Inspection on 20/11/07 for The Orchards

This inspection was carried out on 20th November 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 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 15/05/07

The Orchards 20/09/06

The Orchards 09/03/06

The Orchards 09/08/05

The Orchards 07/03/05

The Orchards 17/09/04

The Orchards 15/01/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Orchards The 164 Shard End Crescent Shard End Birmingham West Midlands B34 7BP Lead Inspector Lisa Evitts Key Unannounced Inspection 20th November 2007 09:50 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 DS0000024876.V349394.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 DS0000024876.V349394.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchards The Address 164 Shard End Crescent Shard End Birmingham West Midlands B34 7BP 0121 730 2040 0121 730 1655 theorchards@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Limited 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) Vacant post Care Home 72 Category(ies) of Dementia - over 65 years of age (72), Old age, registration, with number not falling within any other category (72) of places Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Currently under review 1. 2. 66 persons requiring nursing care and 6 persons requiring residential care The home may accommodate 5 named residents between 50 and 65 years of age. 15 May 2007 Date of last inspection Brief Description of the Service: The Orchards is a modern purpose built care home first registered in 1998 and situated in a residential area close to local shops and public transport links. The home provides 24 hour nursing, residential and respite care for a maximum of 72 older people. This includes the provision of transitional care for up to sixteen older people who are in need of short-term care arranged by two Primary Care Trusts. The home can also provide care to people with Dementia. Accommodation is available over two floors and each bedroom is for single occupancy with an en suite facility. Provision can be made for two companion bedrooms if required, subject to availability. There are two good-sized lounges and one dining room on each floor. The first floor is serviced by two passenger lifts. Corridors are wide and spacious and have handrails to enable people to move freely around the home with any mobility aids they may require. The home has a hair salon. There are four assisted bathrooms and two assisted shower rooms, which meet the needs of the people living at the home. There is a pleasant enclosed courtyard with a variety of attractive features and with easy access for disabled people. There are three disabled parking spaces and limited parking spaces available at the front of the home however there is ample space to the rear of the building. CCTV is unobtrusively installed. There are a number of notice boards in the reception area, which provide relevant information about the home and forthcoming events, which may be of interest to residents and visitors. The current scale of charges for the home are not included in the statement of purpose but can be obtained directly from the home. Additional costs include, hairdressing, toiletries, chiropody and newspapers. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Two random visits had been undertaken in June and August 2007 by our pharmacy inspector to monitor progress made since the fieldwork visit. Details of this visit will be referred to in the main body of the report. This is the second key visit to the home this year and it is recommended that the previous report is read in conjunction with this one. Meetings had been held with Social Care and Health following concerns raised about medication management and general management of the home. Two inspectors undertook this fieldwork visit to the home, over eight and a half hours and the acting manager assisted us throughout. The home did not know that we were visiting on that day. There were 65 people living at the home on the day of the visit and one person was receiving hospital treatment. Information was gathered from speaking to and observing people who lived at the home. Four people were “case tracked” and this involves discovering their experiences of living at the home by meeting or observing them, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety files were also reviewed. Random questionnaires were sent out in order to gain peoples views about the service. Four people who live at the home, one healthcare professional and eight staff returned questionnaires. These contained positive comments about the service provided and are included within this report. Eight people who live at the home and one relative were spoken to. One inspector spent two hours undertaking a short observation framework inspection (SOFI), which is an observation of people who are unable to communicate their care needs easily in order to determine their well being. Prior to the inspection the Project Manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us some information about the home, staff and people who live there, improvements and plans for further improvements, which was taken into consideration. Regulation 37 reports about accidents and incidents in the home were reviewed in the planning of this visit. No immediate requirements were made at the time of this visit. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Written information about the home has been updated to provide people with current information about the service offered to enable them to make an informed decision about whether they would like to live at the home. There have been some improvements to the care plan but these require further development to ensure that staff have sufficient information to meet individual preferences. The management of medication has significantly improved so that people receive their medication safely and as prescribed. Extra hours have been agreed for a second activities coordinator so that people’s interests and activities can be maintained. The recording of complaints has improved so that there are clear actions and outcomes recorded. This means that people can be confident that their concerns are listened to and acted upon. New carpets have been fitted in the ground floor reception and corridors to enhance the environment for people to live in. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 7 One extra trained nurse is on duty throughout the day, which assists in improving communication and ensuring that medication rounds are completed in a safe and timely manner. Staff have received training in Protection Of Vulnerable Adults, challenging behaviour and dementia awareness so that they have the knowledge to safeguard people from potential harm. A manager has been appointed to ensure that the home is run in the best interests of the people who live there. Documentation of personal monies held by the home has improved so that people can be confident that their money is held safely. 