Care Home: Orchard Close

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What the care home does well An excellent pre admission process ensures that service users are confident that their needs will be met by the home and they have a good understanding about the running of the home. Good care planning practices means that staff are able to care and support the service users in the way they like and tat all their personal, social and emotional needs are met. A flexible activity programme means that service users are able to take part in activities and outings that are of interest to them. An effective complaints procedure that is accessible to the service users in formats that are appropriate to them means that service users and their representatives have confidence that concerns and complaints will be managed effectively. A well trained staff team results in service users being care and supported by a staff team that has the skills and abilities to do so. Service users are protected from the effects of abuse by a staff team that have a good understanding about safeguarding adults. Service users are actively encouraged to influence the running of the home. What has improved since the last inspection? The service has implemented various procedures to improve outcomes for service users at the home. The following are examples of these. A kitchen diary is kept that monitors service users opinions of the food provided at the home. This is to be used to develop better menu choices for service users. The weekly menu choices are now displayed for service users to view prior to meal times. Changes have been made to pre admission assessment processes. For those service users that have repeated visits to the home and minimal changes in their care needs, relatives/carers are asked to complete an update form about the service users needs rather than a complete a full care plan. The service has found that this is resulting in more up to date and relevant information being provided about the service user which therefore improves the care and support that can be provided to that person whilst staying at the home. A `bed broker` system has been implemented which is striving to enable service users to have respite at the home when they wish rather than being allocated a period when respite is offered to them. For service users that have complex care and support needs the assessment process is using a scoring tool, the results of which the service is using to seek more funding for extra staffing hours to ensure the person needs are fully met at the home. What the care home could do better: The cabinet that stores controlled medications needs to be secured to wall, not just to the cabinet it is fitted into. The documentation of staff training should be done in a way that allows for an easy assessment of what training staff have had. Service users and stakeholder surveys should be re implemented to enhance the quality auditing process of the service offered at Orchard Close. CARE HOME ADULTS 18-65 Orchard Close 28 Westfield Avenue Hayling Island Hampshire PO11 9AG Lead Inspector Gina Pickering Unannounced Inspection 29th November 2007 10:30 Orchard Close DS0000039585.V349426.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 Orchard Close DS0000039585.V349426.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. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Close Address 28 Westfield Avenue Hayling Island Hampshire PO11 9AG 023 9246 8313 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) Hampshire County Council Post vacant Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (2) of places Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th October 2006 Brief Description of the Service: Orchard Close is a respite / short break unit provided by Hampshire County Council for people who have a learning disability. In general people stay for one or two weeks at a time. At the beginning of each week staff and service users meet together to plan for the week ahead, which can be individual or group activities. Occasional theme weeks are organised by the service. The current range of fees is £122 to £798 for one week or £244 to £1596 for two weeks. Service users are informed in writing of individual fees prior to staying at Orchard Close. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process considered information received by the Commission about the home since the last key inspection in October 2006. This includes information provided to us in the form of the home’s Annual Quality Audit Assessment (AQAA) form in which the registered provider or manager tells us how the service has developed over the past twelve months and how they propose to continue to improve the service. The Commission surveyed service users, relatives and staff; the information in these was used to inform the inspection. A visit was made to the service on 29th November 2007. During this visit conversations were held with the manager, staff members and service user. A tour was made of the environment and several documents were looked at to inform the inspection process. What the service does well: An excellent pre admission process ensures that service users are confident that their needs will be met by the home and they have a good understanding about the running of the home. Good care planning practices means that staff are able to care and support the service users in the way they like and tat all their personal, social and emotional needs are met. A flexible activity programme means that service users are able to take part in activities and outings that are of interest to them. An effective complaints procedure that is accessible to the service users in formats that are appropriate to them means that service users and their representatives have confidence that concerns and complaints will be managed effectively. A well trained staff team results in service users being care and supported by a staff team that has the skills and abilities to do so. Service users are protected from the effects of abuse by a staff team that have a good understanding about safeguarding adults. Service users are actively encouraged to influence the running of the home. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The cabinet that stores controlled medications needs to be secured to wall, not just to the cabinet it is fitted into. The documentation of staff training should be done in a way that allows for an easy assessment of what training staff have had. Service users and stakeholder surveys should be re implemented to enhance the quality auditing process of the service offered at Orchard Close. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 7 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. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 8 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 Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 9 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 & 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good pre admission processes result in service users being assured that their needs can be met by the home. Good information presented in a format suitable to the service users means that they have a good understanding about the running of the home and the services offered at the home. EVIDENCE: The AQAA tells us that a comprehensive admission process is in place. Details about a service users care needs are obtained from their care manager. The service user’s main carer or family member is asked to complete a care plan that details how the person likes to be supported, their usual daily routine, social interests and any special care needs regarding any challenging behaviour. The manager told us that new procedures have been implemented for those service users that regularly return to Orchard Close for respite care. Their main carers now complete an update sheet about their care needs rather than a full care plan, this results the home having better information about a service user’s changing care needs when they arrive at the home. For service users that have complex needs a member of staff visits that person at their home or day centre to gather more information about the support and care needed by that person. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 10 A sample of service user assessment documents were looked at evidencing that these procedures are followed and comprehensive details are obtained to inform staff at the home about the care and support a service user needs. Staff told us that when a person is admitted to the home they have detailed information to support and care for that person: meetings are held during the week prior to that persons coming to discuss their care needs. A care manager told us ‘I am always contacted to ensure there is an up to date care management assessment’. This ensures that the service has up to date information about the service users care needs. An information pack (statement of purpose and service users guide) about the service offered by Orchard Close home is provided to all people expressing an interest in the home. The information is in a format suitable to the needs of the service users and includes easy read and pictorial information about the home, terms and conditions of residence at the home, an easy read version of the complaints procedure and a list of other support organisations that could be useful for service users and their main carers. A welcome meeting is held on Saturdays when services users arrive at the home. Information about the running of the home, including information in the statement of purpose, is discussed with the service users at this time. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 11 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 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported to make their own decisions and good care planning ensures their needs are met. EVIDENCE: The AQAA tells us that service users and their relative/carer are involved in the care planning process. As stated in the previous section this process commences prior to the person being admitted to the care home with the service users relative/carer providing a care plan of that person’s needs. The inspector looked at a sample of care plans. This evidenced the involvement of service users and their representatives. Service users with the support of care staff complete details about their wishes and aspirations, how they communicate their needs, how they like to be addressed and any special needs they have such as how any challenging behaviour is best managed for that individual. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 12 Each care plan provides information about how the service user communicates, the support they need to express their needs and wishes and how they make choices. Service users and their representatives tell us the service users choices and wishes are respected and taken in consideration. During the visit to Orchard Close service users were observed making decisions about the activities and outings they wanted to take part in. Observation throughout the visit and discussion with staff members evidenced that staff respect service users decisions, they have the skills to support service user to make decisions and that the routines of Orchard Close are very much influenced by the wishes and choices of the service users. The AQAA tells us that in the past twelve months more detailed risk assessments have been undertaken which facilitate more choice and appropriate support for service users. The inspector observed risk assessments to include road safety awareness, the use of transport and the community, managing money, interacting with other people, response to fire alarms, and guidance if an individual becomes unwell. The AQAA tells us that in the past twelve months individual evacuation plans have been drawn up for each service user. The relevant evacuation plans were available for the service users staying at the home when the inspector visited the home. Staff demonstrated awareness of risk assessments and it was observed that risk assessments are undertaken before any activity takes place. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 13 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 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the opportunity to access the community and take part in interesting activities of their choice. Service users rights are respected and healthy food is provided in a comfortable environment. EVIDENCE: The AQAA tells us that within care planning service users are assisted to explore leisure and recreational facilities. Orchard Close offers a respite/short break service and service users are encouraged and supported to make use of the local community and take part in activities they enjoy. Staff rotas are organised around the needs and wishes of the service users at the home, including the activities they would like to participate in. Service users’ care plans include sections with information and guidance about leisure interests such as whether a person likes to get out a lot or spend time Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 14 indoors, enjoys other people’s company or prefers time alone are clearly detailed. Service user’s hobbies and interests are also included here as well as guidance about what support is needed by the person to be part of a group. A welcome meeting is held each week during which time the leisure/activity wishes of service users is obtained with the week’s activities planned around their wishes. The programme of the week’s activities is shown on a picture board in the reception area. Examples of the activities that service users can take part in include bowling, vesting car boot sales, shopping, disco, tea dances, country trails, visiting museums, swimming, manicures, barbeques, pub lunches and craft activities. All activities are risk assessed and any hazardous activities are not part of the programme. Service users are supported to maintain contact with friends and families if wished, but as Orchard Close is a respite service staff understand that parents and carers may not want to be contacted every day. Carers/representatives of service users tell us that staff at the home support service users to keep in contact with them if that is needed. Daily routines at Orchard Close are flexible to meet the needs and the wishes of the service users. Due to the nature of the respite service routines do not involve service users with tasks such as cooking and housework. Through discussion with staff and service user was evident there are no rules or routines in place that restricted service users unreasonably. For example service users are encouraged not to come into the lounge areas dressed in their nightclothes, similar to that which would be expected if staying in a hotel. Terms and conditions of residence are clear about the rules regarding