Care Home: Orcadia

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What the care home does well There is a lengthy process for people wishing to move into the home, which includes assessment of the individuals needs and visits to the home so they can decide if its the right place for them to move into. They have good links with health and social care workers and a variety of professionals are asked to be involved with the people living in the home so they can be confident their health care needs are met. People told us that they like living in the home and that staff are great and support them to do the things they want. The relationship between the staff and the people living in Orcadia was relaxed and comfortable so that people seemed well settled. What has improved since the last inspection? The general maintenance is ongoing and some rooms have been decorated and some new furniture was evident. This helps to make sure that people continue to live in safe, comfortable surroundings. There are tentative plans in place to have a resident representative on the interview panel for new staff so that people have a say at Orcadia who comes to work with them. What the care home could do better: The owner of the home needs to arrange for a formal unannounced visit to be made to the home each month, with a record of the findings kept, to help her make sure she knows the home is being run in the best interests of the people who live there. Key inspection report Care homes for adults (18-65 years) Name: Address: Orcadia 86 Buxton Road Disley Cheshire SK12 2HE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Julie Porter     Date: 0 1 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Orcadia 86 Buxton Road Disley Cheshire SK12 2HE 01663765056 01663752666 orcadia17@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Gillian MacDonald,Vincent MacDonald care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following categories of service only:- Care home only - PC, to service users of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories:- Learning disability - Code LD The maximum number of services users who can be accommodated is: 10. Date of last inspection Brief description of the care home Orcadia is a privately owned care home that can provide residential care to ten younger adults who have a learning disability. It is close to the centre of Disley where there are some shops, pubs and churches. Orcadia is a two-storey, former private house, with one twin/double and eight single bedrooms. Communal areas include a lounge with a conservatory (which is used as an office), dining and kitchen spaces. There is a shower/toilet on the ground floor and two bathrooms to the first floor. A laundry room is situated in a small cellar area. The home has a large rear garden that is used by service users. 10 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 24 Brief description of the care home The cost of living in the home depends on the needs of the individual and should be discussed with the manager. Care Homes for Adults (18-65 years) Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use the service experience good outcomes. This visit, part of the key unannounced inspection of the home, took place over 6 hours. It was carried out on 1 September 2009 by one inspector. The report will refer to we and us, as it is written on behalf of the Care Quality Commission. The visit to the home was just one part of the inspection. Before our visit the manager was asked to provide information as part of the inspection. The views of the residents regarding the home were also sought; their comments are incorporated into this report. During the visit we spoke with the manager, some of the staff members and most of the people living in the home. The records for two people were looked at to check the Care Homes for Adults (18-65 years) Page 6 of 24 care they receive. Policies and procedures, records of medication, care plans and training records were also examined to see how the home is run, how care is provided for the people who live there and what training staff have received. Care Homes for Adults (18-65 years) Page 7 of 24 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Processes are in place for peoples needs are assessed before they move to the home so that they are sure their needs can be met there. Evidence: We inspected the care file of one of the people who had recently moved to the home. They sat with us while we did this and said that they had met the manager before they had come to live there. She had also visited the home with her family before making the decision to move there. The records demonstrated that an assessment of the persons needs had been done almost three weeks before they moved in and visits had taken place in between. The resident told us that it was good to visit and it had helped with making the move and they knew what to expect when they got there. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home are encouraged to be as independent as they possibly can be so that they feel in control of their lives. Evidence: We inspected the care plan of one person who had recently moved to the home and could clearly see that the plan would make sure that staff encouraged the person to be as independent as possible. The person told us that they did all the things they liked to do, and staff helped them when they needed help. We saw that risks involved with the persons chosen lifestyle on the whole had been assessed. She told us very clearly that she did not want to wear a helmet when riding her bike and the manager was advised to record this on the care plan. Another person we spoke with told us that they had made their own arrangements to go to college starting next term. They were very pleased that they had done this independently and were looking forward to attending a computer course. Care Homes for Adults (18-65 years) Page 11 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to be involved with tasks at home and are supported to participate in activities so that they lead active fulfilled lives. Evidence: During our visit to Orcadia we saw lots of activities - people were planning to go to work and others were planning to go out for social activities. People were encouraged to be involved with getting lunch ready and/or setting the table for lunch. We were told that one person cooks their own evening meal a couple of times a week. A group of people planned a social evening in the local pub after their evening meal. One person we spoke with told us about the process she had been through so that she could attend a computer course in starting late September. We saw evidence that other people living in the home had met with their key workers to discuss what courses they would like to attend for the coming term. Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: A number of people who live at the home have part time or vocational employment and two we spoke with during out visit told us that they enjoy work, they make their own way there and have friends at work. Care Homes for Adults (18-65 years) Page 13 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Orcadia are supported by a team of staff who know them well and monitor their health so that they get the care and support they need. Evidence: We looked at the records and the storage arrangements of the medicines for two people living in the home. These were stored securely and the records maintained to a good standard. Staff responsible for administering medicine receive training to do and, before this visit, this training was last was held on 13 May 2009. One person we spoke with told us that she has her own medicine and can do this herself. We found that her medication is stored securely and the risks involved with self medicating had been assessed. All the people living in the home are registered with the doctor, the dentist and the optician. We saw evidence that other health professionals are involved with the care and support for the people living at Orcadia. This helps to make sure that they stay as well and healthy as possible. We saw that relationships between the people living in the home and the staff were Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: comfortable and relaxed. There is a low turn over in the staff team and residents and staff have got to know each other well. Two residents have passed away since our last visit, both in hospital; we discussed this with the manager in respect of the impact for the people living in the home and the staff. She told us that some residents and staff had attended one persons funeral and thought this had helped them in coming to terms with the persons death. Care Homes for Adults (18-65 years) Page 15 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected by the policies and procedures and staff training so they know their concerns will be listened to and they will be protected from possible harm. Evidence: There is a complaints procedure in the home that is available to both residents and visitors. The manager told us that she is working on developing the procedure so that it is more accessible to everyone living in the home. She intends to do this either by audio, video or DVD. People we spoke with told us that they would speak with staff if they were unhappy and also to the owner of the home if necessary. We saw that nine of the fourteen staff have attended a refresher training session for safeguarding adults in April 2009. A number of part-time workers and students employed at the home were unable to attend and the staff meeting minutes referred to the expectation of the manager for them to attend at the next training date. Care Homes for Adults (18-65 years) Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is continuing maintenance and decoration so that people living at Orcadia do so in safe comfortable surroundings. Evidence: We had a tour of the building and saw that ongoing maintenance had been happening,. We saw that some bedrooms had been redecorated and one person told us that she had chosen the colours and helped paint her bedroom since moving in. We also saw that some new furniture had been bought. The home was fresh, clean and tidy throughout. Care Homes for Adults (18-65 years) Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are trained and supervised so that people living in the home are supported by a qualified, effective team. Evidence: We inspected two staff files and found that application forms, references and criminal record bureau (CRB) had been obtained before the person started to work in the home. We also saw evidence that staff are receiving one to one supervision with the manager as a minimum six times per year. We spoke with staff who confirmed that they meet with the manager regularly both formally and informally. Staff files also contained information of the training they had completed and achieved. The manager discussed with us that she was planning to interview for new staff and this process would also include a residents representative. We spoke with the person who was able to tell us what qualities they would look for in new staff. This process helps people who live in the home have a say in who is going to provide care and support for them. Information received before our visit told us that more than 50 had achieved a national vocational qualification (NVQ) at level 2 or above in care. We spoke with staff who told us that they were encouraged to continue with NVQ to level 3 and 4, and Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: evidence provided showed this to be accurate. This means that more than the minimum number of staff recommended in the standards have achieved a nationally recognised qualification to show they are competent to provide good quality care for the people who live at the home. There is a staff training plan for the home and training since our last visit there, this has included Health and Safety; Moving and Handling; medicine administration; dealing with challenging behavior and safeguarding adults. Some of the part-time staff and some of the students employed at the home have not attended recent refresher training. The manager showed us evidence on how this has been addressed and how they will achieve the training in future by using accredited training DVDs. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is aware of her responsibilities to ensure that people live and staff work in a safe environment. Evidence: The manager is qualified and registered with the Care Quality Commission and regularly attends training courses to ensure that her knowledge is current. We saw the report following the homes annual survey which includes the views of the people living there and their relatives. On the whole this showed that people were satisfied with the support they get. Because of a misunderstanding, the owner has not been regularly visiting the home to carry out checks on how it is running and make a report on this. In the past the owner has always complied with these visits and reports, as required by the regulations, and sees no reason why they will not recommence. We have sent current guidance about how these visits should take place to the owner. The servicing of the fire detection equipment, alarms, emergency lighting and fire Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: extinguishers happened on 19 August 2009 and we saw that residents and staff have monthly fire drills to make sure they know what to do to stay safe if a fire breaks out. We looked at the accident records and saw that 11 accidents/incidents have happened during 2009,;these mainly involved cuts, grazes and one incident when someone trapped their finger. Records were maintained appropriately. A sample of service certificates showed us that gas and electrical appliances had been checked. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 39 The owner should start making regular visits to the home again to check how it is running, in accordance with the regulations, and a report of the findings of each of these visits should be kept in the home. Care Homes for Adults (18-65 years) Page 23 of 24 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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