Inspection on 21/09/05 for The Orchards

This inspection was carried out on 21st September 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Orchards 02/08/07

The Orchards 15/08/06

The Orchards 05/01/06

The Orchards 13/10/04

The Orchards 15/06/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE The Orchards 1 Wilmer Drive Heaton Bradford BD9 4AR Lead Inspector Susan Knox Announced 21 September 2005 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 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. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Orchards Address 1Wilmer Drive Heaton Bradford BD9 4AR 01274 547086 01274 548776 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Baybury Ltd Mrs Susan Davies Care Home 24 Category(ies) of Dementia (3) Old AGE (19) Physical Disabilities registration, with number (2) of places The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13 October 2004 Brief Description of the Service: The Orchards is a detached property set in its own grounds. Accommodation is provided on the ground, first and second floors. The majority of rooms are singles. A passenger lift provides access to the first and second floors.The home is registered predominately for Older People. A small number may have mental health needs and/or physical disabilities.This care home is located adjacent to Lister Park and is close to local shops, churches and city bus route. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out by one inspector between 9.30 am and 3.30pm. Time was spent talking to residents, staff and observing practice. Records including duty rotas, service user care records; recruitment records and staff training records were seen. Some bedrooms and other areas were checked. The majority of the requirements from the last inspection have been addressed. Requirements and recommendations from this inspection are included at the end of the report. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 7 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 standard(s) 1-5 Detailed information is available about the home. The admission of service users outside the categories registered may put them at risk. Terms and conditions are available. Service users and their families are given an opportunity to look round before deciding whether to move in. EVIDENCE: The statement of purpose needs slight amendment to reflect the changes to the building and increased staffing levels. Once complete this must be submitted to the CSCI. Terms and conditions of accommodation were available in service user files. These include the number of the room occupied as required. Either the service user or relative signed these. All service users are assessed before admission to the home to make sure that their needs can be met. Pre-admission assessments provided detailed information about the individual’s needs. One relative described how staff had The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 8 visited to assess her relative before she was admitted. Good information was provided so that an informed choice could be made. One service user had been admitted outside of the registration categories, as the home is not registered to care for these particular needs. The manager advised that this particular ill health had occurred in the past. However the categories relate to past or present illnesses therefore a variation to registration must be completed and training put in place for staff in order that staff can fully meet needs. The care plan did not follow on from the initial assessment for this service user therefore previous needs relating to mental health were not carried forward. Input from other health agencies showed that progress had been made but this was not reflected in care planning. Service users said that either they or their relatives had come to look round the home before moving in. Intermediate care is not provided. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 10 Care plans are good. They could be better if more detail was included. Residents are treated with respect and their privacy maintained but approaches to those with short-term memory loss needs to be more individualised. EVIDENCE: Three care plans were checked. The format has improved since the last inspection. Care plans were in place for all three and followed on from the initial assessment. Now included are care plans about foot and dental care. It was very clear that service users and relatives were very happy with the care provided. Care planning was good and had improved but lacked sufficient detail at times and should be more person centred. One service user had had recent falls therefore care planning should be more focused on prevention. One other did not address mental health needs. From observations of staff interaction with a service user with short-term memory loss it was clear that the approach although very caring was unsuccessful therefore other methods should be attempted. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 10 During discussions with service users they felt that staff did respect their privacy and dignity. Relatives were happy with the care one saying that staff were lovely. During the visit staff were seen discussing care plans with individuals before asking them to sign the documents. New staff confirmed that their induction into the home included the principles of care about dignity and privacy. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12-15 A programme of activities is provided for service users including trips out. Service users enjoy the food and their preferences are taken into account EVIDENCE: Service users and relatives said that visitors were welcomed into the home. During the visit good interactions were observed between staff and visitors. The manager advised that the home had recently booked a Christmas party for service users at a local hotel. Other activities have been in house musical entertainment or bingo and there has been a trip to a local fish and chip restaurant. The main activity this summer has been using the garden to enjoy the good weather. Representatives from the local church visit the home. A small number of service users leave the home independently to follow own pursuits. This was observed on the day. During discussions service users said that they are asked daily about their preferences for meals. They spoke very positively about the quality of the meals provided. One service user said that they give him the meals that he wants. The cook also said that she speaks to the service users daily and accommodates their likes and dislikes. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 Service users are enabled to speak to management and staff about their problems. EVIDENCE: A detailed complaints procedure is available and included in the Statement of Purpose/Service User guide. A notice is prominently displayed in the hall and there is a complaint/comment book. The manager is aware that any complaints received must be investigated and records kept. She advised that none have been made. Service users and relatives had no problems in approaching management or staff with any concerns. This was apparent from discussions with both during the inspection. One service user said that after discussing concerns staff always checked afterwards to make sure that matters had improved. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19, 20, 21, 26 The providers are planning to improve access to the home for those less able. A clean and pleasant environment is provided for service users to live in. Service users are pleased with the service given. EVIDENCE: Service users and staff said that the garden has been put to full use by a group of service users during the last few months of good weather. A new gardener has been employed and service users have benefited from his work. A very pleasant sitting area has been created. Service users have to be helped down or up the steps to the main door. The rear entrance is not as steep but does have steps to negotiate. The providers are planning to provide a ramp so that access is made easier for wheel chair users. A passenger lift provides easy access to all floors. A full inspection of the building was not carried out other than observations when talking to service users. New lounge chairs have been provided in the The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 14 front lounge and work to upgrade the blue lounge is due to start. The providers work hard to ensure that decoration and refurbishment is well maintained and there is a comfortable and pleasant environment for service users. From discussions with the housekeeper it was clear that she was aware of procedures relating to hazardous substances and infection control. The areas seen were very clean with good odour control. Service users said they were comfortable in their rooms. One was very pleased with the quality of cleaning and the speedy return of fresh towels. Two bedrooms have water damage to the ceiling caused by rainwater. The fault has been repaired and redecoration will take place. A recent environmental health inspection identified some redecoration was required in ancillary areas such as staff WC and storeroom. This work was on going at the time of this inspection. The current procedure for washing the pots from commodes has to be changed, as staff could not easily access the wash hand basin in the laundry. Paper towels and liquid soap are provided in bathrooms and WC’s apart from two. This meets with infection control procedures. Two have been removed due to some service users inappropriate use. The infection control advisor should be contacted for advice. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 Staffing levels are sufficient to meet service user’s needs. Recruitment procedures make sure that staff are suitable before they start work in the home. Training is provided to make sure that staff can carry out their jobs and meet the majority of the service user needs. One area of training is still to be undertaken. EVIDENCE: Duty rotas are maintained for all staff. There are two managers, a deputy and a senior care. These senior staff also provide on call advice when necessary. Staffing levels were appropriate for the numbers and levels of care required for service users at the time. NVQ training is on going. 42 of care staff have NVQ level two or above. Two hold a current first aid certificate. Two staff are due to start NVQ level training. Staff said that a number of training courses had been attended and more were planned for the coming months. In the last twelve months staff have attended person centred care, catheter care, pressure sore prevention and medication training. Staff files contained training certificates. Staff training undertaken and required would be easier for management to monitor if a matrix chart was established. In order to meet all the needs of service users currently accommodated staff must attend mental health training. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 16 Records show that induction and foundation training is provided for new staff. All new staff complete an induction programme. This was confirmed in discussions with staff. Supervision of staff is also ongoing. Recruitment practices were good. Staff files were well kept with evidence of CRB checks and references obtained before employment began. Also included was evidence that the interviewer had discussed any gaps in employment history. This is good practice. Job description and terms and conditions were available. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34, 36, 37, 38. The home is well organised and the managers provide leadership. Service users and relatives are encouraged to talk to management and staff. The health and safety of service users and staff is promoted and protected. EVIDENCE: Service users spoke well about the management of the home. Relatives expressed satisfaction about the care in discussions and feedback in comment cards. Staff and service users meetings are held this was confirmed during discussions with both. The manager returned the pre inspection questionnaire to the CSCI in time for the inspection. In this it was confirmed that health and safety and maintenance checks and tests were up to date. The staff files for new workers showed that fire drills, moving and handling had been provided. Health and safety training The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 18 had been started. The manager was advised to talk to the local fire officer about the recently formulated fire assessment and whether this was satisfactory. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x 3 3 3 The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? 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 3 Regulation 14 Requirement The registered managers must not admit service users outside the categories the home if registered to take. The registered managers must ensure that staff can access WHB in the laundry. Also liquid soap and paper towels are in all bathrooms and WC. The registered managers must ensure that training is provided in mental health. Timescale for action 21.9.2005 2. 26 13 31.10.2005 3. 4. 30 12 30.11.2005 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. 2. Refer to Standard 7 38 Good Practice Recommendations The registered managers must ensure that care plans are more person centred. The registered managers are advised to discuss the fire risk assessment with the local FO. The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley LS13 1HP 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 The Orchards J52 S1167 The Orchards V200449 210905 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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