Care Home: Cherrytree Care Home

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What the care home does well What has improved since the last inspection? What the care home could do better: This was a positive site visit and inspection of Cherrytree Care Home. There was good evidence to demonstrate that people living at the Home are informed on important issues that affect them and they have an opportunity to express concerns or make comments about the care they receive. Staff showed awareness in ensuring people are safe and open to receive comments or concerns from the people living at the Home and their relatives. Cherrytree Care Home should ensure that staff do not use tippex on the medication records sheet and follow the medication procedure and best practice. The Home should seek advice from the Pharmacist to ensure that the existing storage for controlled medication is appropriate in accordance with the new legislation. Cherrytree Care Home should re-introduce a system of quality assurance that gives people using the service and other significant people involved with the Home in a professional capacity, to comment. This would demonstrate the Home measures the quality of the service provided against what the service intended to provide. CARE HOMES FOR OLDER PEOPLE Cherrytree Care Home 123 Station Road Countesthorpe Leicester LE8 5SE Lead Inspector Ms Rajshree Mistry Unannounced Inspection 09:25 10th June 2008 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 Cherrytree Care Home DS0000071420.V366041.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. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherrytree Care Home Address 123 Station Road Countesthorpe Leicester LE8 5SE 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) 0116 2777960 0116 2777960 Cherrytree Care Ltd Ms Carole Voss Care Home 40 Category(ies) of Dementia (40), Mental disorder, excluding registration, with number learning disability or dementia (40), Old age, of places not falling within any other category (40) Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care Home - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE Mental Disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 40. Not Applicable 2. Date of last inspection Brief Description of the Service: Cherrytree Care Home is a large residential home for older people in the village of Countesthorpe. The Home is situated amongst local facilities with a general shop close by. The Home can provide care for up to forty people. There are two double bedrooms and the remaining bedrooms provide single accommodation and have en-suite facilities. The Home has a number of lounges where people can choose to sit. The rear garden and patio is accessible to people living at the Home. The Home’s brochure that includes the Statement of Purpose and the Service User Guide are available on request, which provides information on how the home is organised and what services they provide. The Statement of Purpose and the Service User Guide are provided to all the people living at the Home. The Registered Manager provided the following fees during the site visit on 10th June 2008, which ranges from £334 to £448 per week. There are additional charges for services such as Chiropody, hairdressing services newspapers, clothing and personal toiletries. The latest CSCI Inspection Report is available at the home. Cherrytree Care Home DS0000071420.V366041.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. ‘We’ as it appears throughout the Inspection Report refers to ‘The Commission for Social Care Inspection.’ The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is a selfassessment tool, completed by the Registered Manager and reviewing the other information, we received. Although Cherrytree Care Home is viewed as a new service as it recently become a limited company, we reviewed the last inspection report of the service, when it was known as Cherrytree Residential Home. We sent ‘Have Your Say About Cherrytree Care Home’ surveys to thirty-seven people who use the service of which five were received. Fifteen surveys were sent to the staff working at Cherrytree Care Home, of which one was returned. The unannounced site visit commenced on the 10th June 2008, and took place between the hours of 09:25 and 16:00hrs. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was ‘case tracking’. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Cherrytree Care Home. Four people using the services were selected, records were viewed, and observations made about the day-to-day running of the Home. Discussions were held with three people living at the Home, along with some visiting relatives and friends. Discussions were held with two members of the care staff, the Cook, the Deputy Manager, Registered Manager and the Responsible Individual for the service. Discussion was also held with the visiting District Nurse. Comments received have also been included throughout this inspection report. “Very helpful and forthcoming” “All of the staff are helpful and kind” What the service does well: Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 6 People living at Cherrytree Care Home are encouraged to visit the Home before choosing to move in. People living at the Home are involved in the writing of their care plan, which informs the staff about how their care needs should be met and their preference of daily living that promotes and maintains their independence. People living at the Home are aware of their rights, and know how to complain. People we spoke with said that if they felt unsafe or frightened they would speak with a member of staff, family / friend or speak with an Advocacy whose contact details are displayed in the reception area. People living at Cherrytree Care Home continue to receive visitors without restrictions and are able to live the life of their choice; having the opportunity to fulfil their social, leisure and religious needs, with the care and support provided by the staff, as and when required. People living at the Home enjoy a variety of new and traditional meals, all prepared at the Home. People living at Cherrytree Care Home are have opportunities to