Care Home: Cherry Trees

What the care home does well The home has an activity coordinator who works closely with people. Activities clearly take place and people were enjoying making Christmas cards and in the afternoon people joined in a Christmas party with outside entertainers. The coordinator keeps records of activities that take place although they could be more detailed. The home responds swiftly when complaints have been made. The records confirmed procedures were followed within the timescales stated. Safeguarding procedures demonstrates that they know how to respond when an allegation of abuse has been made. What the care home could do better: The care plans need to be improved to ensure risk assessments demonstrate action to minimise falls. Nutritional assessments should be clear to reduce the risk of choking and assessments must demonstrate the action needed to support peoples mental health. Care plans must clearly demonstrate the agreement with doctors when supporting people with their medication. Social care plans should be more detailed to demonstrate how people`s social and emotional needs are met. Essential training is required in all health and safety areas to ensure staff have the skills and competencies to keep people safe from harm. Random inspection report Care homes for older people Name: Address: Cherry Trees Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ two star good service 13/01/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Valerie Hoyle Date: 1 5 1 2 2 0 0 9 Information about the care home Name of care home: Address: Cherry Trees Simmonite Road Kimberworth Rotherham South Yorkshire S61 3EQ 01709550025 01709556308 cherrytree@exempalhrc.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sheilagh Sweeney Type of registration: Number of places registered: Conditions of registration: Category(ies) : Cherry Health Care Limited care home 66 Number of places (if applicable): Under 65 Over 65 0 66 0 dementia old age, not falling within any other category physical disability Conditions of registration: 66 0 66 The maximum number of service users who can be accommodated is: 66 The registered person may provide the following category of service only: Care home with nursing - Code N, 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 - Code OP; Dementia - Code DE and Physical disability - Code PD Date of last inspection Care Homes for Older People 1 3 0 1 2 0 0 9 Page 2 of 9 Brief description of the care home Cherry Trees Care Home is situated in the Kimberworth Park area to the north west of Rotherham. It is on the fringe of a large housing estate. The home was purpose built and facilities are provided on ground and first floor level; access to the first is by a lift. Cherry Trees is registered as a care home that provides personal and nursing care for 66 older people. There are four units within the home. Two of the units provide nursing and residential care: - 32 beds in total. The remaining two units offer care for people who have dementia: - 34 beds in total. There is a level garden area to the rear of the home suitable for access by pedestrian and wheelchair users, and access to the garden is gained through the conservatories. Cherry Trees Care Home is located in the residential area of Kimberworth Park, a suburb of Rotherham. The home is on a bus route, bus numbers 39,41,42,43 and within a short walking distance of bus stops. Car parking is provided for several cars to the front of the home along with street parking Weekly fees range from £366 to £478.30 at time of visit 15/12/09, dependent on needs assessment. Additional charges are made for hairdressing, Chiropody, Optical, Dental services, specialised toiletries and magazines etc. The registered person makes information about the service available to residents and their families via the homes Statement of Purpose and the Service User Guide. A copy of the inspection report is made available at the home. Care Homes for Older People Page 3 of 9 What we found: The star rating for this service was made at the previous inspection visit, and this cannot be changed during a random inspection visit, however the service will be monitored to ensure that they meet the requirement made. The reason for this visit was to follow up serious concerns raised by Social Services contract/compliance department. The concerns were in relation to care plans, risk assessments, and the skills and competencies of staff to meet the needs of people who use the service. A number of referrals have been made to the social services safeguarding adults team, therefore we looked at the home procedures to ensure people were safe and protected. The visit lasted for five hours starting at 09:30 finishing at 14:30. The manager and clinical manager assisted with the inspection process. The outcome is as follows: We looked at a number of care plans to assess how peoples needs were being met. The clinical manager told us that she was undertaking reviews of care plans to ensure the information was up to date. There was evidence that the new plans had been reviewed monthly. Plans which had not been updated showed monthly evaluations did not always take place on a regular basis. We found that some plans did not have a detailed care plan to give staff direction when meeting peoples nutritional needs. One person had been assessed as requiring a puree diet, although this was not detailed in the plan. There was no choke risk assessment, which potentially poses a risk to the person from choking. There was