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Care Home: Cherry Blossom

  • 252 - 257 Arctic Road Cowes Isle Of Wight PO31 7PJ
  • Tel: 01983293849
  • Fax: 01983299731
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Cherry Blossom is a residential care home providing care and accommodation for up to 35 older people including those within the categories of physical disability and mental disorder. The property is prominently situated overlooking the river Medina in Arctic Road, Cowes. The town centre with its shops, ferry and bus terminals, is approximately half a mile from the home. The premises consist of a large two storey purpose built building and an older property, which has been incorporated. Residents` accommodation consists of mostly en-suite rooms on both levels, accessible via a passenger lift from the ground to the first floor. The weekly fees range from £365.40 - £460.00

  • Latitude: 50.750999450684
    Longitude: -1.2949999570847
  • Manager: Judith Dawkins
  • Price p/w: ~
  • UK
  • Total Capacity: 35
  • Type: Care home only
  • Provider: Islandcare Ltd
  • Ownership: Private
  • Care Home ID: 4374
Residents Needs:
Old age, not falling within any other category, mental health, excluding learning disability or dementia, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 20th March 2008. CSCI found this care home to be providing an Good service.

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.

For extracts, read the latest CQC inspection for Cherry Blossom.

What the care home does well The home is well maintained throughout, and provides a comfortable and spacious living environment for the residents. The manager has settled well into the role of registered manager and has introduced a number of management tools to help ensure the safe and smooth running of the home. The staff are well motivated and their interactions with the service users are friendly and supportive. The meals served at the home are good and offer a variety of dishes to suit the service users, one person commenting that: `very good meals, always suitable. Record keeping within the home is reasonable with the care plans providing a good indication of the persons` abilities and those areas in which support is required. The home`s staff recruitment and selection process is thoroughly operated and ensures that all prospective employees are appropriately vetted before commencing their duties. What has improved since the last inspection? During the fieldwork visit a new bath was being installed in the ground floor bathroom and new radiator covers fitted around the home. The manager indicates, via the AQAA (Annual Quality Assurance Assessment), that a new training room has been created and that several (un-identified bedrooms), have had new carpets fitted. A gate has been fitted to the rear/side of the property to restrict access to the main street from the garden/patio, as required during the last inspection visit. What the care home could do better: The manager needs to ensure the domestic staff pay attention to the removal of dust from surfaces that are not always in direct eye line, as dusty surfaces were evident during the visit and therefore not clean or hygienic. The medication`s cabinet used to store controlled substances needs to be upgraded so it complies with the revised `Safe Custody` Regulations. The in house activities and entertainment are not meeting the needs of the residents and not providing appropriate levels of stimulation and socialisation. CARE HOMES FOR OLDER PEOPLE Cherry Blossom 252 - 257 Arctic Road Cowes Isle Of Wight PO31 7PJ Lead Inspector Mark Sims Unannounced Inspection 20th March 2008 15:30 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 Cherry Blossom DS0000012474.V359239.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. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Blossom Address 252 - 257 Arctic Road Cowes Isle Of Wight PO31 7PJ 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) 01983 293849 01983 299731 Islandcare Ltd Mr Laurence Woodford Gustar Judith Dawkins Care Home 35 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (0), Old age, of places not falling within any other category (0), Physical disability over 65 years of age (0) Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP) Physical disability over 65 years of age - (DE(E)) maximum number of places 8 Mental disorder, excluding learning disability or dementia - over 65 years of age - (MD(E)) maximum number of places 4 The maximum number of service users to be accommodated is 35. 2. Date of last inspection 11th July 2006 Brief Description of the Service: Cherry Blossom is a residential care home providing care and accommodation for up to 35 older people including those within the categories of physical disability and mental disorder. The property is prominently situated overlooking the river Medina in Arctic Road, Cowes. The town centre with its shops, ferry and bus terminals, is approximately half a mile from the home. The premises consist of a large two storey purpose built building and an older property, which has been incorporated. Residents’ accommodation consists of mostly en-suite rooms on both levels, accessible via a passenger lift from the ground to the first floor. The weekly fees range from £365.40 - £460.00 Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection was, a ‘Key Inspection’, which is part of the regulatory programme that measures services against core National Minimum Standards. The fieldwork visit to the site of the agency was conducted over four hours, where in addition to any paperwork that required reviewing we (the Commission for Social Care Inspection) met service users, staff and management. The inspection process involved pre fieldwork activity, gathering information from a variety of sources including surveys, the Commission’s database and the Annual Quality Assurance Assessment information provided by the service’s provider/manager. The response to the Commission’s surveys was good, with seven service user, and nine staff surveys returned, prior to the report being written. What the service does well: The home is well maintained throughout, and provides a comfortable and spacious living environment for the residents. The manager has settled well into the role of registered manager and has introduced a number of management tools to help ensure the safe and smooth running of the home. The staff are well motivated and their interactions with the service users are friendly and supportive. The meals served at the home are good and offer a variety of dishes to suit the service users, one person commenting that: ‘very good meals, always suitable. Record keeping within the home is reasonable with the care plans providing a good indication of the persons’ abilities and those areas in which support is required. The home’s staff recruitment and selection process is thoroughly operated and ensures that all prospective employees are appropriately vetted before commencing their duties. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Cherry Blossom DS0000012474.V359239.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 Cherry Blossom DS0000012474.V359239.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, (Standard 6 is not applicable to this home.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. EVIDENCE: The service tells us, via their AQAA that: ‘we always undertake a preadmission assessment and ensure we are able to meet the needs of prospective service users and that we have sufficient staff levels at all times. We always invite the client’s family to view the home prior to admission and spend time answering any questions that they might have. They are given a copy of our service users guide and a contract, if we have more than one room then they are given a choice’. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 9 The indication from the service user surveys is that five of the seven respondents state they received a contract on admission to the home and six of the seven felt they received sufficient information about the home prior to deciding to move in. One person also added that: ‘I paid a visit prior to moving from another home (the service was identified by the resident but omitted by us to prevent identification of the person). The assessment tool is based on a modified ‘activities of daily living’ (ADL) model of care, which provided a good indication of the persons’ abilities and support needs measured against physical and emotional health care criteria. The review of four care plans established that clear links exist between both the assessment tool and the plans produced, as the latter are also based upon a modified ADL programme. Cherry Blossom DS0000012474.V359239.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The service tells us, via their AQAA that: ‘we have recently put our care plans onto a computer. We have also added far more information into the care plans regarding the clients’ personal needs’. During the fieldwork visit four ‘service user plans’ were reviewed and each found to contain a detailed account of the persons’ present health and social care needs and a well set out plan of how the staff should assist the resident in meeting those needs. The ‘service user plans’ also contained details of the persons’ daily routine, rising and retiring times, social activities/preferences, etc and risk Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 11 assessments, which could be expanded upon as they tend to consider general risks, falls, use of bedrails, pressure sore awareness/monitoring, etc. However, some service users are prone to more intricate risks i.e. the person who attempted to climb out of their bedroom window or people likely to leave the home without informing staff, both issues, which should be risk assessed and appropriate steps taken to manage the situation. As discussed with the manager people’s wish to leave the home may still exist and their abilities to go out unaccompanied should be risk assessed and appropriate action taken to manage this wish/aspiration. Information obtained via the residents’ surveys indicate that people feel their care needs are being met by the service, with six of the seven people ticking ‘always’ when answering the question: ‘Do you receive the care and support you need’, the other person ticked ‘usually’ in reply to the same question. Response to the staff surveys were largely positive, in respect of the home’s care planning process and the delivery of personal care, six staff ticking ‘always’, two ‘usually’ and the ninth ‘sometimes’, in reply to the question: ‘Are you given up to date information about the needs of the people you support or care for’. Some staff provided additional comments, which included: ‘we are always kept up to date with information concerning all our clients in their care plans’, ‘I always read care plans to keep me up to date as sometimes there can be a lack of communication between staff/manager resulting in information being forgotten, so not passed on verbally in handovers’ and ‘In care files yes, but sometimes when clients come into the home we are not always given a full background history on them and this can cause problems’. The overall view of the home’s ‘service users plans’ is that they provide satisfactory guidance to the staff on how to met peoples’ needs. The residents’ surveys also indicate that people feel they are being appropriately supported when accessing health care services, all seven people ticking ‘always’ in response to the question: ‘ do you receive the medical support you need’. The service tells, via their AQAA, that: ‘we work closely with outside professionals and all our service users have their own choice of General Practitioner (GP) and Dentist, etc’. The ‘service user plans’, reviewed during the fieldwork visit, contained specific records of all GP and allied health and social care professional visits, these records providing a reasonable good overview of the residents’ involvement Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 12 with professional agencies and the home’s efforts to support them whilst involved with these services. One persons’ records documenting their history of abdominal discomfort, the role taken by the medical professionals in diagnosing the cause and managing this and the staffs role in monitoring the resident, providing appropriate treatment (medications) and supporting the client when distressed by the discomfort. During the tour of the premise the manager had to leave us (the Commission) to sit with the above mentioned person and provide reassurance that the discomfort felt would pass. She was seen to call for assistance and to ask the staff member to remain with the client, whilst upset and to ensure any medication prescribed was administered. People are provided with a choice of whether to entertain visiting professionals within their bedroom or the small quiet lounge, located on the first floor and seen during the tour of the premise. All accommodation within Cherry Blossom is single occupancy and privacy is assured, however, for people who do not wish to entertain within their own room, the quiet lounge/room provides a useful alternative. The service tells us, via their AQAA that: ‘senior members of staff have attended medications training’, ‘that a new medication policy has been introduced and implemented’ and that ‘ the medication facility has been improved’. However, on reviewing the homes’ new medication storage facility it was noticed that the controlled drugs cabinet required replacing following changes to the ‘Safe Custody Regulations 1973’, although storage of all non-controlled substances or routinely prescribed medicines was satisfactory. The home uses a ‘Monitored Dosage System’ (MDS), for the management of most residents’ medicines, this system entailing the pharmacist dispensing medicines directly into a blister pack, one medication per sleeve. However, for newly admitted residents’, those people on respite or medications that cannot be placed into a MDS sleeve the home dispense directly from the original pack or from containers made up in advance by relatives. During the fieldwork visit the latter, medicines setup by relatives or the residents’ in advance, was discussed, as a newly admitted person had medication dispensed seven days in advance. This contravenes the guidance provided by the ‘Royal Pharmaceutical Society’ for care home’s, which indicates that dosset boxes should only be setup twenty-four hours in advance, as not all medications are suitable for inclusion in such containers. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 13 No resident is currently self-medicating and it was discussed, or mentioned, that this would elevate the problem of the dosset box, as the resident can manage their own medication as they see fit, although a self-medication risk assessment would need completion to ensure the person was safe to manage their medicines and that they would agree to store them safely. As mentioned above the accommodation at Cherry Blossom is single occupancy, which affords the residents’ privacy during meetings with health care professionals or during the delivery of personal care. The home’s quiet lounge/room is also available to residents that do not wish to have visitors in their bedroom and this can be accessed or booked by talking to the staff. Communal facilities, toilets and bathrooms, were fitted with locks that were of a suitable design given some of the physical and cognitive impairments suffered by the residents and staff were observed knocking on toilet doors before entering. Information taken from the residents surveys indicate that people feel they are treated with dignity and respect and that the staff listen and reacted appropriately to their requests. The residents also indicated via the surveys that the staff are ‘always’ available when they need them, as evidenced by the comfort offered to the resident in distress mentioned earlier within the report. The service also tells us, via their AQAA, that: ‘good practice in personal care has been accessed via the internet and placed in service users rooms’, however, the use of notes in people’s bedrooms was discussed, as this can compromise people’s right to privacy and undermine their right to respect and dignity. An example being those residents’ who have continence issues and the notes used to direct staff to the incontinence products to be used, which informs all visitors to their room that they have an incontinence problem. Cherry Blossom DS0000012474.V359239.