Care Home: Orchard Cottage

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What the care home does well The people who live in this home have an active lifestyle and are given many opportunities to develop personally and to try new experiences that may lead to new interests. The process of welcoming new people into the home is well considered and thorough. The home remains homely and welcoming in appearance. What has improved since the last inspection? The fire procedures have been completely rewritten and now take into account the changes to the house made when the extension was built. In the past the people living in this home have not attended an organised day services, recently the whole of their daytime activities have been reviewed, old favourite`s have been continued and lots of opportunities to try new things and to develop new interests are being offered. What the care home could do better: Care plans and client files were removed during the disciplinary investigation and have only recently been returned. They are in urgent need of being reviewed and updated. The task of following the care plan is complicated by the retention of old records and information. The files need to be examined and records that are no longer relevant should be taken out and stored elsewhere. The medication is being administered and stored correctly but this home needs to remind staff to implement procedures that are in place to record and report medication and recording errors. CARE HOME ADULTS 18-65 Orchard Cottage Orchard Cottage 25 Orchard Grove Orpington Kent BR6 0RX Lead Inspector Ann Wiseman Unannounced Inspection 16th October 2007 08.00 Orchard Cottage DS0000038246.V353053.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 Cottage DS0000038246.V353053.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 Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Cottage Address Orchard Cottage 25 Orchard Grove Orpington Kent BR6 0RX 01689 874514 0208 778 2884 melanierevel-burroughes@bromley.gov.uk 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) London Borough Bromley Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 4 24th may 2006 Date of last inspection Brief Description of the Service: Orchard Cottage is owned and staffed by the London Borough of Bromley and was originally a children’s home that was taken over by the adult services once the people who were living there became adults and they continued to live there with the same staff group that had worked with them as children. 0rchard Cottage is a large older style two story detached house providing care and accommodation for four adults with learning difficulties. Orchard Cottage has recently had a full refurbishment and now has five single bedrooms, one being new built with connecting bathroom and there is also a new conservatory off the kitchen. The home is within walking distance from Orpington town centre with its wide range of shops and leisure facilities. Entrance to the house is up a slight incline with steps to the front door. Wheelchair access is through the rear garden. The house has no parking facilities but there is a pay and display car park close by. A great deal of development work is in progress and is planned within the immediate area of the home, all of the houses from the beginning of the road up to Orchard Cottage will be demolished and replaced by flats and the car park across the road is being replaced by a large retail complex that will include a shops, car parking and residential units. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and it was started at 8am. All of the people living at the home were either in the process of getting up or were having breakfast. There were two staff members on duty when we arrived; one was newly appointed and the other was a member of the care bank who has worked at Orchard Cottage often and is familiar with the home and the people living in it. As usual the people at home gave us a warm welcome and we chatted over a cup of tea before they started getting ready to go out to various activities. A new resident has moved into the home since the last inspection so we were able to have a close look at what information people are given before they move in and how a move is handled. We talked with the two staff members on duty as well as the manager, all of whom appeared knowledgeable of the needs of people with learning disabilities. The manager is experienced and has managed other homes before going to Orchard Cottage. He completed the Annual Quality Assurance Assessment we asked him to do in a timely manner and it is one of the tools that have been used while inspecting this home. We also sent surveys to the people living in the home, their families and some of the professional people that have contact with them. The response from the residents and their families was low with only one reply from each group, but three professional people have responded and their views has been mainly positive. There has been a great deal of upheaval since the last Key Inspection. The longstanding manager has been removed from Orchard Cottage and has taken up a post in a different department within the Council. The old manager had worked in the home for many years and had built up a close relationship with the people living in the home and their families who were happy with the way she ran it, so everyone was shocked and disappointed when she was suspended without notice. Relationships between the service and some of the relatives of the people in the home became strained as they did not understand why the manager had been moved and the employers were unable to explain fully because of their need to respect the manager’s confidentiality. Poor communication between managers and families added to the tension and as a result the families still feel that there are still some unresolved issues that continue to have an effect on the relationship between them and the service. The temporary manager who was put into the home, had been asked to change the ethos of the home towards a more adult oriented service which proved to be very unpopular with family members as they felt that their daughters may have been coerced into giving up games and activities before they were really ready so the relationship between acting manager and families continued to be difficult. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 6 The previous managers departure has been made permanent now and a new manager is in post and has started the process of becoming registered. Because of the concerns raised with us by the Families of the people living in the home, we have been closely monitoring Orchard Cottage and have carried out two random visits since the last key inspection. The outcomes of both of these visits will be referred to in this report. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All of these standard have been examined on this occasion. 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 this home benefit from being given the information they need to make an informed choice. Detailed assessments are made so that the home can decide whether it can meet the needs and aspirations of the new person and prospective residents can have as many short stays, as they need to be able to decide if they like it and want to move in. Contracts were not evident. EVIDENCE: Three of the people living in this house have lived together for many years and get on well together so it was important to make sure that when a new person moved in they would fit in with everyone and would not cause to much of a disruption. Records show that the new person had her needs assessed and that the people responsible for placing her in the home had taken the other people into account when considering if she would like the house and if her interests and lifestyle would fit in with that of the others. The home’s statement of purpose and the users guide are written in a friendly and attractive way, the Manager feels that the format could be improved to make it easier to read and has undertaken to review it in the forthcoming year. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 9 The daily logbook records the first visits and overnight stays of the newest person to have moved it. She had several visits to the home before moving in and there was a review held before the move became permanent that included the new person and her family. There was no evidence on the two files that were examined that the people living in this home had been given contracts or that the home is sure their assessed needs could be met by this service. It is possible that this is because all but one of the ladies have lived in this house since they were children. However it is I necessary that all of the people living in the home have contracts and this will be made a requirement. Please see Requirement 1 Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 10 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): All of these standards were examined during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in place but need to be reviewed and updated. The people living in the home are given opportunities to make decisions about their own lives and are consulted on and participate in all aspects of them. EVIDENCE: Care plans are in place but they had been removed during the disciplinary investigation and have only recently returned in an unordered condition. They are in urgent need of being reviewed and updated. Two of the care plans were examined in detail and the task of following them was complicated by the retention of old records and information. The files need to be examined and records that are no longer relevant should be taken out and stored elsewhere. Please see Requirement 2 While sitting at the dinning room table with the people having their breakfast there was a lot of discussion about what they were going to do that day, the staff offered suggestions and guidance but it was the people themselves who made the ultimate choice about what was going to happen. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 11 The people living in the home also choose the menus and they will go shopping together with the staff to shops nearby. One of the ladies was reluctant to get up but was not rushed unduly and was given a drink of tea in bed to help encourage her up. Risk assessments have been done and interventions are in place that allows the people living in this home to take risks as part of an independent lifestyle. One of the ladies made us a cup of tea and talked about helping to cook dinner and how much she enjoyed it, another talked about having to do her ironing and was pleased that there was not too much to do. She preferred to do her own washing and ironing as in the past in another home she was “always losing my clothes, but it doesn’t happen here.” Personal information was seen to be stored in a locked cabinet in the office. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All of this area was assessed during this inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in this home benefit from a lifestyle that is active, where they are given opportunities for further development, to take part in appropriate activities and to be part of the local community. Relationships with family and friend are supported and every one living in the home is expected to respect others rights and to take responsibility for their own actions. EVIDENCE: Senior managers felt that the people living in this home had not been fully supported to develop in ways that were appropriate to their age. The clients and the staff group had been together since they were children and some seemingly childish practices had been continued, such as people being read children’s stories and nursery rhymes at bed time and having their arms rubbed to help them get to sleep. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 13 The families, who believed their daughters were undertaking activities that were at a level that was appropriate to their emotional and psychological development, hotly contended this belief. During a previous inspection it was noticed that there was a lot of child centred films, games, books and music around the communal areas and in the bedrooms, but there were also some more adult appropriate belongings such as pop music CD’s and adult films including Turner and Hooch. Possibly, if this group had not lived in the same house for so long they would not have kept quite so much of their childhood belongings and much of it would have been discarded as is natural to all growing children as they move on in life. A move to change the home into a more adult based service was not very sensitively managed by the acting manager and a requirement was made after the first random inspection that called for her to undertake training and guidance before continuing with the programme of developing a more age appropriate lifestyle in this home. With the arrival of the new permanent manager the home is no longer seeking to rush changes to lifestyles but are supporting the ladies to take charge of their own development at their own pace by offering them a wider choice of