no up to date assessment to confirm how staff was to support the person with their mental health needs. We looked at falls assessment although there was no risk assessment to help staff minimise the risk of falls to individuals. One plan did not have a medication care plan to support the way the person was to have their medication administered. We discussed our findings and the clinical manager who put a plan in place during the inspection. There was evidence to confirm risk assessments had been undertaken where people had bed rails in place and where child gates were fitted to bedroom doors. Social care plans were not in place to demonstrate how staff support people to meet their social, and emotional needs. The activity coordinator completes a grid which shows what activities individuals have joined in, however the grid did not confirm the detail of the activity, or if the person had enjoyed the activity. The clinical manager told us that the Home Care Liaison Team was providing support to staff to reduce falls, assess people for equipment and provide training in specific areas. We was able to speak to two members of staff from the liaison team and they told us staff were cooperating and assisting fully with the process. We looked at the homes complaints procedures and the records were comprehensive and included outcomes for the complaint recorded. The AQAA confirmed that one complaint had been recorded since the last inspection of the service. We looked at safeguarding procedures and it was clear that the manager follows the procedures by reporting incidents to the adults safeguarding team. The AQAA told us that there has been four safeguarding referrals made, and investigated. The outcome of two referrals had resulted in referrals to the Independent Safeguarding Authority (ISA). Two further referrals are still being investigated by the local Social Services Department. We looked at staff training records and they showed thirty-six (36) of the sixty-seven (67) staff employed at the service had not received safeguarding adults training in the last twelve months. This Care Homes for Older People Page 4 of 9 means most staff may not be alert to the signs of abuse or take appropriate action if they suspect and incident of abuse has occurred. We looked at the homes training plan to assess if staff have the skills and competencies to meet the needs of people and keep people safe from harm. The records show that Twenty-two (22) staff had not undertaken moving and handling training for over a year, this means people may be put at significant risk of harm if moved incorrectly. Forty-five (45)staff have not had refresher training in health and safety which includes infection control and Control of substances hazardous to health (COSHH). Most staff have not had refresher training in food hygiene or first aid since 2008, and thirty-seven (37) staff have not undertaken fire instruction for over a year. Gaps in training raises serious concerns about the health, safety and wellbeing of people who live at the home. We looked at fire risk assessments with regard to the use of safety gates fitted to five bedroom doors of the first floor. The manager said they were used to prevent people wandering into peoples bedrooms. Risk assessments were in place on peoples care plans and the manager consulted the fire officer to ensure they were not a hazard in the case of any emergency. We contacted the fire officer who confirmed the gates posed minimal risk in the event of a fire, therefore they had no objection to them being in place on the rooms identified during this inspection. What the care home does well: What they could do better: 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 2. Care Homes for Older People Page 5 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 9 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 1 38 18 Staff must receive training to 17/12/2009 safely move and handle people. Staff who have not been trained must not use moving and handling equipment until they have been assessed as competent. This will ensure people are moved safely 2 38 23 Staff must receive fire instruction. Staff must only be rostered to work with staff who have attended fire training. Confirmation must be sent to us when the training has taken place. To ensure they are familiar with the action to take in the event of a fire 17/12/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 1 8 13 Care plans must describe the 15/01/2010 support they need to take medication. To ensure staff are clear about following guidance from staff 2 8 13 Care plans must include risk 15/01/2010 assessments to minimise the Page 7 of 9 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 risk of choking and falling. To ensure people are safe from harm 3 8 13 Care plans must clearly 15/01/2010 demonstrate how staff will meet peoples nutritional needs. In particular where people need a stage one diet To ensure they are not at risk of choking 4 38 18 Staff must receive training to 15/02/2010 ensure they have the skills and competencies. Training is required in First Aid, Health and Safety, Food Hygiene and safeguarding adults To ensure they can meet the needs of people who use the service 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 7 Care plans should clearly state the support people need to take part in leisure activities. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. Copyright © (2009) Care Quality Commission (CQC). 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