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 who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities could be improved to better meet individual’s expectations. EVIDENCE: Information taken from the residents’ surveys suggests that there is room for improvement within the home’s activities and entertainments programme, one person ticking ‘always’, four ‘usually’, one sometimes and one person declined to answer the question: ‘are there activities arranged by the home that you can take part in’. Comments made alongside the response included: ‘I cannot take part in all activities as I am partially sighted but enjoy what I can’ and ‘Not able to do activities’. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 15 The staff also expressed concerns over the lack of suitable activities for clients, via their survey response, making remarks like: ‘Spend more time talking to service users’, ‘Our service users sit around nearly all day and have very little activities to do to stimulate their minds and bodies’ and ‘Offer more in house activities for clients, as what’s currently available is not good enough’. The service tells us, via their AQAA, that ‘service users are encouraged to maintain their own interests. We have an activities programme, which is displayed on the notice board. We respect their wishes if they do not wish to join in’. However, the service also stated, via the AQAA, within the section ‘What we could do better’, ‘have a more varied programme of entertainment and be more successful in encouraging service users to participate’. During the fieldwork visit their were no organised or structured social activities on-going, although the visit to the home took place later in the day. In conversation with some of the residents’, it was ascertained that they choose which activities they take part in, as some of the entertainments provided do not meet their needs, whilst others were very enjoyable. Details of the home’s activities programme is on display, as stated within the AQAA, and this does suggest and/or indicate that both in house and external entertainments are provided, however, this does not establish if the activities arranged are meeting people’s needs. The service has stated however, via their AQAA that their intention is to: ‘introduce a new activities programme, whilst continuing to work alongside our independent entertainers’. The home’s visiting arrangements are detailed within the ‘service user guide’ and ‘statement of purpose’ documentation, which the manager states she provides to all prospective residents’ or their representatives, copies of these documents were available within the home’s reception hall. During our visit a number of visitors were observed arriving at the home and being welcomed by the staff prior to meeting up with their next-of-kin. As mentioned above the service provides single occupancy accommodation, which allows visits to be conducted in private, however, should the person not wish to use their bedroom for entertaining there is the option of using the one quiet lounge. The service tells us, via their AQAA that ‘Visitors are made welcome at anytime, with no real restrictions. Service users are able to receive family and friends in the privacy of their own room, we also make ourselves available should they wish to discuss any issues or want advice’. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 16 People spoken with during the fieldwork visit spoke of their families, where they lived in comparison to the home and how living at Cherry Blossom meant they were closer and so received regular visits. Choice and independent decision-making within the home, is a little bit varied with some issues like the choice and range of activities and people’s opportunities to self-medicate, etc, suggesting that the home does not always promote people’s rights to express themselves and make independent choices. Whilst the provision of a separate visitors room/lounge enables people to choose where to entertain guests and the steps taken to help people ensure the home will suit their needs before deciding on whether to move in, indicates that people’s rights to self-determination are reasonably well managed. The people spoken with in the upstairs lounge also indicated that they choose to use this lounge, rather than the downstairs lounge, as they can talk to each other much easier, some of the people who use the ground floor lounge described, as being less able to sustain conversation or participate in a conversation. The tour of the premises allowed us (the Commission) to observe people’s bedrooms’ and to speak with the occupants, who confirmed that the room was decorated, furnished and set out in accordance with their wishes. One client was noticed to have a pet budgie, which according to the staff is very chatty and provides continuous company for the resident. The service states, via their AQAA that: ‘All service users have a daily choice of food and drink, all daily routines within the home are flexible’. The home’s risk assessment documents whilst needing expanding or developing, are used to assist people maintain their interests, hobbies or habits in as safe a way as possible. A good example being a resident who smoked and wished to continue smoking in the house, a risk assessment was undertaken and measures put in place to ensure that the resident was able to smoke in their bedroom. The measures including, improved ventilation, agreed hours during which a cigarette could be smoked, no smoking in bed, the use of an ashtray and the bedroom door to be kept closed at all times. Information, taken from the residents’ surveys, indicate that people generally feel they receive both the ‘care and support they require’ and that the staff are available to help them when required, listen to their requests and respond appropriately’. The residents’ surveys also indicate that the meals provided at the home are popular with five people ticking ‘always’, one ‘usually and one ‘sometimes’, in response to the question: ‘do you like the meals at the home’. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 17 The evening meal was observed being eaten during the fieldwork, which largely comprised of assorted sandwiches, although the staff member preparing tea stated that a hot option is available every night, although generally people opt for the sandwich selection. During a conversation, a group of service users confirmed that they prefer a smaller meal in the evening, sandwiches, cheese-on-toast, etc, as the main meals are so large that they cannot eat anything else substantial. The lounge/diners are spacious and comfortable and provide adequate seating for all of the people accommodated at the home, although some people do choose to dine in their rooms, as observed during the visit. The menus operate on a four weekly rotational basis and contain a choice of main meals and/or alternatives should people prefer; copies of the menus are on display within the dining areas of the home. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 18 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. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. EVIDENCE: The service tells us, via their AQAA that ‘a copy of our complaints procedure is displayed and details are available in our service users guide’. The latter statement confirmed during the fieldwork visit, when details of the home’s complaints process were observed on display within the main entrance hallway. The dataset establishes that details of the home’s complaints process are made available to staff via the company’s policies and procedures, although no date for the implementation or review of the policies or procedures was provided. The dataset also indicates that no complaints have been received by the service in the last twelve months. Information taken from the staff surveys indicate that people have an understanding of the home’s complaints process, all nine staff ticking ‘yes’ in Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 19 response to the question: ‘Do you know what to do if a service user/relative/advocate or friend has concerns about the home’. The residents’ surveys indicate that people are generally aware of whom to speak to if they are unhappy about any element, with four people ticking ‘always’ and three ‘usually’ in response to this question. The seven people responding to the residents’ survey also indicated that they are aware of the homes complaints process one person adding in reply to both questions: ‘I’d speak to whoever is in charge on the day’. The service states, via their AQAA that: ‘the staff are trained adult abuse’, ‘a copy of the adult protection policy is available within the office’, ‘our whistle blowing policy is explained to all staff during their induction, they are fully aware of the importance is reporting any suspicions of abuse, knowing they will be supported by the home’. The dataset indicates that the home has a ‘safeguarding procedure, although as with the complaints policy and procedure there is no date for review or updated included. Training records do evidence that ‘safeguarding’ training has been delivered, although this is largely in house training provided by the manager, who said when asked, that she had attended a train-the-trainer session provided by the Local Authority (LA), which enabled her to deliver training in house on ‘safeguarding’ concerns, the LA providing the learning materials to accompany the delivery of their course. The dataset establishes that two safeguarding referrals have been made by the service over the last twelve months, our records evidence that these have been reported to both us and the Local Authority and that these reports have all been appropriately made. Our records also show that these issues have been satisfactorily resolved. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 20 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, 26, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 19 & 26: The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The service tell us, through their AQAA that ‘bins visible from the garden have been removed, curtain tracks and curtains have been replaced/renewed, a plasma screen television brought for the main lounge and restrictors fitted to all ground floor bedrooms’. During the tour of the premise, a new bath was being installed in a ground floor bathroom and radiator covers replaced or renewed, although as Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 21 highlighted at the last inspection these have not been painted and so do not blend in very well with the general décor of the home. The general decorative condition of the home is good and the manager stated via the AQAA that bedrooms are decorated when vacated, although one room vacated shortly before the fieldwork visit, was being shown to a potential short-stay resident, which did not receive the freshened up it required. The home employs domestic staff that are responsible for the day-to-day cleaning of the home. During the tour of the premise the home was noticed to be generally clean and tidy throughout, although a lot of dust was noted on the tops of surfaces, which was brought to the manager’s attention and will need addressing. Information taken from the residents’ surveys indicates that six people feel the home is: ‘clean and fresh’ throughout, whilst the seventh person felt it was ‘usually’ ‘clean and tidy’. The service tells us, via their AQAA that staff receive access to training on the management and control of infections and that