Care Home: Cherry Tree House

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What the care home does well To make sure peoples needs are met these are assessed before coming to live in the home. The Person Centered Assessments and Care Plans are excellent and use pictures , symbols and words to reflect and show peoples personal and health care needs. One person living in the home showed the inspector their plans that were personalized and easy to understand. The plans show what staff must do to meet peoples personal care needs. The reviews show peoples care plans are looked at regularly and are changed to reflect peoples care and support needs. The daily records are excellent and contain a narrative describing peoples choices, preferences, likes and dislikes and any decisions they make about how they live their daily lives. People were observed throughout the visit being treated with dignity and having their wishes respected. How the home runs and what staff do is determined by the people living in the home. The daily and activities records show people do lots of things they like doing. Some people go to college, some people visit the local authority run day opportunities. One person says they like playing snooker and the photographs show they are happy playing snooker. Another person says they like going swimming and the records and photographs show them doing this regularly. People can choose their own menu and have meals that they like. The daily records and menus confirmed that some people usually help do the food shopping and help preparing meals. On the day of the visit everyone appeared to be happy and comfortable. People are protected by the way their medicines and finances are dealt with. People are also protected by the way staff are recruited and selected as records show appropriate checks are taken up before they are employed. Peoples health and safety is promoted and protected as staff training records show they have health and safety, moving and handling, food hygiene and first aid training. People live in a well decorated and well maintained home that is safe as maintenance records show the fire safety equipment is checked regularly. A tour of the home found it to be well decorated and clean. People were pleased to show the inspector their rooms that are personalized, comfortable , homely and clean. Discussion with support workers, the registered manager found people receive the support they need and require on a 24 hour needs led basis and the rota is flexible to make sure peoples needs are met. The staff rotas confirmed this. The homes returned quality assurance surveys show that people living in the home, their relatives and other visiting professionals are very happy with the services provided. On the day of the visit one person said "I like living here, the people are nice", another says they like going on holiday to the sea side". Records show people using the service are part of their local community and have a positive community presence. What has improved since the last inspection? Since the previous visit the home has increased the number of people that can live in the home. A tour of the home found the extension to be well decorated, well maintained, homely and clean. People have their rooms as they want and have chosen their colour scheme and furniture. Some people have joined the local Disabled Peoples Partnership Group and attend meetings held locally. The registered manager says there are also plans to have representation on the new Self Advocacy Group to be held in South Kirby. This involvement in the local community is to be commended. What the care home could do better: To make sure peoples needs are fully met it would benefit staff to have MentalCapacity Act training and in particular the new Deprivation of of Liberty Assessments. To keep people safe and protect them from any kind of abuse all staff should have Safeguarding training as soon as is practicable. It is acknowledged that this training has been planned for May 2009. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cherry Tree House 1 Vickers Avenue South Elmsall Pontefract West Yorkshire WF9 2LL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Railton     Date: 2 2 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Cherry Tree House 1 Vickers Avenue South Elmsall Pontefract West Yorkshire WF9 2LL 01977609884 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Janet Varga care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are withing the following category: Learning Disability - Code LD, maximum number of places: 6 Date of last inspection Brief description of the care home Cherry Tree House provides care, support and accommodation for up to two people who have a learning disability. The support and care offered is based on ordinary living principles and people living at Cherry Tree House are expected to do as much for themselves as possible. People are assisted and supported to take advantage of ordinary community based healthcare and leisure services. Cherry Tree House is a large semi-detached house in a residential area of South Elmsall. All accommodation is provided on the ground floor and there is a large garden to the front and a large patio area to the rear. The home is on a bus route and there are local shops nearby On 19th April 2007 the owners said that the fees for staying at Cherry Tree House are #395.00 per week and that there are extra charges for hairdressing (#3.00 plus). Further Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home information about the service and the role of the CSCI can be obtained from the home or by e-mailing justhomes@yahoo.co.uk Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Following this visit the service has been given a Two Star rating which means people living in the home experience good quality outcomes. This visit started at 08.20 and finished at 11.20. During this visit there was the opportunity to meet and speak to people living in the home and observe their morning routines. There was also the opportunity to speak to support workers in the home and the registered manager/ owner. A sample of peoples records were seen and included assessments, care plans, reviews, daily and medical records. Some staff records were also seen and included application forms, police and POVA (Protection of Vulnerable Adult List) checks