Inspection on 10/10/06 for The Orchards

This inspection was carried out on 10th October 2006.

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

The Orchards 16/10/08

The Orchards 04/10/05

The Orchards 23/06/05

The Orchards 09/09/04

The Orchards 05/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Orchards (The) Orchards (The) 1 Perrys Lane Wroughton Swindon Wilts SN4 9AX Lead Inspector Bernard McDonald Unannounced Inspection 10th October 2006 06:15 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 Orchards (The) DS0000050595.V315356.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 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. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchards (The) Address Orchards (The) 1 Perrys Lane Wroughton Swindon Wilts SN4 9AX 01793 812242 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) Buckland Care Limited Susan McCarthy Care Home 35 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (16), Old age, not falling within any other of places category (32) Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 17 service users in total with dementia (DE and DE(E)) may be accommodated. This is a temporary arrangement and subject to conditions 2 and 3 below When the accommodation occupied by the 10 of the 16 current service users with dementia aged 65 years and over (including those named in the variation application dated 4 October 2004) is no longer required, the maximum number of service users in the category DE(E) must be reduced to a maximum of 6 Only the younger, female service user with dementia named in the variation application dated 4 October 2004, may be aged between 18 65 years. When this accommodation is no longer required by the named service user, occupancy must revert to the category OP No service users with dementia to be accommodated on the second floor 4th October 2005 3. 4. Date of last inspection Brief Description of the Service: The Orchards is one of a number of homes owned by Buckland Care Limited. The Orchards provides accommodation and personal care to a total of 35 service users. The home is located in the village of Wroughton and is close to local shops and public amenities. The home is a large three-storey building set in its own well-maintained grounds. Service users’ bedrooms are located on three floors and can be reached by either a passenger lift or a stair lift and each room has an emergency call bell installed. The home has an attractive conservatory that is appropriately furnished and allows service users the benefit of extra communal space. The fees charged for the service are £410 to £560 per week. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit of this key inspection was completed in eleven hours over two days. The first day of the site visit commenced at 06:15am and was unannounced. The second day was by appointment with the manager. The pharmacist inspector examined the medication records and procedures. There was opportunity to meet with all service users to obtain their views on the care they receive. Service users were interviewed in private and in small groups. As part of our inspection, comment cards were sent to a random sample of service users, their representative’s health care professional and placing authorities. No adverse comments were received. Four care plans were examined in detail. In addition medication records, staff recruitment files, training records, health and safety documents and a sample of risk assessments were also examined. A tour of the building was made and the majority of service users bedrooms were viewed. Seven members of staff were interviewed in private. The relatives of two service users who were visiting the home at the time of the site visit shared their views on the care provided to their relative. Comments received were positive and complimentary. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: The pre admission procedure ensures no service user is admitted without an assessment of need to ensure the home can safely meet their needs. As a matter of good practice the manager would normally complete the in-house assessment and meet with the service user in their current accommodation. One service user confirmed this practice and said they had had the opportunity to look around the home before deciding to move. Care plans reflect the needs of service users and direct care staff to risks associated with their care. A key worker system is in place and discussion with staff demonstrated an awareness of the needs of service users and how they wish to be supported. Service users health care needs are being addressed and there is a weekly Doctors surgery held at the home. National Vocational Qualification (NVQ) training is well underway with 10 staff having completed NVQ 2 and a further 6 staff have completed NVQ3 or are working towards the award. There is evidence to demonstrate service users are offered choices in daily routines such as times for getting up and going to bed what they eat and whether to spend time in their room or in one of the communal living areas. Religious preferences are addressed in the care plan and a monthly non- Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 6 denominational service is held in the home and a number of service users are visited by their priest or lay preacher. 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. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 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 Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 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): 1, 2, 3, 5, 6. The home is ensuring service users care needs are assessed prior to admission and they have opportunity to visit before deciding to move. Information to allow service users to make an informed choice about moving needs to be updated. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The records of two service users who have recently been admitted to the home were examined in detail. Each service user had a completed assessment of need and a pre admission assessment completed by the manager. As part of our inspection process comment cards were sent out to a number of service users. One service user commented that the manager visited them at home and “her visit was most helpful”. Discussion with one service user confirmed they had opportunity to look around the home and see their bedroom prior to moving in. A further comment card from a service user stated, “I was brought here to have a look round and I approved it”. Following admission an interim care plan is developed for each service user on how their needs must be met in the home. The two records examined Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 9 demonstrated service users were involved in the development of their care plan, which had either been signed by the service user or their representative. Where service users were at risk from falling a risk assessment had been completed. As part of the pre admission process service users are provided with a guide. This document needs to be updated to reflect the recent changes made to the Care Homes Regulations. Service users need to be fully aware of the total fee payable and the cost for any additional services not covered by the fee. Each service user has a contract, which explains the terms and conditions of their stay. Samples of these records were examined. Each had been signed by the service user or their representative to acknowledge receipt of the contract. One service user was visiting the home once a week with a view to a permanent move. The home does not provide intermediate care. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 10 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. The home is striving to ensure service users are treated with respect and their care plans reflect their changing personal and health care needs. Staff handle medicines appropriately and individual resident’s needs are considered, however unclear entries on the medication administration record could lead to incorrect doses being given. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The records of four service users were examined in detail. Each service user had a plan of care that directed staff on how their needs should be met. Care plans covered areas of personal and health care needs and were being reviewed every month. Risks associated with the safe care of service users are being addressed as part of the care plan. Less evident was how service users are involved in the development of the care plan or made aware of it’s content. Two of the case files examined did not reflect how the service user had been involved in the development of their plan. When asked the service users had no knowledge that they had a care plan. This was raised with the deputy manager who indicated that responsibility for ensuring care plans are reviewed and discussed with service users was shared between senior members of staff. A random sample of four other care plans found they were either signed by the Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 11 service user or their representative to demonstrate they had been involved in their care plan. On the second site visit to the home the care plans had been updated and the service user or their representative had been informed of the contents. One service user confirmed they had been shown their care plan. The relative of one service user confirmed that they had attended a review meeting and was very happy with the care provided. Discussion with staff demonstrated an awareness of how to meet the needs of service users by giving examples of the care being provided. One member of staff confirmed they had attended a dementia training course and a course on working with older people. The member of staff felt it was a good course and has helped them to understand the complex needs of service with dementia. Training records showed that nine members of staff had completed dementia care training. Service users health care needs are being addressed as part of their care plan. A weekly GP surgery is held at the home to ensure service users health care needs are promptly addressed. Two comment cards were received from GP’s as part of the pre inspection checks. Comments received showed that staff are knowledgeable about the needs of service users and no adverse comments were made. A domiciliary optician and chiropody service is available for service users who want to use the service. Throughout the two site visits staff were observed treating service users in a respectful manner. Comments like “staff are wonderful”, “staff are very nice” and “staff can’t do enough for us” were received from service users when they were asked about staff. One service user summed up their experience of living at the Orchards as “good food, good staff what more can I want”. The pharmacist inspector looked at the records and storage of medication, observed administration, spoke to staff and talked to a service user about their medicines. Medicines are stored securely and all appropriate records are maintained. The fridge temperature should be altered to ensure it remains between 2 and 8c. Staff were seen to use good practice when handing out medicines and to take time with service users who required it. However, this does mean that the round can take some time. On the day of the inspection the morning medicines were not finished until 10.45am, which may cause problems for service users who require further doses at lunchtime. Staff who administer medicines have received training in safe medicine handling and information about the medicines is available to them. Service users who wish to self-medicate feel well supported and appropriate measures are taken to ensure their safety, however the form signed by the resident should be amended to reflect the home’s duty of care. Care plans had been drawn up to cover ‘as required’ medication and medicines had been considered in other plans, for example falls prevention. Printed medication administration records are used. Some entries are printed as ‘as directed’. The correct instructions for use must be printed on the form. Some written entries were not signed, dated or checked. This had lead to the wrong dose being written on one occasion. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 12 The home has a comprehensive policy and procedure for the handling of medicines, including the processes to be used for self-administration and in the event of a medication error. A regulation 37 notice should be filled in whenever there is a drug error and this should be included in the procedure. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 13 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, 15. The home is making every effort to ensure service users enjoy a varied lifestyle that reflects their personal interests. Visitors are made to feel welcome. Mealtimes are relaxed, unhurried and offer choice. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The site visit commenced at 06:15am and two service users were up and dressed and sat in the small lounge. Discussion with the service users confirmed it was their decision to get up at this time, as they liked to get up early. Discussion with the night staff confirmed it is the service users choice whether they get up in the morning and that some service users choose to go back bed after they have been freshened up and made comfortable. Service users were offered a hot drink while waiting for their breakfast. The assistant cook arrived at 06.45 and confirmed that service users have a choice of where to eat their breakfast. Some service users prefer to eat in their room while others prefer to eat in the dining room. One service user who was an early riser chose to have toast when they got up and then an hour later had a cooked breakfast. Service users commented very favourably about the quality of meals provided at the home. Since the last site visit a choice of meals is offered at each sitting and their likes and dislikes are recorded. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 14 The home has appointed an activities coordinator for two hours a day, five days a week. This goes someway to ensure service users are offered a range of activities suited to their needs. It was difficult to quantify service users views of the activity programme. Some service users commented there was a lot to do during the day while others commented there was little to do. Records examined showed outside entertainment is regularly brought into the home and the activity programme is on display. At the time of the site visit no service users from ethnic minority groups were living at the home although there was a multi cultural staff team employed. Service users religious needs are being met and there is a monthly nondenominational service held every month. Service users, who choose, can attend a Sunday service. There was opportunity to meet with the relatives of two service users who confirmed they were able to visit the home at anytime. One service user has a visit from their relative everyday. As part of our inspection comment cards were sent to a sample of service users relatives. Feedback from the surveys showed an overall satisfaction with the care provided at the home and confirmation that they could visit at anytime. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 15 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, 18. The home is ensuring service users complaints are listened to and procedures are in place to protect them but not all staff have received training in safeguarding service users. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: A copy of the complaints procedure is on display at the entrance to the home. The policy states that all complaints will be responded to within 28 days. Since the last site visit four complaints have been recorded in the complaints log. These complaints relate mainly to the loss of service users clothing that had later been found. The Commission for Social Care Inspection has received one anonymous concern about service users having to get up early in the morning, lack of heating and insufficient hoists. This could not be substantiated on the site visit. Discussion with service users found they were very positive about the care provided in the home. When asked whom they would speak to if they had any concerns or complaints the majority of service users responded the staff or the manager. Copies of Wiltshire and Swindon’s “no secrets” guidance was on display in the home. Discussion with staff demonstrated an awareness of what constitutes abusive practice however though, examination of staff training records showed that not all staff have received abuse awareness training. The manager commented that a number of staff have been put forward for the next available training course to ensure they are fully aware of what action to take should they be concerned about the welfare of service users. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 16 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, 21, 22, 23, 24, 25, 26. Improvements made to the overall décor and fabric of the building ensure service users live in a home that is well maintained, comfortably furnished and free from odour. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service EVIDENCE: The early arrival at the home found the building warm and the two service users who were up stated it is always nice and warm. The previous heating problems found at the last site visit had been resolved and a new central heating system had been fitted. A tour of the building was made and all communal living areas and the majority of service users bedrooms were seen. Significant improvements had been made to the overall decor and fabric of the building. The majority of bedrooms had been decorated and new carpets and curtains purchased. Service users commented they had a choice of colour for their room. New furniture had also been purchased for the dining room. One service user Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 17 commented, “I couldn’t fault it” when asked about their accommodation. One service user had brought items of personal furniture when they moved and commented they found it comforting to have some of their personal items with them. Bathrooms had been upgraded and a new electric hoist had been purchased and installed. For service users who require assistance with moving and handling, hoists were in place, and staff confirmed they had received training in their use. One member of staff had recently completed the “train the trainer” award for moving and handling and can now instruct other staff. This should ensure trained and competent staff support service users who may require manual handling. The laundry room is situated well away from any food preparation area. Access is by keypad to prevent service users from entering. A risk assessment on the use of this area has been completed. The home has two commercial washers and dryers, which are sufficient for the needs of the home. Red alginate bags had been purchased to reduce the risk of infection from soiled or infected laundry. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 18 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, 30. The home is ensuring staff recruitment is being safely managed and training is provided to ensure staff have the necessary skills to meet the needs of service users. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Examination of the staff rota shows there are normally five care staff on duty in the morning, four on duty between 2pm and 8pm and three staff between 8pm and 10pm. There are two waking night staff. The manager’s hours are in addition to the rota. Service users were satisfied with the level of staff on duty although it was commented that they were always busy. No adverse comments were received from the relatives of service users regarding the number of staff on duty. More than 50 of the care staff have completed National Vocational Qualification (NVQ) training at level 2. Senior members of staff are currently working towards NVQ 3. One member of the domestic staff has also completed NVQ 2 in Support services. This demonstrates the homes commitment to ensuring staff are sufficiently trained for the work they do. Copies of the NVQ certificates were on display in the home. The manager has completed a training needs analysis for individual members of staff. A copy of the plan was made available and showed staff are receiving training appropriate to their role. Three staff recruitment records were examined in detail. From the sample of records examined all staff had received a satisfactory Criminal Records Bureau (CRB) check at enhanced level together with a Protection of Vulnerable Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 19 Adults (POVA) check. Each of the records examined contained a completed application form and two written references. On the second site visit one member of staff had commenced employment the day before. Discussion with the member of staff confirmed they have been made aware of the fire safety procedures and that they are shadowing a senior member of staff as part of their induction. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 20 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, 38. The manager is making every effort to ensure the home is run in the best interest of service users, though more attention needs to be given to extending the scope of the quality assurance audit. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The manager has been in post for over seventeen months and is working towards completion of NVQ 4 in care. The manager has brought about a gradual change in the working of the home, which has in turn improved the overall outcomes for service users living there. Staff commented that they feel supported in their work and a new annual staff appraisal system has been implemented. As part of the home’s quality assurance programme questionnaires have been sent to service users, their families and staff working at the home. This Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 21 practice also needs to be extended to GP’s, other health care professionals and any relevant stakeholders. As part of the quality assurance audit the manager has compiled the results from the survey and completed an outcome summary. This demonstrated service users were either satisfied or very satisfied with the service provided in the home. An action plan has been developed in areas that could be improved upon and timescale set for completion. The manager needs to share the outcome of the quality assurance survey with the participants. Service users are encouraged to manage their own money. Where this is not possible the service users family or legal adviser takes on this responsibility. As a result the home was only holding a small amount of money on behalf of service users. A random sample of these records were looked at in detail and showed a clear audit trail of money being held and money returned to service users. The last fire safety practice was held in September and records showed regular fire drills and staff training were taking place. To ensure the safety of service users hot water was being regulated close to 43 degrees celsius and all radiators were guarded or had low surface temperatures. Risk assessment had been completed on safe working practices. Records showed the majority of staff have received training in first aid, food hygiene and infection control. Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 22 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 2 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 3 3 3 3 3 2 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 Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 5(1)(a)(b) (ba)(bb) (bc)(bd) 13(2) Requirement The registered person must update the service user guide to include the total fee payable and the cost for any additional services not covered by the fee. The registered person must ensure all written additions to the printed medication administration record are signed and dated, and then checked by a second member of staff. The registered person must ensure the medication administration record shows clear instructions for all medicines. The registered person must ensure staff are made aware of the necessity to inform CSCI of any medication error. The register person must ensure that the views of service users representatives and relevant stakeholders are included in the system for evaluating the quality of the service provided in the home. Timescale for action 01/01/07 2. OP9 25/10/06 3. OP9 13(2) 25/10/06 4. OP9 37(1)(e) 01/11/06 5. OP33 24(2)(b) 01/04/07 Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 24 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 OP9 Good Practice Recommendations The registered person should ensure the temperature of the fridge is altered to keep it between 2 and 8 degrees celsius in accordance with the home’s policy. The registered person should give consideration to the length of time of the morning drug round and its affect on later doses. The registered person should amend the wording of the self-medication form to better reflect the home’s duty of care. The registered person should ensure all staff receive training in safeguarding adults. The registered person should ensure service users personal laundry is promptly returned after it has been washed. The registered person should ensure the outcome of the quality assurance audit is made available to the participants. 2. 3. 4. 5. 6. OP9 OP9 OP18 OP26 OP33 Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Orchards (The) DS0000050595.V315356.R01.S.doc Version 5.2 Page 26 - 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!