they have access to relevant policies and procedures, although again the date for the revision or updating of the procedures was not provided. However, the staff tell us via the surveys that they are not being provided with access to training on the management of infection control, with two of the nine people responding via the surveys picking out infection control training, as something they require. Communal toilets and bathrooms were noted to contain liquid soaps, papertowels and bins for the disposal of waste. All chemicals were stored in accordance with the ‘Control Of Substances Hazardous to Health’ (COSHH) regulations. The laundry is located within the main building and the staff are responsible for laundering residents clothing and returning this to the client room. Clothes are labelled to reduce the possibility of lose or the item being returned to the wrong person. The laundry is situated just off the kitchen, although the manager stated access to this facility is via the courtyard and not the kitchen, which would pose a serious health risk to residents. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and provided in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: Information taken from the residents’ surveys indicate six of the seven people feel they ‘always’ the care and support they require, the seventh person ticking ‘usually’ in response to the same question and all seven feel the staff are available when they need them. This however, differs from the staffs view with only one person ticking ‘always’ in response to the question: ‘are there enough staff to meet the individual needs of all the people who use the service’, three ticking ‘usually’, four ‘sometimes’ and the ninth person ‘never’. In addition the staff provided comments such as: ‘if staff suddenly go sick sometimes it maybe difficult to get cover but generally we are well staffed’, Between 6-8am we dont have a very good ratio to residents to staff’, ‘owners of the home say yes, staff would disagree, as due to costs, lack of money, etc, staff do not always feel they have the time to sit and chat with the clients as they would like to’, ‘on occasion there has been instances where a shift hasnt been covered resulting in staff having to work shift, so clients needs are not Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 23 being fulfilled as required’ and ‘more hands on support with the clients from the manager, as many staff feel that she should escort clients on hospital appointments, rather than take staff off the floor where they are needed for the care of the clients’. Copies of the home’s four weekly duty rosters were seen during the fieldwork visit and seemed to indicate that sufficient staff, both care and domestic, were available. The use of care staff in the preparation of evening meals might could be seen as an inappropriate use of the care staffs time, however, during the fieldwork visit a senior staff member had time to leave the home to collect a new resident and escort them back to the home, with no apparent detriment caused to any service user. During the visit the manager produced her training matrix, which provides evidence of the courses attended by staff over the last twelve months, including: medication training, mental capacity act training, safeguarding training, etc. Certificates, relating to the educational achievement of the staff are retained by the manager and displayed in frames within the main entrance hall. Feedback from the staff, via the surveys, is a little varied, as in response to questions about, ‘are you being given training which - is relevant to your role, helps you understand and meet the individual needs of service users and keeps you up to date with new ways of working’ the majority of the responses are ‘yes’. However, as highlighted within the ‘Environment’, section of the report some staff state they have not been receiving regularly updated infection control training and one person felt their training needs covered: ‘I am still waiting to update my first aid, manual handling, infection control and health and safety due to costs and funding we are unable to undergo regular training’. The service states, via the AQAA that ‘staff are keen to attend training’. However, the manager also indicates that funding for staff training might be an issue recording, under ‘what we could do better’ that they should ‘continue to use outside organisations for possible funding’. Information taken from the dataset and confirmed with the manager, indicates` that currently the home employs twenty care staff. Eleven of the twenty staff has completed a National Vocational Qualification (NVQ) at level 2 or above and this provides the home with a rate of 55 of its care staff possessing an NVQ at level 2 or above. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 24 The dataset also indicates that one other person is completing their NVQ, which would increase the percentage of staff holding an NVQ level 2 or equivalent to 60 . Information contained within the dataset establishes that a recruitment and selection strategy/procedure exists to support the manager when employing new staff. It also indicates that all of the people who worked in the home over the last twelve months have undergone satisfactory pre-employment checks. On reviewing the files of two newly recruited staff all of the required checks were in place, Criminal Records Bureau (CRB) checks, Protection Of Vulnerable Adults (POVA) checks and two references. The files also contained completed application forms, health declarations, photographs of the employee, interview summaries, personal information and information used to support the CRB application process. Feedback provided by the staff, through the surveys, establishes that they feel they completed a thorough recruitment process and that the employer ‘carried out checks, such as your CRB and references, before they started work’. Information taken from the surveys indicates that people are satisfied that the staff possess both the skills and knowledge to meet their needs and that they are appropriately looked after. