Care Home: Cherrymead

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What the care home does well Cherrymead does well to ensure it provides prospective residents and their representatives with information about the home, it assesses if it can meet their needs and supports them to become familiar with their new surroundings and others living in the home prior to moving in. This is followed up by a review of the persons stay. The home provides staff with information about the residents in the form of care plans, these provide specific detailed information on each resident and how they wish their care to be carried out. Care plans are detailed and contain the information needed for staff to provide support to meet the residents` individual needs. The people who use the service have access to GP`s dentist, speech therapists, psychologists, physiotherapists and other health professionals where needed. Cherrymead offers a homely, safe and welcoming environment, which is spacious, tastefully decorated and furnished and offers individual bedrooms that are personalised and decorated to the residents liking. What has improved since the last inspection? The home has made many improvements and has now met all the requirements made following the last inspection. Staffing levels have been improved to enable staff to meet the social and emotional needs of residents. An activity log has been put in place to monitor individuals` access to the community. The home is now using a "person centred" approach in care plans and has developed communication passports for the residents. Care plans have also been reorganised so it is easier to identify key information about residents. Advice from healthcare professionals has been sought regarding eating and swallowing difficulties experienced by some residents. Medication recording and management has also improved. Records have been made up to date and regular checks on fire alarms and fire safety equipment are now being made. What the care home could do better: Cherrymead needs to sustain the improvements it has already made and continue to look for other ways in which they can improve the running of the home and the positive experiences of residents who live there. CARE HOME ADULTS 18-65 Cherrymead Station Road Angmering West Sussex BN16 4HY Lead Inspector Jo Hartley Unannounced Inspection 20th May 2008 14:30 Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 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 Cherrymead DS0000064747.V361231.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherrymead Address Station Road Angmering West Sussex BN16 4HY 01903 783791 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) Outreach 3 Way Mr Mark Daniel Peirce Care Home 7 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1), Physical disability (1) of places Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to seven (7) male and/or female service users in the category Learning disability age 18 to 65 years may be admitted/accommodated. one (1) person with Learning and Physical Disability may be admitted/Accommodated. One (1) Service user over the age of 65 years may be accommodated. The total number of service users that may be accommodated must not exceed seven (7). 29th November 2007 Date of last inspection Brief Description of the Service: Cherrymead is a care home registered to provide accommodation for up to seven adults with a learning disability. Outreach 3 Way owns the services. The registered manager responsible for the day-to-day running of the home is Mr Mark Peirce. The responsible individual on behalf of the providers is Mrs Vanessa Keen. The property is a large detached property. Accommodation is provided on ground and first floor level, a vertical lift is in situ enabling residents to access all areas of the home. There is an enclosed garden to the rear of the property and parking facilities to the front. The establishment is near to Angmering train station and local amenities. The weekly fees are £961.50 - £1261.51 per week. Extras include hairdressing, trips out and personal items. Cherrymead DS0000064747.V361231.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 site visit formed part of the key inspection process and was carried out over an afternoon by Ms J Hartley, regulatory inspector. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Commission for Social Care Inspection prior to the visit to the home. The information obtained to inform this report was based on viewing the records of the people who use and work at the service, where possible speaking with the residents and staff and observing care and support practices. The people who live at Cherrymead have little verbal communication, communicating their needs through gestures and other forms of communication. A tour of the home took place and documents pertaining to health and safety were viewed. What the service does well: Cherrymead does well to ensure it provides prospective residents and their representatives with information about the home, it assesses if it can meet their needs and supports them to become familiar with their new surroundings and others living in the home prior to moving in. This is followed up by a review of the persons stay. The home provides staff with information about the residents in the form of care plans, these provide specific detailed information on each resident and how they wish their care to be carried out. Care plans are detailed and contain the information needed for staff to provide support to meet the residents’ individual needs. The people who use the service have access to GP’s dentist, speech therapists, psychologists, physiotherapists and other health professionals where needed. Cherrymead offers a homely, safe and welcoming environment, which is spacious, tastefully decorated and furnished and offers individual bedrooms that are personalised and decorated to the residents liking. Cherrymead DS0000064747.V361231.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. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that people who wish to use the service are provided with information about it prior to moving in. The home has good systems in place for assessing the needs of the people who wish to use the service. Those who are currently using the service have their needs regularly reviewed. EVIDENCE: The AQAA informed us that the home has an accessible Service User Guide and a clear admissions policy. The Statement of Purpose and Service User Guide are displayed within the home for all residents to access if they wish. The admission procedure includes inviting prospective residents for tea visits. This enables the home to observe the impact of new people on the group of people already living there. Records viewed during the visit confirmed this. Pre-admission assessments are also thorough. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service have care plans in place, which identify their individual support needs. The home supports people who use the service to make day-to-day decisions and choices about their daily lives. The home supports the people who use the service to take risks as part of an individual lifestyle. EVIDENCE: The AQAA informs us that the home implements social services care plans with their own support plans and risk assessments. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 10 We tested this by viewing the personal plans of three residents, speaking with the manager and observing interactions between staff and residents. Each resident has an individual personal plan that provides information on social interaction and engagement, health and welfare, personal care, communication, behaviours, independence and includes daily notes. The plans provide comprehensive detail on how to support the residents. Care plans provide detail on residents’ individual likes and dislikes and enforce the message of promoting the residents to be involved in making choices. Since the last inspection the home has completed the process of adopting a person-centred approach for the care planning of each resident. They have also made progress in developing communication passports for each resident. We didn’t receive any surveys back from relatives but at the last inspection a relative told us, “I feel the home does well to provide a high standard of care in a small family environment which suits the needs of my relative”. During the visit staff were seen engaging positively with residents. One member of staff was assisting two residents with colouring in pictures. All residents were occupied in various activities while waiting for their evening meal. Lots of chatting and laughter were heard throughout the visit. At the last visit it was found that limited numbers of staff restricted opportunities for the residents to socially engage, access the community and undertake activities of their choosing. Since then the home has recruited more staff, including ten hours of domestic help and thirty-five hours of support. The manager said that when the new staff have settled they will be changing the rota to ensure that there are more staff on duty during times when residents are able to take part in activities of their choosing. The manager told us that trips out to various shows are being planned for the residents. The home has now put an activities log in place so that they are able to monitor individual residents access to the community and participation in activities. Daily records of three residents that were seen during the visit recorded various trips out including shopping, day centres and church. Risk assessments are evolved from the risks highlighted in assessments. They provide detail of the risks and the action required by staff to minimise them. At the last inspection it was established that for one resident an area of risk regarding their eating habits and subsequent weight loss had not been risked assessed. This has now been addressed. Weight charts and a food diary are now being completed and a referral has been made to a speech therapist and Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 11 dietician. Training has been booked for staff regarding dealing with eating and swallowing problems. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support is now available for people who use the service to be involved in peer, age and culturally appropriate activities The home does well in ensuring the people who use the service maintain links with family and friends. The complex eating and feeding needs experienced by some of the residents are now being addressed. Support is provided the appropriate health care professionals. EVIDENCE: The AQAA informed us that the home is good at promoting individual lifestyles through support planning and the risk assessment process, that they ensure Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 13 people are treated with dignity and in a respectful manner and are provided with planned menus that meet their dietary needs and preferences. Care plans and communication passports list the residents likes, dislikes and preferred activities such as colouring, listening to music and watching films and doing jigsaws. The spiritual needs of residents are supported for those wishing to exercise their faith; arrangements are made for residents to access church and church groups. The manager stated that arrangements are made for the residents to visit relatives and relatives are always made welcome when visiting the home. The advice of health care professionals such as speech and language therapists regarding the changing needs of resident’s diets, and the way in which food could be presented, has now been sought. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical care needs and emotional needs of the people who use the service are met. Professional advice has now been sought regarding the dietary needs of service users. The management and administration of medications has been improved since the last inspection. EVIDENCE: The AQAA informed us that the home provides sensitive support to each person’s personal and health care needs. It informs us that the home has developed good working relationships with health care professionals and the local pharmacist and they administer medication appropriately. Personal plans describe how the residents require support to undertake everyday activities from getting up to going to bed and in some instances describe what the preferred time these take place. The care plans have been reorganised since the last inspection to make it easier to identify key information. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 15 The home keeps records on the visits made to or by health care professionals. The records provide information on the nature of the visit, the outcome and any treatment required. Since the last inspection the home has accessed the services of outside professionals for support and advice in respect of residents’ eating habits and support requirements. Currently all the residents living in the home are supported to take their medication. A record of medication held and administered is kept, and support guidelines are in place to support staff when they are to give “as required“ medications. No staff signature gaps were found on the medication administration record. A clear audit trail is now in place from the receipt of medication through to disposal. The manager stated that the home has developed a good relationship with the local pharmacist, who has assisted with the training and support of staff. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the people who use the service with information on how to express concerns and complaints. The home protects people from abuse, self harm and neglect. EVIDENCE: The home has complaints, concerns, compliments and safeguarding policies and procedures in place that were seen at the site visit. The home has developed an accessible complaints procedure to support the residents to understand the process of making a complaint. The majority of the residents would struggle to understand the concept of making a complaint and therefore their behaviours and interactions are monitored to establish if the residents are unhappy. The home keeps a complaint and compliments log book, which details the nature of the complaint, what action was taken and the outcome of the action. The manager confirmed that all staff had received training in abuse awareness and certificates held on file evidenced this. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a welcoming, comfortable and clean environment for service users. EVIDENCE: The home is spacious, and is decorated and furnished in keeping with the needs of the residents. Residents with mobility difficulties are located on the ground floor, however the home has a lift to the first floor if required. Handrails are positioned in places where required such as bathrooms. The garden is enclosed, well kept and easily accessible for the residents. The kitchen is spacious and provides ample workspace to support the residents to participate with meal preparation if the opportunity arises. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 18 The manager stated that the residents are supported to choose the colours, fabrics and furnishing of their bedrooms. All bedrooms seen during the visit had been personalised and contained personal possessions belonging to residents. At the last inspection comments were received from relatives and a health care professional complimenting the home on its comfort, homeliness and cleanliness. The home is clean and follows recognised practices in maintaining a clean hygienic environment. Staff have access to equipment to minimise the risk of cross infection such as disposable gloves and the home has a clinical waste contract. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the people who use the service with competent staff. The home has improved staffing levels to meet the current needs of the people who use the service. The home has undertaken robust recruitment procedures in order to safeguard the people who use the service from potential risk of harm. Staff now receive regular support and supervision. EVIDENCE: Since the last inspection the home has increased staffing levels so it is able to meet the social, care and emotional needs of the residents. An extra ten hours of domestic help and thirty-five hours of support staff are now in place to enable care staff to spend more time meeting residents’ needs. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 20 During the visit residents were seen to be occupied and staff were interacting and communicating well with residents. The home does not hold staff recruitment details, these are held with the services human resources department, however, the home uses Annex 4 forms to demonstrate that it has taken appropriate steps to employ its staff. Staff records were checked and it was evidenced that staff have received the required checks including Criminal Records Bureau and POVA checks, two written references and employment history. Training records for individual staff and the staff-training calendar were seen. Staff have received mandatory training courses such as First Aid, Health and Safety and Fire training. They have also attended courses in dementia, safeguarding adults, equality and diversity and the administration of medication. Evidence was seen that training has been booked for Epilepsy, Swallowing and Eating and Nutrition. Staff receive regular supervision from the manager. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The home ensures the people who use the service benefit from a well run home. The home undertakes quality monitoring to seek the views of service users and other stakeholders. The home promotes and protects the health, safety and welfare of the people who use the service. EVIDENCE: The manager has a level 4 NVQ and a Registered Managers Award. Risk assessments are in place for the health, safety and welfare of the people using the service and those working in the service. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 22 Staff told us that the manager is supportive and caring. At the last inspection it was found that certain records had not been maintained and kept up to date by the manager. During this visit it was seen that all these records are now up to date and managed well. The manager provided evidence that the service undertakes regular quality audits and is visited monthly by a senior manager to assess the quality of the care to the residents. Questionnaires are sent to families, health care professionals and funding authorities to seek their views on the service provided to the residents. The manager has collated the information received. The resident’ views are monitored through their behaviours as their limited communication, cognitive and sensory abilities prevents them from completing written documentation. Fire record also provided evidence that regular checks are now taking place on fire alarms and fire safety equipment. Other areas of health and safety such as service checks on utilities and the lift were in good order. Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cherrymead DS0000064747.V361231.R01.S.doc Version 5.2 Page 25 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. 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