references, training and supervision records. The way medicines are dealt with was checked and the way medicines are used by the service. Other information considered included information sent in by the service before the visit and in particular the AQAA Care Homes for Adults (18-65 years) Page 6 of 26 (Annual Quality Assurance Assessment). Some returned quality assurance surveys were also seen and included those from people living in the home, their relatives and other visiting professionals. This was a very positive visit and the inspector would like to take the opportunity to thank the people living in the home, their support workers and the registered manager for their hospitality and cooperation throughout the visit. What the care home does well: What has improved since the last inspection? What they could do better: To make sure peoples needs are fully met it would benefit staff to have Mental Care Homes for Adults (18-65 years) Page 8 of 26 Capacity Act training and in particular the new Deprivation of of Liberty Assessments. To keep people safe and protect them from any kind of abuse all staff should have Safeguarding training as soon as is practicable. It is acknowledged that this training has been planned for May 2009. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To make sure peoples personal and health care needs can be met by the service these are assessed before coming to live in the home. Evidence: To make sure peoples personal and health care needs can be met these are assessed before coming to live in the home. Records show everyone has an assessment completed by the local authority social workers or Learning Disability Team Nurses. However, the assessments provided by the home are better as they are provided in an easy read format and use pictures, symbols and words to show peoples care and support needs. To make sure staff understand peoples care needs they include emotional, mental health and behavioral assessments that show what people do when they are unhappy or angry. They also show staff what people do when they are happy and what they like to do and how they like to be supported. They assessments show peoples likes , dislikes, choices and preferences and tell staff what they need to do to make sure people are safe and enjoy their daily lives. The reviews show the assessments are looked at regularly to make sure they reflect and show any changes Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: to what people want or how they should be cared for. Discussion with the manager and one person living in the home found the assessments work well and are easy to understand. Care Homes for Adults (18-65 years) Page 12 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their personal care and support needs are set out in their plan of care and they have a say in what they do and how they live their lives. Evidence: Peoples care plans are provided in an easy read format and are easy to understand.They show how people want to be cared for and supported. They use pictures, symbols and words to describe peoples care needs and they are signed to say they and their relatives agree wit them. These are looked at regularly to make sure they are right and changed if needed. The daily records are very good and use descriptive words to show peoples choices, preferences and any decisions they make about how they live their daily lives. People were observed being treated with dignity and having their wishes respected. The returned quality assurance surveys show people living in the home and their relatives are happy with the quality of the care provided. One visiting professional writes The quality of care given to the service user under my care is fine. Another relative writes We are extremely happy. Another Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: says The care is wonderful could not be better. Records show there are also risk assessments showing what staff must do to minimize any risks to people in living an ordinary lifestyle. Care Homes for Adults (18-65 years) Page 14 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and encouraged to live as ordinary a lifestyle aspossible and have a say in how they live their lives. People have a choice of a varied and balanced menu. Evidence: The inspector arrived early and observed peoples morning routines. People were observed choosing what they did, including choosing what clothes to wear, what to have for breakfast and what wanted to do next. The records show peoples choices and preferences are written in their care profiles and the daily records use descriptive words to reflect and show peoples choices ,preferences and any decisions they make about how they live their lives. People are supported and encouraged to use ordinary community based leisure services and people said they like going swimming, to college, playing snooker, bingo and going to see shows. One person said they Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: particularly liked going to see a production of Grease at a local school. The photographs displayed around the home show people enjoying playing snooker, visiting the coast, playing bingo and having parties. One person says they like going to their relatives for the weekend. The returned quality assurance surveys show people and their relatives are very happy with the support provided and the lifestyle experienced matches their expectations. One relative writes I am happy to know my relative is happy and has a better lifestyle, I cannot find anything that needs improving, long may it continue in the same way. Another writes The food is just beautiful. One person living in the home says they like salads, another spaghetti bolognas,someone else says they would like fish and chips more often. People were observed choosing their meals and having a say in what they had to eat. The daily records are very good and use descriptive words to reflect and show peoples choices and preferences. Records show and the manager confirmed that some people help in food preparation and enjoy going shopping to the supermarket. Care Homes for Adults (18-65 years) Page 16 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples have a say in how their health care needs are met and they are protected by the way medicines are dealt with. Evidence: As part of living an ordinary lifestyle records show