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 25 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, 33, 35, 38, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect and has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The manager tells us, via the AQAA, that she has completed her National Vocational Qualification Level 4 in care but that she has yet to commence the Registered Managers Award (RMA), which she is considering taking alongside one of her deputy managers. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 26 The AQAA also provides details of a change in the homes’ managerial setup, with the creation of two deputy manager posts in support of the manager’s position, although it does not state why this change has been introduced. Information taken from the staff surveys indicate that the manager is meeting with her staff team from time-to-time to provide supervision, four staff indicating this occurs regularly, two ‘often’ and the remaining three ‘sometimes’. The staff indicate that staff meetings occur infrequently, a subject raised with the manager during the fieldwork, which she has undertaken to review and address. Generally the indication within this report is that the manager is providing good day-to-day leadership and that she has introduced, or is using, management tools, such as the recruitment and selection process, the improved care planning system and the system for managing/storing residents’ finances to good effect. The home’s approach to quality assurance is reasonable, with questionnaires or comment cards made available to people within the main entrance hall, although the take up and use of the surveys is low. The manager does maintain a comments and compliments folder and this was read during the fieldwork visit, the letters and cards contained within this file thanking the staff for their care and consideration of peoples’ relatives during their time at the home. The service tells us, via their AQAA that residents’ meetings are arranged and minutes are available to confirm they have taken place, however, the records do not show who was in attendance at the meeting. The manager is also using one-to-one visits with the residents to gauge their satisfaction with the service provided, however, the records of these sessions are not really adequate for the purposes of audit or quality assurance, as discussed with the manager at the time of the visit. Care plans and risk assessment documents are being reviewed and updated accordingly and other records, like those relating to service users monies, etc, checked and balanced. The homes’ management and storage of residents’ monies was considered safe and appropriate, with people’s monies held individually and separate accounts or books maintained of the amounts stored. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 27 The books or accounts are regularly audited by the manager who signs too confirm completion of her audit, all transactions were double signed and have an accompanying receipt. The manager had only the day before the fieldwork visit undertaken and audit of all accounts and each one balanced according to her statement at the time of the visit, four records were dip-sampled and all did balance. The service tells us, via the AQAA and dataset information that health and safety policies and procedures are made available to the staff and that domestic appliances and personal equipment is regularly maintained and serviced. Health and safety training is being made available to staff, with the training matrix and plan providing evidence of the courses attended and those to be attended by staff, including: health and safety, infection control and moving and handling, etc. The tour of the premise identified no immediate health and safety issues, and the environmental risk assessments do consider both potential areas of harm and how these can be managed, as highlighted by the service’s decision to improve the ramped access at the front of the home. Generally the service users and their relatives are satisfied with the service being provided at the home and raised no concerns in relation to either Health or Safety issues. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 28 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 X X 3 X X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 3 X 3 X X 3 Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 29 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. 2. Standard OP9 OP12 Regulation Requirement Timescale for action 16/07/08 16/05/08 Regulation The home must ensure its 13 medication storage facilities are safe and secure. Regulation The manager must ensure that 12 sufficient activities, entertainments and stimulation is provided for the service users. 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 OP26 Good Practice Recommendations The manager should make sure the cleaners check all surfaces for dust build up and remove it appropriately. Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Cherry Blossom DS0000012474.V359239.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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