Care Home: Orchard House

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What the care home does well The staff give good care with dignity, privacy and relate well to the residents. `The staff are excellent` ` They give us good care` The residents have a clean and pleasant home to live in. The home gives the residents good, fresh home cooked food and gives them choices in what they have to eat. The residents have a good range of activities arranged that recognize peoples` interests. The manager and the staff welcome visitors into the home and communicate well with them. The home has a good recruitment practice, with all the required documentation in them. This makes sure that, as far as possible, the residents are safe. The staff are well trained to meet the needs of the residents. What has improved since the last inspection? There is a system in place for the proper receipt and administration on controlled drugs, to make sure that any controlled drugs are given safely. The complaints book now has an audit trail with each entry being signed and dated. The home has had new dining room furniture, which has helped to make the dining room a nicer place for the residents. What the care home could do better: The Statement of purpose could include all the required information, including the results of the annual questionnaire. This would make sure that prospective residents have all the information that they need to make a decision about the home. The daily records for the residents could contain more information so that the staff have better knowledge of how the resident has been during the day or night.The complaints policy should contain the contact details for social services, so that people know who to send complaints to if they needed to. Maintenance work could be completed more regularly and more quickly to make sure that the home is safe and pleasant for the residents. The application form could be designed to have more space for the employees` previous employment history. This would allow the manager to ask about any gaps in employment. Formal supervision of the staff should be put in place so that they can have time with their `line manager` to discuss work and training issues. The manager should be given enough time to complete her management duties. CARE HOMES FOR OLDER PEOPLE Orchard House Weston Drive Market Bosworth Warwickshire CV13 0LY Lead Inspector Thea Richards Unannounced Inspection 09:30 30 August 2008 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard House Address Weston Drive Market Bosworth Warwickshire CV13 0LY 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) 01455 292988 F/P 01455 292988 CHERHT@aol.com Mr John William Nunn Mrs Barbara Elsie Nunn Mrs Sharon Heather Turner Care Home 30 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (30), of places Physical disability (5), Physical disability over 65 years of age (5) Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one under the age of 55 years may be accommodated in the home in category PD. Service User Numbers - PD or PD(E) No more than 5 people who fall within categories PD or PD(E) may be admitted in the home when there are already 5 persons within those categories/combined categories already accommodated within the home. 26th November 2007 Date of last inspection Brief Description of the Service: Orchard House is a care home providing personal care and accommodation for 30 older people with a physical frailty and/or mental health needs. The home is part of the Broadoak group of homes owned by the Registered Providers Mr John William Nunn and Mrs Barbara Nunn. Mrs Sharon Turner has been the registered manager for several years. The home is situated close to the centre of the town of Market Bosworth and can be reached by private and public transport. There is parking in the road outside the home. The accommodation is a purpose built single storey home with lounges, a dining room and a mixture of single and double bedrooms all with en-suite facilities. The home is well maintained and provides a safe, comfortable and homely environment for the residents to live in. Outside, there is a well - maintained patio and garden area with seating and flower beds, which is easily reached for the residents to use in the better weather. Information about the service is provided in the home’s brochure and would be made available in other formats, such as large print if it was needed. The current registration certificate from the Commission for Social Care Inspection is available in the reception area with an up to date insurance certificate. The latest report from the Commission for Social Care Inspection is available for people to read. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 5 The home can be contacted by telephone or fax. The current fee level is £ 460.00 p.w. The people who live at the home are responsible for any additional charges such as hairdressing personal toiletries, private chiropody, newspapers, magazines, dry cleaning and homely remedies. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 2 Star. This means that the people who use this service experience good quality outcomes. This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we (throughout the report the use of ‘we’ indicates the Commission for Social Care Inspection), spent four hours reviewing information received by the Commission for Social Care Inspection (CSCI) since the last inspection on the 27th October 2007. The visit took place on the 30th August 2008 and lasted five hours. During the visit we checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that we looked at the care provided to three of the residents. To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and their families. With their permission the residents’ bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. We read the Annual Quality Assurance Assessment that the home had sent us when we asked for it. This gave us information about the home and how they have managed to achieve the national minimum standards and what they are going to do to improve the service. It also gives us numerical information about the residents and the staff. During the visit we spoke with the registered manager, the staff, the residents and families and visitors to the home. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: The Statement of purpose could include all the required information, including the results of the annual questionnaire. This would make sure that prospective residents have all the information that they need to make a decision about the home. The daily records for the residents could contain more information so that the staff have better knowledge of how the resident has been during the day or night. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 8 The complaints policy should contain the contact details for social services, so that people know who to send complaints to if they needed to. Maintenance work could be completed more regularly and more quickly to make sure that the home is safe and pleasant for the residents. The application form could be designed to have more space for the employees’ previous employment history. This would allow the manager to ask about any gaps in employment. Formal supervision of the staff should be put in place so that they can have time with their ‘line manager’ to discuss work and training issues. The manager should be given enough time to complete her management duties. 