people are supported to use ordinary community based health care services.The person centered profiles show peoples health care needs are assessed including , emotional, mental health and behavioral assessments. Peoples plans are in an easy read format using pictures, symbols and words and include peoples choices and preferences and how they like to be supported. Records and in particular the reviews show that peoples physical and mental health care needs are met.They also show people are supported by the Community Learning Disability Team Nurses and Specialist Social Workers and hospital based consultants. To keep people safe staff training records show they receive training in the safe administration of medicines. Peoples medical records and the medicine systems show people are protected by the way medicines are dealt with. The returned quality assurance surveys show people and their relatives are happy with the support and services provided. Care Homes for Adults (18-65 years) Page 17 of 26 Care Homes for Adults (18-65 years) Page 18 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their relatives know that what they say will be taken seriously and acted upon and they are protected from any kind of abuse. However, people will be further protected when all staff have had Safeguarding training. Evidence: To make sure people have access to the complaints policy and procedure it is displayed on the notice board. Everyone living in the home is given a Service User Guide that has a copy of the complaints policy and procedure. To make sure people are protected from abuse there is a Safeguarding Policy and Procedure that includes the Wakefield Local Authority Safeguarding policy. To further protect people living in the home staff training records show some have Safeguarding training. However, the training and development plan shows there is Safeguarding training organized for all staff in May 2009. The service history and the Annual Quality Assurance Assessment shows the home has not received any complaints since the previous visit. Records also show the service has not had to make any Safeguarding Referrals to the local authority. People were observed throughout the visit being treated with dignity and having as say in how they live their lives. The reviews and quality assurance surveys show people and their relatives and other stakeholders have the opportunity to comment on the quality of the services provided. Care Homes for Adults (18-65 years) Page 19 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy living in a well decorated, well maintained home that is comfortable, homely , clean and safe. Evidence: People were observed relaxing in a home that is well decorated, well maintained , homely and comfortable. The maintenance records show people also live in a home that is safe. The returned quality assurance surveys show people , their relatives and other visiting professionals are very happy with the services provided and all said the home was excellent. One relative says I can not find anything that needs improving , may it continue in the same way. One person says they like their bedroom and have everything they need. Peoples bedrooms are personalized and people have their home as they want it. Care Homes for Adults (18-65 years) Page 20 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People care and support needs are met by staff that are trained and are protected by the way staff are selected and recruited. However, they will be better protected when all staff have received Safeguarding and Mental Health Act training. Evidence: To make sure people living in the home are protected staff records show that two references, police checks and POVA (Protection of Vulnerable Adults List) checks are taken up before they are employed. Records also show staff have induction training to make sure people are safe and training includes First Aid Moving and Handling, Food Hygiene, Health and Safety, Infection Control and Fire Awareness training. Records show some staff have National Vocational Qualifications at Level 2 and 3 and others are registered on NVQ Training. To make sure people remain safe and protected from abuse the records show all staff are due to receive Safeguarding training in May this year. The manager says to protect peoples rights they are currently looking to provide Mental Health Act training and in particular Deprivation of Liberty training. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run , well managed home where they have a say in what they do and how the home runs, peoples health, safety and welfare is also promoted and protected. Evidence: People were observed throughout the visit being treated with dignity and having their wishes respected. The morning routines are set by people living in the home who have a say in what they do and how they live their lives. A sample of three peoples records including easy read assessments and care plans and reviews show there are good care management systems in the home.The daily records are very good and contain a narrative which uses descriptive words to show peoples choices, preferences, likes and dislikes, plus any decisions they make about their daily lives. All this evidence shows people are involved and have a say in every aspect of their lives and how the home runs. People are protected by the way their finances are dealt with as three peoples finances were checked and found to be properly kept and recorded and safe. Peoples health , safety and welfare is also promoted and protected as the maintenance records Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: show the fire safety equipment including fire alarm system are checked regularly. To further protect people staff training records also show they have Health and Safety, Moving and Handling,Food Hygiene and Infection Control training. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 23 35 35 To further protect people living in the home all staff should have Safeguarding training as planned for in May this year. To protect people fully all staff should have Safeguarding training as soon as is practicable. To make sure peoples rights are protected staff should have Mental Health Act training and in particular Deprivation of Liberty training. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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