Inspection on 07/10/05 for The Orchards

This inspection was carried out on 7th October 2005.

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

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

Other inspections for this house

The Orchards 21/10/09

The Orchards 23/05/07

The Orchards 16/03/06

The Orchards 10/12/04

The Orchards 08/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 The Orchards 140/142 Birkrig Skelmersdale Lancashire WN8 9HY Lead Inspector Val Turley Unannounced Inspection 7th October 2005 11.45 The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 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 The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Orchards Address 140/142 Birkrig Skelmersdale Lancashire WN8 9HY 01695 726118 01695 555327 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) Dawaking Care Ltd Mrs Lesley Ferguson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of seven service users requiring personal care who fall into the category of LD - Learning Disability. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 10th December 2004 3. Date of last inspection Brief Description of the Service: The Orchards is a large end terraced house comprising of two properties in the Digmoor area of Skelmersdale. It is close to local shops and amenities. The home has been extended and adapted to provide long term care for seven people all of whom have a learning disability. Service users are accommodated in single rooms situated on three floors. The home is able to accommodate a service user with a physical disability providing ramps to the front and rear of the home, a ground floor bedroom and a ground floor shower room. There is a separate kitchen, dining room and two lounges. A well-maintained garden can be accessed through the dining room. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one day in October 2005 by two regulation inspectors. The inspection involved observation of and discussion with one of the service users who lived at the home and also discussion with and observation of the staff working there, an examination of records, policies and procedures and a tour of the premises. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on one of the service users living at the home. All records relating to that individual are inspected along with the room occupied. The service user is invited to discuss their experiences of living at the home, however this was not to the exclusion of other people living there. What the service does well: The home provided a comfortable and homely atmosphere for both staff and service users. Care was taken to ensure that any new service users to the home were fully assessed to ensure that their needs could be met. Care plans were detailed; outlining service users specific support needs, and providing the support staff with clear guidance as to how support should be provided. Risk assessments were detailed and balanced potential risks to service users against the benefits of undertaking activities. Service users were encouraged to become involved in the development of their care plans and their reviews. A number of health and social care professionals provided additional support to both the service users and the staff at the home ensuring that any specific challenges were considered and managed appropriately. The service users were encouraged to personalise their rooms and it was evident from this that they were encouraged and supported to follow their individual hobbies and interests. The service users were involved in a variety of community based activities through the week which again the staff supported them to follow. Service users links with families and friends were supported appropriately as were service users personal relationships. The home was well managed with the manager having a clear understanding in terms of her responsibilities to ensure that the service users had a fulfilling lifestyle and that all necessary work was undertaken to protect them as far as possible. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 6 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 DS0000005979.V255503.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The pre-admission process was in sufficient detail to ensure that a potential service users needs could be met. EVIDENCE: The file of one recently admitted service user was examined. The documentation indicated that a full assessment had been undertaken prior to admission and assessment information had been provided by the care manager. The information obtained had been used to form the basis of a comprehensive care plan, which included information on strategies to deal with any challenges presented by the service user. The plan indicated that a community nurse from the Learning Disability team was involved providing additional support and guidance to the service user and staff team. This involvement had assisted the service user in the settling in process and had been helpful for the staff at the home as they gained an understanding of the service users needs. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 The care plans for service users living at the home were very detailed outlining individual support needs. They ensured that staff were able to provide a safe and structured environment, and also work towards extending the service users range of experiences and options for the future. EVIDENCE: The file of one service user was tracked. The care plan was based on a number of assessments that had been undertaken. Appropriate risk assessments were in place with regard to any agreed restrictions on choice and freedom. The plan also included strategies to deal with any challenging behaviour. A number of health professionals had also provided support to both the service user and the staff team. On the day of the inspection staff were observed to provide appropriate support to the service user. The service user was familiar with the contents and lay out of the file and it was clear that she had been involved in developing the care plan and had signed the various documents that it comprised of. An advocate from the local advocacy service had been involved appropriately providing additional support. A review was taking place on the day of the inspection and the service user was very much involved in this process as was an invited relative. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 10 The service user stated that she was ‘fine’ and was keen to discuss what she had achieved since the last inspection. During discussion with her, she was able to explain that she was receiving support that she appreciated and that it was allowing her to achieve her individual goals. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 and 17 The home worked hard to ensure that service user were supported to take part in appropriate and fulfilling activities and to maintain contact with friends and families. The home placed an emphasis on encouraging service users to make decisions themselves with regard to their choice of meals and developing their self-help skills in this area. EVIDENCE: From discussion with a number of the service users, staff and from information on files it was evident that the service users were provided with a range of opportunities to get involved in valued and fulfilling activities. These included college courses, attendance at day centres, swimming and church based activities. On the day of the inspection one of the service user discussed with staff the possibility of undertaking some voluntary work with children. Two of the service users spoke with great enthusiasm about the Health and Social Care course they were both attending. Again from discussion with service users and staff and from a conversation with a visiting relative, it was clear that family links were encouraged and supported and personal relationships were supported appropriately. On the day of the inspection two of the service users were supported to make a family The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 12 visit. In addition to the above the service users discussed their links with the local community and the enjoyment they got from being involved in a singing group in the local church. Documentation on files confirmed the support provided by the staff team to ensure that the service users were able to participate in these activities. Menus were examined and the service user explained that they discussed these in their regular meetings. There was evidence that alternative meals were available and this was confirmed by the service users. Two of the service users were observed to be encouraged to help prepare lunch and appropriate assistance was provided were necessary at the meal itself. The weights of the service users were recorded and a healthy eating menu had been adopted with the service users health in mind. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home had worked with other agencies to ensure that the health needs of the service users were fully assessed and addressed. EVIDENCE: The file of the service user whose care was ‘tracked’ included a health action plan. This had been developed in conjunction with the service user and was comprehensive in its approach and content. The information it contained was consistent with the information included within the service users care plan. From the information in the health action plan and the care plan and from discussion with staff and the service user, it was evident that the health needs of the service user had been fully assessed and addressed. The service user was supported to attend any appointments and staff were observed to provide day–to–day support with regard to the service users health needs. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The homes policies that dealt with the protection of vulnerable adults needed to be amended, to ensure as far as possible the safety of the service users. EVIDENCE: The homes policy that dealt with the protection of vulnerable adults included all of the necessary detail ensuring as far as possible that service users were protected from any abusive situations. It was recommended that one amendment be made to the section dealing with the management of physical aggression. The policy should state that any strategies devised to deal with such incidents for the protection of service users, must be agreed at a multidisciplinary level. The manager was however aware that this should be the case. Records of service users financial transactions were seen and service users were observed to be involved in accessing and signing for their own monies. This ensured as far as possible that the processes were transparent and the interests of the service users were safeguarded. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home was clean and comfortably furnished, providing a safe and homely environment for both service users and staff. EVIDENCE: The home was clean comfortable and homely. The manager had taken into account the challenges presented by the service users group and had furnished the home with furniture and fittings that were durable in nature. Bedrooms were personalised by the individual service users allowing them to follow their own hobbies and interests. The home was accessible to all service users. The premises were well placed for local amenities and transport was available to support service user to make use of these facilities. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 The home had a thorough recruitment procedure in place, which ensured as far as possible the protection of the service users. EVIDENCE: There was evidence in place to indicate that the home had a thorough and robust recruitment policy and procedure in place. Appropriate checks had been made on a recently appointed member of staff. The manager was able to describe the steps taken to ensure that service users were protected as far as possible through the recruitment process. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home had a number of quality assurance checks in place to ensure that the care provided was appropriate to the service users needs. EVIDENCE: The home had a number of quality assurance and quality monitoring systems in place to ensure that the home was being run for the benefit of the service users. Questionnaires had been given to service users, families, friends and involved professionals and at the time of the inspection the information provided by these questionnaires was being analysed with a view to the findings being circulated to everyone concerned. The home had an annual plan in place and the manager stated that the homes policies and procedures were in the process of being reviewed. Staff meetings and service user meetings were both held on a regular basis, minutes were in place and a member of staff and a service user confirmed that they were held. These gave both groups opportunities to influence the way in which the home was run. The home had been awarded the Investors in People Award which is a quality assurance system accredited by an outside body. The manager stated that the The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 18 home was a member of the British Quality Foundation and that it was working towards its quality assurance award. The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X x Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Orchards Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000005979.V255503.R01.S.doc Version 5.0 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 YA23 Regulation 13(6)(7) Requirement The homes policy dealing with the protection of vulnerable adults must be amended to ensure that staff have clear guidance when managing physical aggression. Timescale for action 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Orchards DS0000005979.V255503.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 DS0000005979.V255503.R01.S.doc Version 5.0 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. 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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