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. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 8 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 DS0000024876.V349394.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have sufficient information about the home to enable them to make an informed decision about whether they would like to live there. Pre admission assessments ensure that people know their needs can be met prior to moving in. EVIDENCE: The organisation has produced a comprehensive service user guide and statement of purpose. These documents have been updated since the last visit to the home to ensure that they contain up to date information about the service provided. Both of these documents were on display in the reception area of the home, which ensures that the information is available to people if they choose to read it. The documents are available on audiocassette so that people with visual impairments can access the information. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 10 The certificate of registration and public liability insurance certificate are on display and a copy of the previous inspection report is displayed so that people have access to this information. Comprehensive pre admission assessments are undertaken prior to people coming to live at the home. This should ensure that peoples individual needs can be met when moving into the home. People told us: “Its quite nice here” “I am happy here” One relative said “Its a lovely home” Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans require further development so that staff have specific details to assist people to meet their needs. The management of medication ensures that people receive their medication safely and as prescribed. EVIDENCE: Each person had a written care plan. This is an individualised plan about what the person is able to do independently and states what assistance is required from staff in order for the person to maintain their needs. Four care plans were reviewed and one partly reviewed. Care plans had improved since our last visit and reflected the current care needs of the individual person. Further development of these is now required so that specific details are recorded in order for staff to assist people to meet their individual needs and preferences. For example plans said to “give regular turns” and “wears pads” but the plans did not consistently state how often the turns should be or what size pads the person may require. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 12 Staff must also ensure that any actions they determine as necessary are implemented. For example one person had a risk assessment for weight loss, which stated to monitor an intake and output chart. Staff advised that this was not being done and therefore staff could not effectively monitor dietary intake. Monthly weights were recorded so that changes could be identified and risk assessments for nutrition and sore skin were completed. Moving and handling assessments were detailed with the type and size of equipment to be used and this information was available in people’s rooms so that staff had up to date information. Wound assessments provided information about the size of the wound and photographs had been taken, so that staff could monitor any changes. Care plans were not written for short-term care needs, for example when antibiotics had been prescribed for infection. This is required so that the condition and effectiveness of treatment can be monitored. There was evidence of people receiving visits from external healthcare professionals including General Practitioners, Tissue Viability Nurse, Dietician, Occupational therapist, Physiotherapist and Optician. Staff told us: “Care staff can always look in the clients care plan for information regarding the care to be given and their preferences” “We always had information but I have found recently that we get more information on new residents” Due to concerns with the management of medication at our last visit, our pharmacy inspector has been to the home to monitor progress with the management of medication on two occasions. Following the last visit there had been a significant improvement in the management of medicines within the home however a small number of issues identified during that inspection meant that the accepted standard was not being met for some of the people who lived at the home. During this visit the management of medication was reviewed on both floors and the improvements had been sustained to ensure that people receive their medication safely and as prescribed. All balances of medication were found to be correct. There were copies of prescriptions so that staff could check that they had received the correct medication into the home. There were no gaps on the Medication Administration Records (MAR) and eye drops were dated when opened so that they could be disposed of at the correct time to minimise the risk of contamination. One extra nurse is on duty during the morning so that people receive their medication in a timely manner and so that an appropriate time gap is given in between medication rounds. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 13 A payphone is located in the small lounge or people can have their own phone lines installed at an additional cost. This ensures that people can make calls in private. Staff were observed to assist people in a sensitive manner, one exception to this was a member of staff who wheeled someone out of the lounge without explaining where they were going. This member of staff was also observed lifting the person’s arm onto her lap without talking to her and this was brought to the attention of the manager at the time of the visit. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are able to choose the activities that they participate in which promotes their individuality and independence. People are offered a choice of meals to meet their dietary, cultural needs or preferences but improvements to serving of meals to promote peoples dignity is needed. EVIDENCE: The home has a dedicated activities coordinator and a second post has been created so that more hours are offered to support people with their interests. This post was currently being recruited to and should improve activities available further. There is an in house activity programme which runs over four weeks and activities are different on each floor. People are encouraged to join in activities on different floors so that they can meet with other people. Activities include ball games, board games, quizzes, music, reminiscence, art and cinema. External entertainers are booked to visit the home and there are notice boards around the home advertising the events so that people know when they are taking place. There were photographs displayed in the home of events that had been held. People are able to have newspapers delivered and this means that Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 15 they can continue to keep up with articles of interest to them. At the last inspection we were told that a hairdresser visits each week and a church service is held once a month. There was no evidence of outings or trips outside of the home and this is recommended so that people continue to have contact with the community. On the day of our visit an entertainer arrived and people were observed to enjoy taking part in the music. The short observational framework (SOFI) was undertaken during this time and this showed positive interactions from staff who encouraged people to play musical instruments and be involved in the singing. Each person has an activities record, which details the activities that they have participated in and any that they have declined. These indicated a range of activities on offer for people if they wished to participate in them. People told us: “I like to stay in my room and watch TV” “I really enjoyed the entertainment today” “She always gets asked if she wants to attend the activities” “I enjoy bingo and the occasional music concert” There is an open visiting policy, which means that people can see their visitors as they choose. People were seen to visit throughout the day and one relative was having tea in the lounge with the person who lived at the home. The home has a four-week rolling menu and these identified a range of meals. The home was introducing the NUTMEG nutritional analysis system, which is a software package, which helps to plan a balanced meal. Cooked breakfasts are available if people choose these; there are two choices of hot meal at lunchtime and a hot or cold meal in the evening. Snacks are available throughout the day. The lunchtime meal was observed, tables were presented with cloths and cold drinks were available. Condiments were not available for people to use however staff did meet individual requests for these. Staff were observed to ask people what they would like to eat and sat down to assist people who needed help to eat their meal. There were a number of people who were unable to sit at the dining table and they were seated across the back of the dining room, giving the impression of a very full room. One person was banging their fork on the table until staff gave him his lunch. These observations were discussed with the acting manager as it did not promote a pleasant environment or promote peoples dignity. The manager said that she would discuss these issues with the staff and review how mealtimes are managed. This will be reviewed at our next visit to the home. People told us: Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 16 “I can’t grumble at the food” “I don’t see anything wrong with the food, you get a choice” “I would change the menu a bit” “The food is ok, I survive on it” Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is comprehensive and is accessible to people should they need to make a complaint. The home has policies, procedures and staff training, which should safeguard people from harm. EVIDENCE: The complaints procedure is displayed in the home and is included in the statement of purpose and service user guide so that people know how to make a complaint if they need to. Since our last visit to the home, we have received one complaint that was referred to the providers to investigate using their own complaints procedure. The home has received twelve complaints since the last fieldwork visit. Documentation regarding complaints has improved and there were outcomes recorded, including any actions taken to minimise the potential of the same complaint being made. People told us: “I would go to the managers office if I needed to make a complaint” “I’ve got no complaints” “I would speak to one of the care workers” This suggests that people are confident that they can raise concerns and that they will be dealt with appropriately. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 18 The home has an adult protection policy, which incorporates the Department of Health’s, ‘No secrets’ policy, and the home has copies of local Multi Agency Guidelines so that staff have guidelines to follow in the event of an allegation of abuse. This should safeguard people from harm. There had been three incidents, which were raised as adult protections. These had been dealt with appropriately by the home and the cases were now closed. Staff have received training in the Protection Of Vulnerable Adults, dementia awareness and challenging behaviour, which should ensure that staff have the knowledge and skills to act appropriately to safeguard people from harm. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with a homely, clean and comfortable environment in which to live where their privacy is maintained. EVIDENCE: Access to the home is via a call bell and this ensures that people know who is accessing the building to ensure that people are safe. A partial tour of the home was completed to review areas which were relevant to the people we case tracked. Since our last visit, the ground floor corridors have had new carpets, which promotes a homely environment for people to live in. The home has spacious corridors and handrails and this enables people to move freely around the home with the use of any mobility aids they require. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 20 At the last inspection people were observed not to be able to summon help and communal areas were left unattended. During this visit people who were in their rooms had access to call bells and communal areas were staffed at all times. This should ensure that people could summon help, as they require. Bedrooms seen were personalised and reflected individual tastes, gender and cultural preferences. People are encouraged to bring in their own possessions in order to have familiar items around them to make their rooms as homely as possible. Door guards had been fitted to some doors so that people could have their doors left open but would safely close in the event of a fire. One room was noted to have an offensive odour and this was brought to the attention of the manager at the time. One person said, “The home is always clean”. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by staff who receive training to ensure that they have the knowledge to meet individual needs. The recruitment procedure is robust and ensures that people are safeguarded from harm. EVIDENCE: There are two trained nurses and six care staff on each floor throughout the daytime. An extra trained nurse is utilised following the last inspection and this assists with communication and completion of medication rounds in a timely and safe manner. During the night each floor has two carers and a trained nurse and an additional carer assists on both floors where required. The home currently has vacancies for three care assistants and a second activities coordinator, however generally maintains a core group of staff so that people know who will be assisting them to meet their needs. In addition to nursing and care staff the home also employs maintenance, domestic, kitchen and administrative staff to meet all the needs of the people living at the home. 83 of staff have completed a National Vocational Qualification (NVQ) level 2. This should ensure that a knowledgeable and skilled workforce can meet people’s needs individually and collectively. People told us: “Staff are lovely night and day” Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 22 “Everybody is always happy to do anything for me when needed” “Staff are all very good” “Staff are friendly” “Staff are brilliant, 150 out of 100” “Staff are second to none” Three staff files were reviewed and these contained all the required information to ensure that people were safe from harm. There was evidence that people receive an induction into the home so that they are aware of their responsibilities. The home has a detailed training matrix, which enables the home to plan future training. There is a dedicated and enthusiastic in house trainer who coordinates training across the home. There was evidence that people receive training in pressure area care, customer care, challenging behaviour, dementia awareness, bed rail safety, food hygiene, moving and handling, health and safety, infection control and control of substances hazardous to health (COSHH). Fire training was taking place on the day of our visit. Training has been arranged for epilepsy and learning disabilities via the Older Adult Nurse. Staff told us: “There is always training available and mandatory training is updated on a regular basis” “The training is very clear and very thorough and the trainer is very good at teaching” “We get plenty of training and support” Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A manager has been appointed to address previous shortfalls and this should ensure that the home is run in the best interests of people who live there. There have been significant improvements since the manager was appointed. EVIDENCE: Since our last visit to the home, an acting manager has been appointed. She is a Registered Nurse and has previous experience of managing care homes, including The Orchards. The acting manager is currently working towards the Registered Managers Award and completes in house training. This will ensure that her knowledge and skills are updated in order to lead the staff team effectively. An application is in process with us for her to become the Registered manager of the home. In addition to the appointment of the Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 24 manager, external managers and project managers have supported the home so that improvements could be made. It is evident that improvements have been made in the home however it is acknowledged that the manager needs time to sustain and continue with improvements. There are plans to have three unit managers to support the home manager and this should further improve communication. The manager holds a ‘surgery’ each Wednesday so that people can come and discuss their needs with her and their relatives. Relatives, residents and staff meetings are held so that people have the opportunity to voice their concerns and suggestions for improvement. External managers visit the home and complete Regulation 26 visit reports, which are sent to us to see. The organisation has a number of audits in place to monitor the service provided and had recently sent out satisfaction surveys to residents, relatives, staff and healthcare professionals in order to gain their views about the service provided. This information is collated into an annual report. Individual records are maintained for people where the home holds personal monies. Receipts were available to confirm all expenditure on the accounts. The balance of money was found to be correct. There was a clear audit trail, which had improved since our last visit, and this should ensure that people’s money is held safely. Health and safety and maintenance checks had been undertaken in the home to ensure that the equipment was in safe and full working order. Water temperature checks are recorded each month and this assists in the prevention of people accidentally scalding themselves. Maintenance checks are completed on the fire system and equipment and staff receive fire training and drills so that people should be safe in the event of a fire occurring. Accidents records are audited each month so that any trends are acted upon, for example someone who had had a number of falls was referred to a falls clinic for further investigation and advise. We are informed of any accidents or incidents that occur within the home as per Regulation 37. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 25 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 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 3 3 X 3 X X 3 Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation 12 15 Requirement Timescale for action 29/01/08 2. OP7 15 Each person must have an individual care plan outlining their care needs and the specific support required by staff to meet these needs. (Previous timescale of 03/07/07 partly met) Short-term care plans must be 21/12/07 written so that conditions are monitored. Staff must ensure that monitoring charts are implemented when identified so that changes are monitored. 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 OP12 Good Practice Recommendations Trips outside of the home should be arranged for people who wish to take part so that they maintain contact with the local community. DS0000024876.V349394.R01.S.doc Version 5.2 Page 27 Orchards The 2. 3. 4. OP10 OP15 OP26 Staff should inform people what they are going to do and where they are moving them to so that they know what is happening. Mealtimes should be reviewed so that people receive their meals in a timely and dignified manner. The odour in one bedroom should be eliminated to provide a pleasant environment. Orchards The DS0000024876.V349394.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Orchards The DS0000024876.V349394.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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