Care Home: Cherry Tree House

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• St Vincents
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• Winton House
• Rush Court
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• The Maypole Nursing Centre
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What the care home does well People using the service tell us that they are happy with the provision of care they receive and find the manager and staff to be very approachable. Service users feel confident in using the complaints procedure if the need arose. Any concerns or complaints are acted upon appropriately and in a timely manner. The staff were observed to treat residents with dignity and respect throughout the inspection offering help discreetly and sensitively where necessary. The home deals with a number of diverse care needs and always ensures to offer a personalised service to meet the individual needs and preferences of their service users. There is a commitment to ensure that all users of the service, however diverse their needs may be, receive a person-centred package of care which meets their needs appropriately and in a safe manner. What has improved since the last inspection? Since the last inspection undertaken in August 2006, the recruitment procedure now ensures where staff have been checked against the POVA list and their CRB checks (Criminal records Bureau) have not been received, a risk assessment has been put in place, the authenticity of references are now followed up to ensure the health, safety and welfare of those using the service. Medication administration records contain two staff signature where any hand written entries are made or where an entry is changed following the advice of a GP. Since the last inspection, the service have made improvements to the environment, which includes; updating and refurbishing two shower rooms, replacing carpets in the corridors and to one bedroom, upgrading furnishing and fittings in a number of bedrooms and purchasing new bed linen, towels and flannels for all of the residents bedrooms. New washing machines and dryers have been purchased for the home`s laundry facilities, CARE HOMES FOR OLDER PEOPLE Cherry Tree House 49 Dobbins Lane Wendover Aylesbury Bucks HP22 6DH Lead Inspector Jane Handscombe Unannounced Inspection 12th August 2008 11:00 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 Tree House DS0000022959.V369039.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 Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree House Address 49 Dobbins Lane Wendover Aylesbury Bucks HP22 6DH 01296 623350 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) Mr Peter Hall Mrs Janet Parker Mrs Janet Parker Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th August 2006 Brief Description of the Service: Cherry Tree House is a privately owned care home providing accommodation for twenty elderly residents. The home has twenty individual bedrooms with five having en-suite facilities and one of these rooms provides respite care. The accommodation is on two floors with only three residents having bedrooms upstairs which are accessed by stairs. The communal areas are well situated on the ground floor. The home is situated in the village of Wendover, with local shops and facilities close by. The home is in a road of well maintained properties and appears well integrated within the local community with train and bus links to near by towns. The home is supported by the local General Practioners surgery with regular support from the district nursing service. There is an established staff team which welcomes residents relatives and new staff. The fees for the home range from £580.00 to £ 4600.00 for a single room per week. Cherry Tree House DS0000022959.V369039.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 star. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection, which took place over 1 day. The visit took place on the 12th August 2008. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The home was currently providing care and support to 19 service users with one vacancy available. Ten of these users were sent questionnaires in order to ascertain their views upon the care they receive, however, only one response was received at the time of writing this report. Likewise surveys were forwarded to six permanent staff, five of whom responded. A selection of surveys were also sent to health care professionals and the advocacy service who provide advocacy services to those using the service to gain their feedback; three healthcare professionals completed the surveys which have been received by us at the time of writing this report. Any further completed surveys we receive will however be considered as part of CSCI’s ongoing regulatory responsibilities for registered services. The CSCI Inspecting for Better Lives (IBL) involves us requiring the service to complete an Annual Quality Assurance Assessment (AQAA), which enables them to evaluate the quality of their service and forward to ourselves when asked. This initially helps us to prioritise the order of the inspection and identify areas that require more attention during the inspection process Results of this inspection report are derived from feedback gained from the service users, discussions with staff during the visit, responses to questionnaires sent out prior to this visit, viewing client’s records held within the service, viewing policies and procedures, staff personnel files, general observation throughout the day, along with information provided to us within the AQAA and any other information that CSCI has received about the service in order to gain an understanding of how the service meet the service users’ needs, and impact upon their lives. We looked at how well the home was meeting the key standards set by the government and have in this report made judgments about the standard of the service. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 6 Comments from those using the service include: ‘I like it here’ ‘The meals are very good’ ‘I would recommend the home to others’ ‘the staff are all very kind’ ‘We have a lovely garden’ We would like to thank all those who gave their time during the inspection process. What the service does well: What has improved since the last inspection? Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 7 Since the last inspection undertaken in August 2006, the recruitment procedure now ensures where staff have been checked against the POVA list and their CRB checks (Criminal records Bureau) have not been received, a risk assessment has been put in place, the authenticity of references are now followed up to ensure the health, safety and welfare of those using the service. Medication administration records contain two staff signature where any hand written entries are made or where an entry is changed following the advice of a GP. Since the last inspection, the service have made improvements to the environment, which includes; updating and refurbishing two shower rooms, replacing carpets in the corridors and to one bedroom, upgrading furnishing and fittings in a number of bedrooms and purchasing new bed linen, towels and flannels for all of the residents bedrooms. New washing machines and dryers have been purchased for the home’s laundry facilities, What they could do better: Whilst service users spoke highly of the care they receive at Cherry Tree House and of the staff who deliver the care, there are areas highlighted within this report for which requirements and recommendations have been made. The registered person must ensure a robust recruitment procedure is followed and not employ persons to work at the care home until two appropriate references, a full employment history and a recent photograph have been obtained as listed under Schedule 2 of the care home regulations It is recommended that regular audits of service users care plans are undertaken to ensure that information within them are up to date and that any risk assessments interrelate with the care and support plan. It is recommended that the annual quality assurance questionnaire allows for GP’s, social workers and any other stake holders involved with the home to take part to allow for a more ‘rounded’ view of the service. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 8 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 Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 9 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 Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. The home provides good clear information, which is used by prospective residents to help them choose a home that is right for them. All residents have their care needs assessed before moving into the home. The home does not provide for intermediate care This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides good clear information, which is used by prospective residents to help them choose a home that is right for them. All 9 residents who completed questionnaires felt that they had received enough information about the home before they moved in. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 11 The manager of the home or her deputy undertakes an assessment with all prospective service users to ensure that the home is able to meet their assessed needs appropriately. The assessment is undertaken in collaboration with the individual and/or their representative. A sample of care plans was examined and very thorough assessments had been made of each of the residents’ care needs. Wherever possible, prospective residents, family and friends are given the opportunity to visit the home and join fellow residents, in order to gain a ‘feel’ of the home and meet staff before making a decision as to whether the home is suitable and meets with their expectations. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 12 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 and 10 Quality in this outcome area is good. Every user of the service has a care plan in which their care needs are identified and details the actions required to meet them. Personal support is offered in a way that promotes and protects service users’ privacy, dignity and independence This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided to the Commission, prior to the inspection, informed the inspector that each user of the service has an individualised plan of care detailing their health, personal and social care needs and how these needs are to be met. They contain relevant moving and handling assessments as well as any risk assessments identifying any risks that could impact upon their health and the provision of care, and how these identified risks are to be minimised. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 13 During this visit we chose to view a sample of service users files all of which were found to be individualised and personalised. Relevant moving and handling assessments were found contained within the files, although one file needed updating since it contained out of date information; it informed that the service user has the use of a hoist for moving and handling although this was no longer needed. We were assured that this would be updated accordingly. Within the same file, we noted that the service user had the use of bedsides and whilst this was documented there was no evidence to suggest that relevant discussions had taken place over their use and consent gained and neither was a rationale for their use in place. A recommendation has been made within this report to address this issue. Nutritional assessments are undertaken and regular monthly weights are recorded within each service users file. The home has good working relationships with healthcare professionals and evidence within care plans informs us that the service accesses them when required and records their visits appropriately