by adding more items of interest such as pictures and an aquarium. This has made the area more homely. In discussion, the manager advised us that work is ongoing to provide a multi sensory area where people can relax and enjoy attractive lights and relaxing music. We carried out a tour of the home and found that all areas were clean, warm and comfortable. Residents were observed moving around the home freely and appeared
Care Homes for Older People Page 22 of 31 Evidence: comfortable in their surroundings. All the people who responded to our written survey and those who we consulted during our visit told us that the home was always fresh and clean. The home has comprehensive infection control procedures in place and records confirm that all staff are provided with training in infection control at the start of their employment. Care Homes for Older People Page 23 of 31 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The careful recruitment procedures followed by the home help to protect peoples safety and wellbeing. Evidence: We viewed a selection of staff personnel files and saw evidence that the home follow careful procedures when recruiting new staff. All files viewed provided confirmation that people had been required to attend a formal interview (of which notes are maintained) and undergo various background checks including Criminal Records Bureau and full employment history checks. In addition, there were at least two references from previous employers on each file we viewed. We found that the home have thorough induction processes in place. On the day of our visit we met two new staff members. They told us they were in the process of receiving two weeks training before they were put on the rota. We also confirmed that the manager had arranged all their mandatory health and safety training and safeguarding training as part of their two week induction. Records showed that all new staff members are provided with their mandatory training in the first two weeks of employment and access to additional training in areas such as working with people with dementia is regularly offered. In addition, well over half the
Care Homes for Older People Page 24 of 31 Evidence: carers at the home now hold National Vocational Qualifications in care at level two or above. We viewed rotas and discussed staffing levels. The manager advised us that the home is now fully staffed and this was reflected in the feedback we received from people as part of the inspection. One relative told us There seems to be a lot more staff around these days and they dont seem as rushed. The manager advised us that staffing levels would be kept under constant review to ensure that they continue to meet the needs of people living at the home. On viewing rotas we noted that some staff at the home work long shifts as part of their working week. We discussed this with staff who told us that they felt the current shift patterns worked well for them. However, we advised the manager to ensure that peoples shift patterns are carefully monitored and reviewed during supervision to ensure that their performance is not affected. Staff we consulted told us that they felt well supported by the manager. One staff member said It feels as though we all know what is expected of us now and the manager is always approachable if you have any concerns. We viewed a selection of supervision files and found that people are provided with regular supervision. We also noted that where any performance issues had been identified, the manager was closely monitoring these and using supervision to address the issues with the staff members involved. Care Homes for Older People Page 25 of 31 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from strong leadership and effective management. Evidence: This was the first inspection of the home under the current manager. The manager, who is in the process of registering with the Commission, demonstrated a good understanding of her role and was able to provide evidence of a number of improvements made at the home since the last inspection. Prior to our visit the manager completed a comprehensive self assessment which examined all aspects of the service. This was completed to a very good standard and confirmed that the manager was able to identify and address areas for development. We received positive feedback from people who live and work at the home about the new manager. One staff member wrote I feel like we are working well as a team and standards have definitely improved.
Care Homes for Older People Page 26 of 31 Evidence: We were also able to confirm that the manager has additional support and regular supervision from the area manager of Orchard Care Homes. In addition, the area manager visits the home on a regular basis and carries out a range of quality checks. There are a number of processes in place to monitor quality and we saw examples of how quality assurance processes had helped to identify issues that required attention so that they could be addressed straight away. The manager also advised us that she had examined ways in which people living at the home and their representatives could be more involved in developing the service. Residents and relatives meetings had been increased as a result and the manager was in the process of developing a residents committee. The home has a health and safety policy in place which is supported by individual procedures in areas such as fire safety and infection control. We also found that there was a very thorough approach to health and safety training and in most cases, new staff members would receive training in areas such as moving and handling within the first two weeks of their employment. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 16 22 A record of all complaints received, action taken and subsequent outcome must be kept within the home. This is so that the manager can demonstrate that all complaints have been dealt with appropriately. 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 3 Social histories should be obtained for all residents (who are in agreement) so that carers have a greater understanding of the individual resident. The manager should continue to develop opportunities for people to take part in community based activities. The manager should continue to develop opportunities for people to take part in activities on a one to one basis. Pictorial menus should be developed for people who cannot access written information. It is recommended that the manager continues to develop the environment on the units for people with dementia to
Page 29 of 31 2 3 4 5 12 12 15 19 Care Homes for Older People ensure it meets the needs of people living there. Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - 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!