make decisions and influence the running of the Home through ‘residents meetings’ and can speak with the management team at anytime. Cherrytree Care Home has welcoming and relaxed atmosphere. The Home is well maintained and decorated to a good standard with complimentary décor and furnishings. All bedrooms have en-suite facilities, are bright, light and personalised with personal items such as photographs and pictures that create a homely feel. Many of the people living at the Home, felt it was ‘their Home not a Care Home’. Staff appear professional in their distinct uniforms and wear name badges to help people identify staff. Staff showed a lot of attention, care and compassion towards the people living at the home and their visitors. Comments received from people living at the Home, health care professionals and staff working at the Home: “This is my home, not a care home” “I like working here, I wish my Nan could have stayed here” “Everybody is so kind, friendly and we get on like a family” “There’s always something going on for the residents here, Bingo, singing songs and generally enjoying themselves” What has improved since the last inspection? The recommendations made at the last inspection have been addressed. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 7 Cherrytree Care Home is now a limited company and treated as a new service even though it was previously registered a Cherrytree Residential Home. The information received from Cherrytree Care Home before the site visit, stated the improvements made and this was confirmed during the site visit by looking at the records, observations and discussions. The improvements include: • Environmental improvements with the development of the new rear garden, which is level access and block paved for people to use without the risk of falling. New garden furniture and planters have been purchased to compliment the garden. • The two smaller lounges have been decorated, carpeted and furnished. • A number of armchairs have been purchased to benefit the people living at the Home. • The medication for people living at the Home is now provided by a contracted Pharmacy that provides the pre-packed medication. The Home benefits from using the new Pharmacy who conducts the annual routine visits and staff training. 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. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 8 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 Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 9 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into the Home have information about the services provided; encouraged to visit the home and are involved in the assessment of their care needs to ensure that the Home is best suited to them. EVIDENCE: People considering using the services of Cherrytree Care Home are provided with information in the form of the Statement of Purpose and Service User Guide, which outlines the services provided by the Home. This information is at the entrance to the Home. The contact details of an Advocacy Agency are displayed on the notice board at the entrance to the Home. We spoke with four people at the Home and two relatives of the people living at the Home. They said that they were encouraged to ‘pop-in’ and have a look around the home at anytime. People said they were asked to speak with the Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 10 Registered Manager or the Deputy Manager if they were considering using the Home, how their care needs could be met and the fees payable. Comment received in a survey stated “Accommodation was chosen by daughter”. One person that we spoke with had recently moved to the Home and was only planning to stay at the Home for a short time. The person said they ‘found the staff had been helpful and mindful to making sure they were comfortable and knew the main areas of the Home such as the lounge, dining room, toilets and their bedroom’. We looked at the records of four people who were case tracked living at the Home, of which two were funded by Social Services. The records showed a thorough assessment of person’s care needs were carried out before they moved to the Home, looking at all aspects of personal care and daily living needs. The files for two people living at the Home contained a copy of the assessment of needs carried out by the Social Worker. The information gathered enabled the Registered Manager to decide whether the needs could be met by the Home. As part of the moving in process, the Registered Manager gathers details about the individual’s preferences, known as the ‘preference profile’. There is information about the persons likes and dislikes of food, routines and lifestyle, which they wish to continue and may include keeping in contact with family and social groups. People we spoke with said they were offered a month’s trial period to see if this place was suitable for them and thereafter their stay was confirmed with a contract detailing the terms and conditions of stay. A copy of the contract detailing the terms and conditions of occupancy is held within the person’s records at the Home. Two people whose placement was funded by Social Services also had an Individual Placement Agreement, prepared by the Social Worker, in addition to the Home’s contract. Comments received from the people living at the home and their visiting relatives, indicated that they were involved in the assessment of their needs and the move to the home. We looked at the monthly visit records carried out by the Responsible Individual, which showed assessments records and contracts were checked for people living at the home, indicating that there is an internal auditing system in place. The Home does not provide intermediate care. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 11 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. This judgement has been made using available evidence including a visit to this service. People living at Cherrytree Care Home have their individual personal and health care needs met by trained staff and health care professionals. EVIDENCE: We looked at the care plans of four people living at Cherrytree Care Home, all set out the personal and health care needs of the individual. There was easy to read guidance for staff to follow that enables the person to have their independence maintained and promoted. The care plans were personalised, which means they were written from the point of view of the person receiving the care and support. Two people said they were involved in developing their plan of care, which ensured important things about their daily life such as favourite meals are included and made known to staff. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 12 The care plans are written in an easy read format and gives clear guidance to the care staff as the level of support and care needed by the individual person. For example one care plan reminded staff to ensure the person has their glasses and walking frame, this showed that the person’s independence is being promoted within the Home. Staff said they report changes in the person’s needs to the senior carer in the first instance and then the care plan is reviewed. The information received from the Home before the site visit stated that the individual’s personal care and support needs are gathered through the admission and assessment process. Records showed all care plans were reviewed on a regular basis to ensure their privacy and dignity is maintained. This was consistent with the information received from discussion with the people tracked living at the Home. The care plans that we read showed the safety measures that were put in place. These were identified in the risk assessment carried out such as making sure there are no obstructions in the bedroom that would restrict the person using a walk frame from moving around. The care plans are written in a sensitive manner that respected the dignity and wishes of the people living at the Home. The records we read showed people were accessing a range of health care professionals ranging from the General Practitioner and District Nurse. Records are maintained of the visits in the ‘Health / Professionals Visit’ log and support the daily records, which detail the wellbeing of the people living at the Home. We spoke with the District Nurse who said they felt the people living at the Home are well cared for by the staff, provided with the equipment that promotes their wellbeing and staff follow instructions left. The District Nurse said they have provided staff with training in hand-washing, relating to prevention of cross infection; moving and handling; wound dressing; recognising pressure areas and diabetes training for named individuals living at the Home. We spoke with three staff on duty all demonstrated a good awareness of the individual needs, level of support they require and the preferences of the people living at the Home. We spoke with staff about improvement were made at the Home and was told their responsibilities for people living at the Home. Staff are responsible for up to 6 people, making sure they are well presented, assisted to the toilet when needed and to spend some quality time with them throughout the day, whether it be doing an activity of interest such as puzzles, chatting, singing and a short walk to the shops. The Registered Manager told us this system has encouraged staff to take personal responsibility for the wellbeing people living at the Home. This showed the independence and the wellbeing of people living at the Home was promoted and they were making decisions. This further supported by the Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 13 daily records made by the staff about the people’s physical and emotional wellbeing. People living at the Home and their visiting relatives all comments that they were treated well and staff were always polite. Medication is stored safely and staff receive medication training, which is regularly updated. The medication records of three people living at the home were viewed and found to be in good order. However, we found one medication record where tippex had been used to re-start the medication. The senior carer provided an explanation that the changes were made following instructions from the General Practitioner to re-start a medication and the staff re-used the old record. It was strongly advised that tippex should not be used. This would ensure that people living at the Home and the staff are protected. The management and system for ordering, receiving and returning medication is good and auditable. People living at the Home said they always receive their daily medication on time. The Registered Manager said that the Home has benefited from changing the Pharmacy that supplies the medication. We spoke with the Registered Manager about the storage of controlled medication and strongly advised that they seek advice from the Pharmacy to ensure that the existing storage for controlled medication conforms to the new legislation. We looked at the monthly visit records carried out by the Responsible Individual and showed a random sample of care files were checked to ensure care plans were in place and comments from people living at the home indicated that they were satisfied with the care and support provided. This shows internal audits are regularly carried out. Comments received directly from the people living at the Home, surveys, health care professionals and staff included: “You get to see the District Nurse and the GP, as they come every week to see people” “They do help me as I do forget things sometimes” “I don’t have any concerns about how the clients are cared for here” “The staff will ask me if they have any concerns and find that they do as they are asked” “More help would be useful with dressing myself” “Have trained some staff how to dress wounds and there is a supply of dressing here, should it be needed”. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Cherrytree Care Home experience and enjoy a lifestyle that suits them; having visitors; socialising at the Home and in the community and have a healthy choice of meals. EVIDENCE: On the day of the visit to Cherrytree Care Home, some people living at the Home were having their hair done by the visiting hairdresser. In the afternoon, several people living at the Home went out into the garden with their relatives and staff. Some were seen singing, whilst folding some laundry whilst others were eating choc-ices. Bingo was arranged for after lunch, after the member of staff asked several people living at the Home what they wish to do. We spoke with the people living at the Home including those that were case tracked. One person said they enjoy doing the puzzles and often have their relatives that visit joining in with the activities. It was evident from watching the people living at the Home that they were making decisions about their lifestyle and daily routines. People told us that they could do what they like, Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 15 “enjoyed living at Cherrytree because it is a friendly”. One person said they “had a Holy Communion last Thursday and have had this arrangement in place since moving to the Home”. We read the care plans for the people that were case tracked, where known, people’s social interests and hobbies were recorded such as music, reading and listening to music. It was evident throughout the day the people living at the Home were making decisions about their day from what they wish to eat to how they wish to spend the day. People who live at the Home have the opportunity to develop and maintain their personal and family relationships; visitors are welcome at any time and are made to feel they are visiting their relatives’ own home. Throughout the day, visitors were seen popping into the home to meet with their relatives and some were seen going out with their visiting relatives. Information about the social events and activities are displayed on the notice board at the entrance to the Home that include chair-aerobics and boat trips. Some people were aware of the planned ‘Strawberry Fayre’ on 21st June 2008, to which relatives of the people living at the home were invited. We spoke with the Cook about the development of the menus, choice of meals and having balanced and nutritional meals offered. The Cook told us that he speaks with the people living at the Home about any special dietary needs ensures meals are suitably prepared. The Registered Manager said groceries are purchased from local stores. This showed people living at the Home were having fresh food, nutritional and wholesome meals, which was also good for the environment. Care staff were seen to be sensitive to the needs of the people living at the Home who find it difficult to eat, gave assistance with their meals, and remained unhurried. Meals were served at the dining tables individually, appeared to be balance and appealing. People we spoke with said they always have a choice of meals with fresh vegetables and fruit. One person said they enjoyed the pudding and said they “wouldn’t mind having a second helping of the lemon meringue’, and was pleasantly surprised when a carer brought over a second helping. Other comments received from people living at the home and in the surveys: “I’m happy here”; “I get a daily newspaper and enjoy doing puzzles”; “Looking forward to playing Bingo, never played it before” and “More outings would be nice”. The Home has it’s own internal quality assurance system whereby the Responsible Individual carries out a monthly visit, which is comprehensive and seeks the views from people living at the Home about the meals, social and leisure opportunities provided and what could be improved to benefit them. Cherrytree Care Home DS0000071420.V366041.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. This judgement has been made using available evidence including a visit to this service. People living at Cherrytree Care Home are confident to raise concerns with staff and are supported by staff that are confident in their role to report concerns regarding the welfare of individuals. EVIDENCE: Cherrytree Care Home has a complaints procedure, which is displayed within the Home, is available in larger print and would look at the possibility of producing it in other languages, if required. Alongside the complaints procedure is information about Advocacy services, which includes the contact details, should people living at the Home, wish for an independent person to act on their behalf. We looked at the Complaint Book and saw that the Home had received no complaints or concerns about the Home or the services provided. We received no concerns or complaints about the Home. We asked three people living at the Home if they received information about making a complaint. All said they received the information at the time of moving to the Home. Two people said they know how to complain and the third preferred to express concerns initially to the family, who would approach the Registered Manager. We spoke with a visiting relative of a person living at Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 17 the Home, who was confident that any concerns raised would be addressed quickly. Comments received directly from the people living at the Home: “We haven’t got anything to complain about” “We can tell any of the girls if there was something not quite right” “The management are always around and are very approachable”. “Confident to complain but would tell the girls first” We spoke with three members of staff to ascertain their knowledge and understanding of safeguarding issues, which means promoting the well being of people using the service from abuse. All were aware of the policies and procedures and that issues of concerns should be reported to the person in charge and were confident to report poor or bad care practices using the Home’s ‘Whistle-Blowing’ policy. The senior staff were aware that the Registered Manager would inform the Local Authority and the Commission for Social Care Inspection. This was consistent with the information we received from the Home before the site visit stating that policies and procedures were in place and staff had received training in what they should do. Staff recruitment files and the training records viewed showed that all staff underwent recruitment checks in line with the law and all had undertaken training, which provides information on the types of abuse. This demonstrated that staff recruitment processes protect the people living at the Home. We spoke with the District Nurse to ascertain how the Home responded to concerns raised by them. The District Nurse said they had no concerns and were confident that the Registered Manager would promptly address any concerns or issues raised. Cherrytree Care Home DS0000071420.V366041.