within the individuals file. At the time of writing this report we have received three completed comment cards sent out to healthcare professionals prior to this visit, two of whom inform us that residents’ healthcare needs are always met by the service and one of whom informs us that they are usually met. One commented that ‘staff are very responsive to acting on advice and ask for instruction if it is outside of their experience’ and all three inform us that the service responds appropriately if either they or the person using the service have raised concerns about their care. The home has clear medication policies and procedures in place and staff are provided with appropriate medication training to ensure the health and safety of those using the service. Medication is supplied to the home by Intercare pharmacy who also support the home in undertaking medication audits and in training staff members. People who wish to maintain responsibility for their own medication are enabled to do so within a risk management process and are provided with lockable storage facilities in which to store them. All medication was found to be stored appropriately and securely, refrigerators used to store medications are maintained appropriately with regular recordings of temperature to ensure any medications requiring storage in such conditions are maintained at the appropriate temperatures. Samples of medication administration records were viewed as part of our case tracking; the medication administration records were completed and were signed appropriately. Residents spoken to overall felt that the care provision was good and that the staff were kind and considerate, respecting their privacy and dignity at all times. Cherry Tree House DS0000022959.V369039.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): 2, 13, 14 and 15 Quality in this outcome area is good. People using the service are able to take part in meaningful activities suited to their needs and abilities and maintain contact with families, friends and the wider community. The food provided in the home is of good quality, freshly prepared and cooked on the premises, offers choice and meets the dietary needs of those using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People using the service are supported to live as independently as possible, exercising their rights to make choices and decisions with assistance when needed. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 15 Discussions with service users was positive acknowledging that the lifestyle experienced at Cherry Tree House matches their expectations and enables them to exercise choice and control over their lives. The home employs an activities co-ordinator who ensures that there is a varied programme of daily activities provided for those who wish to partake. The activities offered to those using the service are based upon the service users’ likes, dislikes and abilities, which include general knowledge quizzes, board games, gentle exercise sessions, reading club and bingo. Activities are provided both on a one to one basis and in group setting to meet people’s individual needs and preferences. Recently, residents have enjoyed the twice weekly ‘shake and wake’ gentle exercise to music sessions, a clothing party, reminiscence sessions and hand massages. There is a visiting hairdresser who visits the home once a week for those who require. People using the service are encouraged to maintain contact with their families, friends and their local community. Service users are able to receive visitors at the home and there are no restrictions imposed on visiting unless requested by the service user themselves. Service users are able to entertain them in their own bedrooms or in the communal areas of the home and meals can be provided for visitors who visit during mealtimes if required. Two users of the service have an interest in bridge and attend a local bridge group in the village, Pets as Therapy dog visits the home regularly, whilst others enjoy talking walks into the village and visiting the local library and coffee shops; staff support those who require assistance. In order to promote equality and diversity within the service the home ensures that service user’s religious and spiritual needs are met through the local community, either by service users attending a place of worship or appropriate member of the religion being welcomed into the home. People who use the service are provided with good quality food, which is freshly cooked on the premises and are offered a choice. Special diets are available to meet residents’ health and cultural needs. The chef always endeavours to take individual tastes into account and discusses their preferences with them periodically. Breakfast can be taken either in the dining room or service users’ own rooms; many of the residents choose to take their breakfasts in their rooms and are offered a tray service. Lunch is the main meal of the day and is usually taken in the dining room although those who wish can take their meal in their rooms. The inspector took lunch with those using the service, which consisted of cottage pie, broccoli, peas and beans, followed by rice pudding. The portions were of good size and the meal was well presented and very tasty. Each table, was covered with a table cloth and condiments were placed on each table. We found the dining environment to be relaxed and comfortable and residents were able to enjoy their lunch at their own pace. Discussions around the meals provided were all very complimentary. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. People using the service are able to express their concerns and have access to an effective complaints procedure and are safeguarded from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home tell us that it has not received any complaints within the last 12 months. They continue to let us know about things that have happened since the last inspection through their notification procedures. Those sent to us since the last inspection were read again as part of this review. People using the service tell us that they know how to make a complaint and are confident that any concerns that they may have would be dealt with appropriately. The home’s complaints procedure is clearly set out in the Statement of Purpose and Service User’s Guide information. All complaints are taken seriously and logged in a complaints book detailing any actions taken and the resulting outcome. An independent advocate regularly visits the home to hold monthly meetings with those using the service, which enables those using the service to ‘air their views’ and discuss concerns. Any issues raised are, with the approval of those Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 17 attending the meeting, fed back to the management and addressed. Minutes of these meetings were observed during our visit. The independent advocate is available to meet with individual service users to discuss any concerns that they may have, on a one to one basis and the home ensures to provide people with relevant information about this service and support people to access the advocacy service where the need should arise. There is also a Cherry Tree House Open to Suggestions Scheme (CHOTSS) in place enabling service users, relatives, visitors and staff to contribute and make suggestions to the policies and procedures within the home. There are policies and procedures in place to guide the manager and staff on how to respond to any suspicion of abuse., these are in line with the Buckinghamshire multi agency policies and procedures. Training is provided to all members of staff to assist them in becoming aware of their own care practices, to recognise signs and symptoms of abuse and to emphasise each staff member’s responsibility to ‘whistle blow’ on any poor practice or concerns that come to their attention. Since the last inspection undertaken in August 2006, there have been three safeguarding incidences, all of which we were notified about and all have been investigated appropriately using a multi disciplinary approach to ensure the health, safety and welfare of those using the service. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 18 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, 21, 24 and 26 Quality in this outcome area is good. People using the service are provided with a safe, well maintained, comfortable, homely, environment in which to live which is kept to a high standard of cleanliness and meets their needs appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People using the service are enabled to access their communal and private space, through the provision of a number of aids and adaptations. The home provides grab rails in corridors, bathrooms and toilets and hoists and assisted toilets and baths are available to meet the residents’ needs. The Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 19 home has sufficient toilet, washing and bathing facilities, all of which are accessible and clearly marked. Accommodation for each resident is furnished and equipped to ensure them the right to comfort and privacy in a homely atmosphere. The manager informed the inspector that the home always encourages residents to bring small items of furniture and memorabilia to personalise their rooms to their own liking, which was confirmed by those spoken to during our visit and evident on touring the home. Residents spoken to on the day informed the inspector that they were happy with their bedrooms and their surroundings, that the home is kept to a high standard of cleanliness at all times. All bedrooms are individual and contain either a wash hand basin or en-suite facility and have a call system with an accessible alarm facility, which allows residents to call staff in the case of an emergency. Residents spoken to informed the inspector that in situations where they have had to use this alarm they had been answered swiftly and appropriately. There is a pleasant medium sized garden area with a patio area for users of the service and their visitors to enjoy during the warmer months which is equipped with tables, chairs and umbrellas for their use. Since the last inspection, the service have made improvements to the environment, which includes; updating and refurbishing two shower rooms, replacing carpets in the corridors and to one bedroom, upgrading furnishing and fittings in a number of bedrooms and purchasing new bed linen, towels and flannels for all of the residents bedrooms. During our visit, the home presented as clean, tidy and no odours were present. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. The home is staffed in accordance with the needs of the service users and staff receive the appropriate training to meet their needs appropriately. A more thorough recruitment procedure needs to be followed to ensure, as far as is possible, the health, safety and well being of the residents in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing levels on the day of inspection were sufficient to meet the needs of the residents The inspector looked at a sample of 3 staff member’s files. These generally showed evidence of a thorough recruitment process, with references and required checks generally being taken up before employing the member of staff. However, one staff personnel file did evidence that there was no up to date photograph, only one reference gained and a failure to gain a full employment history. We were assured that these omissions would be dealt with and added to the said personnel file. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 21 The service endeavours to introduce those using the service to any potential new staff, giving them the opportunity to meet and chat with them and gain their views on the prospective member of staffs’ suitability. Evidence viewed within staff personnel files informs us that members of staff undergo induction training, upon appointment to their posts, and are offered ongoing training, which equips them to meet the assessed needs of the residents within the home. Likewise feedback gained from staff members informs us that they were all provided with an induction programme and four of the five completed questionnaires tell us that the induction they were provided with covered everything very well, with one telling us that it mostly covered everything however, all five tell us that they are being provided with training that is relevant to their role. The home has a good programme of training in place for staff. The staff records viewed contained evidence of induction training, all relevant mandatory training and ongoing training that has been undertaken, to ensure that they have the skills and knowledge to undertake their roles competently. The proportion of care staff who have attained National Vocational Qualification (NVQ) in Care at Level 2 or above is above the 50 recommended by the Commission and a number have achieved the NVQ at level 3. We are informed that service have started to utilize staff with NVQ level 3 to develop their skills in the area of care planning and to assist with supervision and induction of new staff. Staff are provided with supervision and support on a regular basis, which is documented within their personnel files, this was further confirmed from feedback from carers themselves. The service strives to hold staff meetings eight weekly and plans are in place to increase the frequency of these meetings. One recently appointed carer tells us that he/she has found all the staff to be friendly, helpful and welcoming and have a good approach in providing him/her with the right support, experience and knowledge to meet the different needs of those using the service. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 22 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 and 38 Quality in this outcome area is good. Cherry Tree House is a well managed home, run in the best interests of the residents, using the service. Safeguards are in place to protect their health, safety and welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is experienced, knowledgeable, and is competent to manage the home. She displays a good sound knowledge of matters related to the management and running of the care home for older people and is Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 23 presently undertaking the registered managers award. Residents and staff spoke in complimentary terms about her management ability and the support she gives. The management approach of the home creates an open, positive, transparent and inclusive atmosphere. Service users and staff spoke in complimentary terms about her management ability as did the feedback from surveys sent out prior to the inspection. In discussion with the manager, we were informed that she is working towards working in the area of staff development and it is anticipated that the deputy manager will be registering with the commission as the registered manager of the service. The deputy manager has many years experience of working at cherry tree house and has gained the registered managers award. People using the service, their relatives and relevant health care practitioners have all been kept informed of the proposed changes. The inspector discussed health and safety issues and saw appropriate maintenance records relating to maintaining a safe environment for residents. Regular safety checks are undertaken relating to fire safety and infectious diseases and regular servicing and maintenance of equipment, all of which were seen to be documented appropriately. The home does not act as agent or manage monies on behalf of residents, however there are systems in place to ensure that residents’ personal allowances and small amounts of cash are safely managed and there are receipts and records for all transactions. The home engages regularly with users of the service to gain feedback on the service it provides; this is undertaken on both an informal and formal basis through feedback and suggestion forms, noting any comments or concerns when undertaking residents care reviews, resident meetings and an annual questionnaire. It is recommended that the annual quality assurance questionnaire allows for GP’s, social workers and any other stake holders involved with the home to take part. The home deals with a number of diverse care needs and always ensures to offer a personalised service to meet the individual needs and preferences of their service users. There is a commitment to ensure that all users of the service, however diverse their needs may be, receive a person-centred package of care which meets their needs appropriately and in a safe manner. Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x x Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 Schedule 2 Requirement The registered person must ensure to not employ persons to work at the care home until appropriate copies have been obtained of each of the documents listed under Schedule 2 of the care home regulations. Timescale for action 30/09/08 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 OP7 Good Practice Recommendations It is recommended that regular audits of service users care plans are undertaken to ensure that information within them are up to date and that any risk assessments interrelate with the care and support plan. It is recommended that the annual quality assurance questionnaire allows for GP’s, social workers and any other stake holders involved with the home to take part to allow for a more ‘rounded’ view of the service. 2 OP33 Cherry Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 26 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 Tree House DS0000022959.V369039.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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