smoking and drinking and respecting the rights of other service users. These rules are explained to service users in the welcome meeting or when they arrive at the home. Service users hold keys to their rooms and lockable storage unless they have an agreement that their keys are held in the office. Service users and their representatives told us that they are supported to make choices about their daily life. Service users have a choice of menu each day and any special diets or allergies are recorded and included on a checklist in the kitchen. The menu promotes healthy eating options and the kitchen staff interact with service users and know their needs and preferences. The AQAA tells us that in the past twelve months a kitchen diary has been introduced to record comments on food on a daily basis and now display the weekly menu. The service expects these actions to help in the development of menu planning. The AQAA tells us that in the next twelve months they intend to provide the menu in a pictorial form that will enable service users to have a greater informed choice about the meals they are having. Service users said the food was very good and confirmed they are offered choices. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 15 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 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal and health care needs are met at the home. Clear procedures and staff training about handling medication protect service users wellbeing. EVIDENCE: The AQAA tells us that personal preferences with regard to personal care are an integral pat of the Care planning process. By looking at a sample of care plans it was evidenced that the way in which service users like support to be given regarding their personal care is clearly documented, such as washing and dressing, daily, evening and night routines. Service users and their representatives/carers told us that staff at the home care and support them in the way they like and expect. Due to the nature of the service it is not often necessary for the staff to support service users to access healthcare services. The AQAA tells us that if health care support is needed this is done through the local health care centre. During the inspectors visit to the home it was observed that staff were supporting a service user to access the medical centre and pharmacy for assessment of a health care need and collection of prescription medications. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 16 The AQAA and staff members tell us that if a service users is coming into the home who has a specific medical need training is sourced and provided to staff prior to that person coming onto the home. One example of this is that all staff have received stoma care training prior to a service user coming to the home that needed assistance in caring for a stoma. Polices and procedures are in place about the handling and administration of medications. Staff tell us that they have received training about the handling and administration of medications. Certificates are in staff files evidencing that this training has been given. Medication is stored securely in two purpose built cabinets in the office and two members of staff sign the administration records in respect of each service user. Medication administration records are completed accurately and clear documentation provides an audit trail of the amount of medication in the home at any one time. There is a storage facility and separate record for controlled drugs, but despite this being secured inside another medication cabinet the actual controlled medication cupboard is not secured independently to the wall. This needs to be done to comply with the Misuse of drugs Act 1973. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 17 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 & 23. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Service users are confident that any concerns or complaints made will be taken seriously and responded to appropriately. Service users are protected form the effects of abuse by a staff tem that has a good understanding about safeguarding adults. EVIDENCE: The AQAA told us the service provides all service users with written details about how to make a complaint about the home. The procedure is displayed in the home and is made available to service users in an easy to read format. Other formats such as Braille, audiotape and other languages can be provided if needed. The AQAA also told us that no complaints have been received by the service in the last twelve months. Procedures are in place for managing complaints received by the service. Staff told us in surveys and conversations that they are aware of the process for managing complaints and said that any concerns would be resolved promptly to reduce anxieties for service users and to negate the need for a service user or relative to make a formal complaint. The Commission in the last twelve months has received no complaints about the service. Staff and the manager told the inspector that as part of the welcome meeting the process for making a complaint is explained to all service users. Service users and their carers/representatives told us in surveys that they are aware of how to make a complaint and are confident that the service will respond appropriately to any concerns or complaints raised. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 18 Staff have access to adult protection policies and procedures. Staff told us that they have training about the protection of vulnerable adults. Staff were able to discuss the various types of abuse that could happen and the action to take if they suspect an act of abuse had occurred. There have been no safeguarding referrals in last twelve months. This is because of a lack of incidents rather than a lack of understanding about when incidents should be referred. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 19 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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the opportunity to stay in an environment that is clean, well maintained and have appropriate adaptations to meet their needs. EVIDENCE: The AQAA tells us that Orchard Close has been redecorated in the last twelve months with new carpets being fitted in the downstairs corridors. The inspector toured the home viewing communal areas, some bedrooms, bathing and toileting areas, the garden area, laundry and kitchen areas. A variety of communal areas are available for service users to use including a games room that has facilities for art and craft activities and a snooker table. Service users were observed using a variety of communal areas enjoying each other’s company. The garden areas are attractive, well kept with newly planted areas and fully accessible to all service users. During the inspectors visit to the home service users were observed enjoying walking in the garden. Individual rooms are available for all service users. A double room and a twin room are also available for couples or for people who particularly want to share with another person. There are a sufficient number of bathrooms and toilets Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 20 throughout the building and some are adapted for people with physical disabilities. There is also an assisted bath for people who may require it. Bathrooms offer a choice of shower or bath. Two of the bedrooms have ceiling tracked hoists for people with physical disabilities. The home was clean and free from offensive odours during the inspectors visit. Service users and their representatives commented in surveys that the home is always spotlessly clean. The AQAA tells us that all staff have received training about the control of infection. Individual staff files held certificates evidencing they have received training about the control of infection. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 21 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, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Services users benefit from a well trained staff team that have the skills and knowledge to care and support them. Robust recruitment procedures protect the wellbeing of service users. EVIDENCE: The AQAA tell us that the number of staff on duty is planned according to the assessed needs of the service users at the home for a particular week. The manager has commenced using a ‘scoring tool’ when assessing service users that have complex needs to support her request for extra funding for increased staff hours to support the person. Staff told the inspector there is usually sufficient staff to meet the needs of the service user group at the home, this includes being able to support service users on outings and activities. Robust recruitment procedures are in place. Four staff files were seen evidencing that this procedure is adhered to, ensuring that all the required checks such as references and CRB and POVA checks are obtained prior to a person commencing employment at the home. Staff told the inspector that they had to wait until their CRB checks were obtained before being able to Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 22 commence employment at the home. This ensures that service users are supported by staff that are suitable to work in care. Procedures are in place that includes service users as part of the recruitment process, however there were no relevant service users at the home during the inspectors visit to the home to make any comments about their involvement. A programme of training is planned for throughout the year which equips staff with the skills and knowledge to support and care for the service users. Training includes fire safety, moving and handling, food hygiene, equality and diversities, dementia and SCIP (Strategies for Crisis Intervention and Prevention). The training needs of staff are identified through appraisals and two monthly supervision sessions. Records are available for these and conversations with staff confirmed that they are taking place. A week is set aside in January when there are no service users at the home for staff to complete refresher courses for their mandatory training. The AQAA tells us that all new staff receive induction training based on the Learning Disability Framework (LDAF). Staff told us that they are undertaking this training. Copies of training certificates are kept in staff files. This means that to assess what training staff members have had a person needs to look through staff files that are not all clearly laid out. A data sheet of staff training is also kept. But both this and the filing of staff certificates does not at present allow for an easy assessment of what training staff have received. The manager identified to the inspector that the recording of staff training is an area that needs improving. However through conversations with staff members it is evident that staff have had regular training equipping them with the skills and knowledge to meet service users needs. Service users and their representatives have not expressed any concerns about the skills of staff at the home. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 23 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): 27, 29 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that continuously works to improve life for those staying at the home. Service users are able to contribute and influence the running of the home. Good health and safety practices protect the welfare of all at the home. EVIDENCE: The manager is a registered nurse with many years experience of supporting people with a learning disability. She has appointed as manager at Orchard Close since the previous inspection of October 2006. She has submitted an application to the Commission to be registered as manager of Orchard Close. Staff, service users and their representatives speak highly of the manager stating that she is always approachable and supportive. The manager has demonstrated in this inspection her commitment to developing the service to improve outcomes for service users. Examples if this include the Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 24 implementation of an up date form for service users and their carers to completed before coming to the home to ensure that care staff are ware of the changing needs of the service user, the implementation of a scoring tool fro those service users that have complex needs to assist in securing extra funding for increased staff hours so that persons needs can be fully met and the introduction of a ‘bed broker’ who endeavours to ensure that service users have the respite period when they want it, not when the home says they can have it. Quality auditing of the service is managed in various ways. Six monthly surveys to service users and their representative had been used and the manager told us these are to be re implemented. Departure meetings are held weekly for those service users that have completed their respite stay. The service user views about the service are obtained during these meetings and records are kept of these meetings. Issues discussed in these meetings include the activities arranged during their stay, the meals provided, staff support and the bedrooms and facilities provided at Orchard Close. At the beginning of each week a welcome meeting during which service users wishes regarding activities is obtained. The week’s activities are then arranged according to the service users wishes. Safe working practices are maintained in the home for the safety of service users, visitors and staff. Staff members receive training and updates in mandatory health and safety subjects as part of the rolling programme of training. A fire evacuation plan and current records of fire drills and equipment checks were in place. Comprehensive risk assessments are in place for the environment and all working practices that detail the action to be taken to reduce the effect of any identified risks. Certificates relating to tests and services of equipment and appliances were seen. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 25 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 4 2 4 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 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 X 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 Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13(2) Requirement The cupboard that stores controlled medication must be secured to the wall in manner that meets relevant legislation. Timescale for action 30/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA35 Good Practice Recommendations Staff training should be documented in a way that allows for easy assessment of what training each staff member has had. Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Orchard Close DS0000039585.V349426.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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