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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Cherrytree Care Home provides a clean, comfortable, homely and wellmaintained environment for people who live there. EVIDENCE: Cherrytree Care Home is a situated in a residential area. The home is easily accessible for people using walking aids or wheelchairs. Information about the Home and other publications related to care services is located at the entrance to the Home. There are several information boards detailing social and leisure activities and events planned at the home. There are a number of communal lounges and dining room on the ground, furnished to a good standard with complimentary décor and pictures. The living Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 19 and communal areas were clean, homely and welcoming and people living at the Home who appeared to be very relax. The information we received from the Home before the site visit indicated that there have been some improvements made to the Home. We saw that the two smaller lounges had been decorated, carpeted and furnished with new furniture. The hallways had been decorated and the bathrooms had been redecorated and new flooring. The four main doors to the Home now have keypad system for entry and exit, for the safety of the people living at the Home. The garden to the rear of the Home has been blocked paved, with new garden furniture, planters and a bird table. During the afternoon, several people living at the Home were seen sitting out in the garden staff and visitors enjoying a chat and choc-ices. We looked at three people’s bedrooms; all of which were personalised with pictures, photographs and ornaments. The décor in the bedrooms are coordinated with the soft furnishing and furniture. All the bedrooms have ensuite toilet facilities. There are a number of bathrooms and toilets, both on the ground and first floor, which are equipped with grab rails and bath hoists for the benefit of people who may need help with their mobility. We spoke with two people about viewing the bedroom; both said their relatives had seen the bedroom before they deciding to move in. One person living at the Home said their family help furnish the bedroom with their preferred armchair and television. Another person living at the Home said the staff make sure the bird cage is cleaned daily and there is always fresh water and food for the budgerigar. The Deputy Manager said the Home has ensured couples are able to live together and have their privacy respected. We received comments in the survey returned from a person living at the Home: “It’s a lovely home that is clean and homely”. Throughout the site visit, domestic staff and care staff were seen working in specific areas within the home. Staff wore gloves and aprons when assisting people with personal care, meals and handling people’s laundry. Staff spoken with showed good knowledge, practice to prevent the risk of cross infection and use equipment safely, and the training records seen supported this. The Responsible Individual conducts the formal monthly visits to the Home and completes a comprehensive check and report of the findings. A report of the last monthly visit showed that the Home environment is audited and identifies the areas for improvement. Cherrytree Care Home DS0000071420.V366041.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. This judgement has been made using available evidence including a visit to this service. People living at the Home are protected by good recruitment processes; staff trained and supervised, to care and support the people using the service. EVIDENCE: People living at the Home and the visiting relatives said that there was always sufficient numbers of staff on duty: both domestic staff and care staff. We made observations of the interaction between the staff and the people living at the Home, and they appeared confident with the staff helping them with their daily care needs. We looked at the staff rota for the day, which showed the staffing structure is based around delivering outcomes for people living at the home and is not led by staff duties and responsibilities. This showed the importance to supporting and caring for the people living at the Home. We spoke with four people living at the Home about their views on the staff; they all spoke highly about the staff that assisted them with the personal care. Staff wore names badges and had distinct dress to identify them as a care staff or a senior care staff. People living at the Home told us they were able to recognise the care staff and staff that cleaned their bedrooms. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 21 We viewed the records of three members of staff: care staff, including a new carer and a senior carer. All the files contained a completed application form, Protection of Vulnerable Adults (POVA) first check, a Criminal Records Bureau (CRB) check and two written references. This was consistent with the information received before the site visit and from discussion with staff on duty. The Deputy Manager told us she is responsible for the recruitment, induction and training of staff. This demonstrated that Cherrytree Care Home has a good recruitment procedure that ensures people living at the Home are protected. We spoke with staff on duty who described the induction training completed. This included moving and handling, health and safety and caring for the people living at the home with the dementia, physical disability and general deterioation in health due to old age. Staff understood importance of training linking the training to the needs of the people living at the Home that promoted their independence. The example given showed staff encourage people to maintain their personal hygiene, as far as practicable. Staff