opportunities, so they can explore new experiences, that may spark new interests. It was also required that the residents must have their speech and language abilities reassessed and to have their emotional and psychological levels defined so that staff can offer activities that will be best suited to them. It took a long time for the assessments to start due to the high demand that the speech and language department experiences. This is not a fault of the home and was without their control. The work has stated now. All of the people living in the home take part in choosing the meals, writing the menus and everyone helps with the cooking, shopping and tidying up afterwards. The dinning table has been moved out of the kitchen and into the conservatory so that there is more room to move around the kitchen. It was comfortable and relaxed as we sat around the table and talked about what they had planned for the day, discussed how they felt about the home and what people thought about their lives. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All of this area was examined on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People in this home are supported in the way they would choose and have their physical and emotional needs met. People do not manage their own medication but is managed as required although staff need to be reminded to follow procedures that are in place to record and report medication and recording errors. People living in the home can be assured that they will be treated with respect through ill health. EVIDENCE: It was evident from discussions that took place between staff and the people living at the home, that the ladies are more that able to express preferences and that the staff respected and followed them. One of the residents talked about how she would sit and discuss her problems with a staff member who would offer advice that she would sometimes take but also said “sometimes she talks rubbish so I do my own thing.” There was an easy relationship between the staff and the people living in the home with a lot of banter and laughter. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 15 All of the people are registered with a local doctor and there is evidence on file that they visit him if needed and records are kept of the appointments and treatment given. The medication was examined and was found to be stored as required however it became apparent that something was amiss when the blister pack and the recording sheet were compared. Further examination by the manager determined that medication had been taken from the wrong blister by mistake and that it had been rectified and action had been take to make sure that none of the residents had been put at risk. The procedures had been followed in as far as the mistake had been noticed and rectified but fell short when the incident was not recorded and the manager had not been notified, it will required that staff are reissued the medication policy and that they are reminded to implement procedures that are put in place to record and report medication and recording errors. Please see Requirement 3 It is the homes policy and expectation that Service Users will be cared for at home in the event of any serious illness as long as it falls within the capabilities of the staff group. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Both of these standards have been assessed during this inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints have been received by this service and they are being dealt with in accordance to its procedure. EVIDENCE: It has been a difficult time for people living in this home and their families because they were very unhappy that the previous manager was removed from Orchard Cottage and with the way it was done. This has caused a great deal of dissatisfaction which has generated many complaints, some of them are still progressing through the procedures as the people complaining do not feel that they have yet received a satisfactory response. The Commission was involved at an early stage and we have been monitoring the situation and will continue to do so. To try and rebuild relationships regular meetings have been held where family members are able to meet with senior managers away from the home to air their views and to seek answers. Some of the relatives have found this useful and although they are still very unhappy with past events feel that it may be possible for they can move on and look forward to a more settled time for their daughters. As another step forward the meetings are now being held at the home. Policies and procedures are in place that protects the people living at the home from abuse, the manager reports in the Annual Quality Assurance Assessment that they have been reviewed and updated are legislation dictates. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All of these standards have been judged during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home has a homely, comfortable and safe environment. Bedrooms suit the needs and lifestyle of the Service Users and it is clean and hygienic. EVIDENCE: Orchard Cottage is a homely and comfortable place to live, the furniture is domestic and the decoration is contemporary and in good order. Health and safety issues around fire safety that have been highlighted previously have now been satisfactorily concluded, an independent health and safety inspection has been carried out and recommendations have been actioned. A new fire safety policy has been produced that reflects the changes made to the house by the building work; it has been reviewed again since the new manager has taken up his post. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 18 Fire doors were propped open to allow ease of access. It will be made a requirement that other means are used to keep the doors open that do not contravene the fire safety regulations. Please see Requirement 4 The lock on the conservatory door has been replaced by a ”snib lock” that allows the door to be secured without the use of a key that could be taken out and lost. All of the fire extinguishers have now been secured to the wall and were all seen to be in place to have been serviced recently. We asked everyone if it would be all right for us to go into rooms their rooms to look around, all but one said it would be fine. The manager gave us a tour of the house and we respected the ladies request not to enter her room. Each of the rooms we saw were individual to its occupant, they were well decorated and comfortable. One lady had been moved to a room on the ground floor as she finds managing the stairs difficult, at first she was unsettled and unhappy but as time has gone by she has become adjusted to the new room and work with her advocate has determined that she no longer wants to move back to her own room. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This entire area has been assessed during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff appear competent and are working towards achieving the appropriate qualifications, the recruitment policy is as required and staff are well supported and supervised. EVIDENCE: Staff records were examined and were found to contain the required information and indicated that the recruitment policy is followed. The staff on duty confirmed that reference’s had being taken and that Criminal Records Bureau checks are made before they can starts work at the house. Rotas were checked and staff on duty corresponded to those detailed. There are two staff members on duty each shift, which enables the four people living in the house to have ample 1-1 support. The manager has taken steps by rearranging the rota to try and ensure that there is always a permanent staff member on duty and if care bank must be used they are people who have worked in the home before and know the people who live there. The rota has been amended and now clearly indicates who the designated person is, this was a previous requirement. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 20 On talking to staff on duty and the Manager it became apparent that the people’s aspirations are very important to them and that they were committed to offering a high standard of care. Records show that the required percentage of staff have gained NVQ qualifications or equivalent. The home offers training as evidenced form certificates placed in the training records, including Induction, Protection of Vulnerable Adults, Health and Safety, Basic food Hygiene and first Aid. Both staff and Manager state that regular supervision is offered and it was confirmed by the number of and regularity of supervision records. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All of these standards have been judged during this inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an air of being well run and organized, the resident’s views are sought on a daily basis and he people who live in the house have their rights safeguarded by the homes Policy and procedures. EVIDENCE: The ethos, leadership and management of the home is based very much on the needs and aspirations of the residents; we spent some time sitting around the table in the kitchen with the residents drinking tea and discussing what they enjoy doing, what they plan to do, what they think of the home and how it was run. The atmosphere was relaxed and friendly, the people living in the home obviously felt able to talk openly and are very confident in talking about how they liked living in the home and how well the staff looked after them. When asked if they knew how to make a complaint all said they did. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 22 Although given opportunities, privately, to tell us about anything that made them unhappy, none of the residents chose to say anything. The survey that was returned to us from one of the residents said that she was disappointed that the staff at the home had changed and that she wanted it to go back as it was. She did however say that she liked the new manager. One of the residents mothers expressed a concern that, just as the new manager was settling in and beginning to make a difference, he had been given extra responsibilities that would take him away from the home. When asked the Manager informed us that he was temporally covering a senior manager who was on extended leave, but the work would only take him away from the home two days of the week. He would remain responsible for the home while he was away and would remain contactable to deal with difficulties that may arise. At present he is already expected to do on call duties at Yeoman House once a week. Once he has taken on the extra duties he will be excused from being on duty so in effect he will only be away from the house for one extra day. The professional people that responded to the survey sent out by the Commission, felt overall that the home cared for the people who lived there well, but an opinion was expressed that the staff team would benefit from training that included recognising and dealing with general health care issues and in specialist healthcare issues that are specific to the people living in the home such as Downs Syndrome. Please see recommendation 1 Quality Assurance surveys are taken annually and there are plans for the Manager to write a short summery of the outcomes and to give a copy to the people living in the home and their families. The completed Annual Quality Assurance Assessment reports that all the required health and safety checks are completed and that equipment is serviced and safety checks are carried out as necessary and certificates are in place except for the electrical hard wiring certificate which as been overlooked but arrangements have been made to have it done. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA5 Regulation 5(c) Requirement Timescale for action 05/01/08 2 YA6 15 3 YA20 13 (2) 4 YA24 23 (4a) The Registered manager must develop a written contract with each of the people living in the home. The care plans must be reviewed 05/01/08 and put in order, archiving material that is no longer current or relevant so that the information can be easier accessed. The Registered Manager must 05/01/08 reissued the medication policy to all staff members that are responsible for dispensing medication and reiterate the importance of following procedures that are put in place to record and report medication and recording errors Doors must not be wedged open, 05/01/08 other means to keeps doors open must be provided that do not contravene the fire safety regulations Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 25 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 Consideration should be given to training being offered to staff that included recognising and dealing with general health care issues and in specialist healthcare issues that are specific to the people living in the home. Orchard Cottage DS0000038246.V353053.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Cottage DS0000038246.V353053.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. 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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