said training is on-going and some provided by the District Nurse, which helps them provide the right care to the people living at the Home. We spoke with the District Nurse who said she had been involved in training staff at the Home. The training included hand washing, moving and handling, dressing wounds, and diabetes training. The staff training records showed the range of training provided to staff from Protection of Vulnerable Adults from Abuse; medication training; first aid; moving and handling, infection control; health and safety and dementia, alzheimers and Parkinson Awareness. Senior staff had training in safe administration of medication and pressure area care. The information we received from the Home before the site visit regarding the number of staff with National Vocational Qualification in care level 2 and above was 51 . We spoke with the Deputy Manager who confrimed that this was correct and new staff will be registered to start their NVQ in care level 2, after completing their induction training. Staff we spoke with said that they receive supervision from their line Manager and the frequency of supervision, which was consistent with supervision schedule displayed in the office and minutes of the meeting in the staff files. Staff said they could approach senior staff and management team for advice and support. Staff confirmed they attend staff meetings, which are held regularly, which enables staff to be kept up to date and promote a consistent approach as to the care and welfare of people living at the Home. This supported by the information received from the Home before the site visit. Cherrytree Care Home DS0000071420.V366041.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. This judgement has been made using available evidence including a visit to this service. People living at Cherrytree Care Home, live in a well managed Home and have opportunities to express and contribute their views to influence the care they receive. EVIDENCE: The information we received from the Home before the site visit stated that the Registered Manager and the Deputy Manager have attained the National Vocational Qualifications level 4 and the Registered Manager’s Award. The Registered Manager said the staffing levels and responsibilities have been structured with staff being clear about their duties that benefits the people living at the Home. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 23 The information received from the Home before the site visit, which is the Home’s own assessment contained limited information about what the service does well and planned improvements. These comments were accepted and assurance given that in future the information sent to us would be more comprehensive. The information received from the home before the site visit indicated that all policies and procedures are updated and reviewed regularly. The staff we spoke with knew where to find the policies and procedures and said they were confident that the person in charge would respond to concerns or issues that affected the people living at the Home. People living at the home said they were encouraged to express themselves views, ideas and opinions that would improve their quality of life individually at any time. There are regular ‘Residents’ Meeting’, held at the home and the date for the next meeting was displayed on the notice board. We read the minutes of the last ‘Residents Meeting’, which showed the discussion topics: trips, meals, improvements in the Home and the Easter Sunday lunch. People living at the home either they manage their own money, some with the support of their families and whilst others prefer to have their money held in safe-keeping by the Home, for which records of the expenditure and balances are kept. The Registered Manager said at present there is no other system in place to randomly check the expenditure records against the money held. The Responsible Individual is involved in the running and the maintenance of the Home. They told us they carry out the monthly and the records of the findings, which includes speaking with the people living at the Home, staff, reading records and checking the environment. We read the last monthly visit report that showed the Home has an internal system of monitoring the service. The Registered Manager told us that there is no quality assurance system in place and was confident that people living at the Home would tell the management if there were any issues. The Registered Manager gave assurance that a quality assurance system would be re-introduced to gather the views of the people living at the Home, relatives and people involved in with the Home such as the General Practitioner and District Nurse. The information received from the home before the site visit stated that the servicing and testing of equipment, gas and electrical testing are carried out at annually. Risk assessments are in place for the home, the people living at the Home and the staff. Cherrytree Care Home has a planned programme of maintenance and records of checks carried out are kept up to date. Cherrytree Care Home DS0000071420.V366041.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 3 8 3 9 2 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 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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. 1. 2. 3. Refer to Standard OP9 OP9 OP33 Good Practice Recommendations To make sure tippex is not used on people’s individual medication records. To seek advice from the Pharmacy to ensure that the existing storage for controlled medication is appropriate in accordance with the new legislation. To ensure that a system of quality assurance is in place to enable people living at the Home and involved in the care of people living at the Home to comment and influence the running of the Home. Cherrytree Care Home DS0000071420.V366041.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Cherrytree Care Home DS0000071420.V366041.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. Re-publishing this information is in breach of the terms of use of that website. 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