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 House DS0000001702.V371029.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3. 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are always assessed before moving into the home and they have good information to help them make the right choice about the home. EVIDENCE: All of the residents who were ‘case tracked’ told us that they had seen the Statement of Purpose and had been given the terms and conditions. The Statement of Purpose and Service Users’ Guide should give people the information that they need to know about to help them make a decision about the home. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 11 The Statement of Purpose does not contain all the information that is required by the national minimum standards, although the service user guide does have some of the informatin. Consideration should be made to include the results of the homes’ annual quality audit. This will give the prospective resident and their family a view on what people who use the service think about it. Providing a comprehensive Statement of Purpose & Service Users’ Guide gives the residents good information, making sure that they they can get the most suitable care. The manager or a senior member of staff always visits prospective residents before they are admitted to the home and there is a thorough pre admission assessment form in place. This was seen in the care plans looked at and confirmed by the residents and the families spoken with. This makes sure that that the manager and the staff in the home have the the right information before the resident is admitted, so that they can get the best care. It makes sure that the home can meet the residents’ needs and that the resident meets someone from the home who they can recognise. This makes the move into care easier to manage for them. The families spoken with confirmed that they were given the opportunity to visit the home before their relative came in and that they had a months’ trial to see if they liked it. Members of the staff spoken with said that they always knew what the residents’ needs were before they moved in. The current registration certificate from the Commission for Social Care Inspection (CSCI) was displayed in the entrance of the home with an up to date insurance certificate. The latest report from the CSCI was available in the managers’ office. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff meet the care needs of the residents as identified in the care plans with privacy, dignity and respect. EVIDENCE: All of the ‘case tracked records were found to contain good individual evidence of the care being given to the residents and reflected the care that the residents needed. The residents and the families spoken with told us about the care that they needed and that they were happy that they received it. There are records of the involvement of G.P.s, district nurses, chiropodist, optician and dentist in the care plans, showing that thorough health care is being provided for the residents. The residents and their families spoken with said that they could see the doctor Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 13 and other health professionals when they needed to. The local doctors are very supportive of the home and visit every week as well as whenever needed. A district nurse spoken with told us that the standard of care in the home was excellent and that there was good communication with the home. She told us that the staff were always aware of the needs of the residents and informed her quickly of any changes that she needed to know about. They were also aware of what they were able to do and informed her if they needed her support and help. ‘ The best home in my area’ ‘ The staff are brilliant’ There was evidence that the care plans had been reviewed regularly and had been signed by the resident to say that they had seen the care plan and agreed with it. Signing the careplans makes sure that the resident and/or their families were involved and aware of the care to be given and that they were happy with it. The residents and the families spoken with told us that they had been involved and were happy with the care being provided. The daily record of care is up to date , but could have more detail about the residents’ day. Fully completed daily records make sure that the residents receive the right care and the staff know what has happened to them during the day or night. We saw residents being treated with dignity and respect when staff spoke with them and undertook their care. The staff sat down with the residents and spoke with them individually. Staff seen giving care did so in the right way, with dignity and giving the residents privacy where needed, particularly when moving them. There are records of the residents meals and drinks that make sure that the residents are eating and drinking properly. There are records of the residents’ weight, which makes sure that they are not losing or gaining large amounts of weight. The staff spoken with were aware of the care needs of the residents and the residents and the families spoken with were happy that all care needs were being met. This was also confirmed in the response from the homes’ questionnaire and reported in the AQQA. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 14 The residents who had to stay in bed were well looked after and their care documented, this included being turned regularly to prevent damage to their skin. There were risk assessments in place to cover all the identified risks for the residents and how the staff should manage those risks. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. Comments from the residents included ‘ The staff are excellent ‘ ‘ The care is very good’ A member of a family whose relative had died in the home told us how well they were cared for until she died. They also told us that the home had excellent caring staff, who had supported the family well. Medication records for the case tracked residents were in order. Medicines are given by the senior care staff who have had training to give medicines. This was by the pharmacist who supplies the medicines and all the senior staff have completed a distance learning training in the safe handling of medicines. We saw that the medicines were administered individually and the residents were seen to be taking them. The medicines are packaged by the chemist into a ‘monitored dosage system’ where each tablet is in a separate ‘pop out’ card, which helps to make sure that the resident is always given the right medicines. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. The manager carries out a monthly written audit of the medicines and the medicine sheets to make sure that they are correct. There was a self-medicating policy in place but there were no residents looking after their own medicines at that time. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome group is excellent. This judgement is made using available evidence including a visit to the service. The residents enjoy good and varied activities and have their spiritual and nutritional needs met very well. EVIDENCE: On the day of the visit the Summer Fair was being held and a lot of the residents were helping with the preparation. The staff were seen to be involving individual residents in the process who all appeared to be enjoying it, even if just watching. Many of the staff who were off-duty came into help with the fair. There was music on in the lounge, for most of the visit, which the residents were enjoying and singing along to. The staff, the residents and the activities programme confirmed that there were regular activities such as, bingo, quizzes, sing-a-longs, word games, reminiscence group, trips and meals out. The staff watch the news with the residents and talk to them about it. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 16 There are one to one activities and individual interests catered for, one lady told us how she had been able to start painting again. Another told us how he was able to continue with some gardening, which he really appreciated. The County Link library visits regularly so the resident are able to have library books. The staff were enthusiastic about the activities and arrange their own fund raising ideas. They recently held a car wash to raise money. The residents spoken with were happy with the level of activities and said that they had plenty to do. The families spoken with felt that there were enough activities for the residents to do. The lady who did the crafts with the residents has recently left and the home are looking for someone to replace her. There was evidence in the daily records and in the care plans about the activity that the residents take part in. All the families spoken with said that they were made very welcome in the home, which we saw whilst we were there. The residents spoken with all said that they enjoyed the food and that they sometimes had two or three choices of what they had. The menus were varied and were discussed with the residents individually. We spent time talking with the residents at lunch- time. The meal looked plentiful and well presented and the residents were enjoying it. The days’ menu and the activities were displayed on a board in the home. The hairdresser visits once a week, which the residents said that they appreciated. The religious needs of the residents are met individually and through the monthly service held in the home. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. There are systems in place to support and protect residents and staff are aware of the processes. EVIDENCE: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. The contact details for Social Services are not in the policy. This could be made available in a large print and other languages if it was needed, which would make sure that as many people as possible could read it. The home has received no complaints since the last inspection on 27th October 2007. The Commission for Social Care Inspection has not received any complaints in this time. The residents and the families spoken with were aware of the policy, of how to complain and who to complain to. They were happy that their concerns would be listened to and acted on. The staff spoken with were aware of how to handle any complaints. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 18 The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the manager and the records seen supported this. Arrangements had been made for the staff to attend training in the Mental Capacity Act, which describes what people’s rights are and how they can make sure that they are meeting them. All of the staff have either got an NVQ at least at level 2 or have started the award, during which they receive training in safeguarding as well as the training given in the home. They were confident that the management would handle any issues correctly. There was information about an advocacy service displayed on the notice board so that the residents could contact them if they needed to. We looked at the accident book, which had been completed correctly. These practices make sure that the residents are safe from any abuse and that any concerns are handled correctly. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24, 26. Quality in this outcome group is good This judgement has been made using available evidence including a visit to the service. The residents are protected by the policies and procedures in the home to provide a safe environment. EVIDENCE: Orchard House is a purpose built single storey home close to the town of Market Bosworth. The home was clean and welcoming on our arrival. All of the accommodation of a large and a small lounge, a dining room and single and shared bedrooms with en-suite facilities, are on the ground floor The lounges and dining room were clean and bright, with suitable seating for the residents. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 20 All of the bedrooms seen had been personalised and were found to be clean. The residents spoken with were happy with their rooms and said that they were able to bring their own belongings in with them. The use of a shared room is discussed and agreed with the residents before they are admitted to the home and their privacy is maintained by the use of screens and each resident has their own storage for their belongings. The bathrooms were clean and clear of any items that could cause a hazard for the residents. There is a lovely patio area and gardens that are easily reached by the residents and makes a pleasant place to sit for them. The summer fair was taking place in the garden and many of the residents were going outside to join in. The residents and the families spoken with were mainly happy with the cleanliness of the home, although they told us that sometimes they were short of staff and the bedrooms were not cleaned as well as they could be. They told us that it often took a long time for maintenance work to be completed. Although the staff told us that the maintenance time had improved a little, it usually took a long time for things to be done. There are staff employed to complete the cleaning in the home and they have had training in health and safety. The cleaning products are stored in a locked cupboard, which we saw. This was confirmed by the staff spoken with and by the manager. The laundry service has improved since the home has a person who just does the washing and the ironing. The residents and the families told us that they were much happier with the service and that the clothes didn’t get lost so often. The records for hot water testing were up to date and all the temperatures were within the recommended levels. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome group is good. This judgement is made using the available evidence including a visit to the service. The recruitment policy and the training meet the residents’ needs and protect their safety. EVIDENCE: The duty rota reflected the number of staff on duty on the day of the visit and all the shifts covered by the four weeks seen had good numbers of staff. The residents, staff and families spoken with felt that there were enough numbers of staff on duty to look after their needs. We looked at two staff files and the required information was complete in both of them. This included evidence of identification, adequately completed application forms, two written references, a Criminal Records Bureau (CRB) check and a Protection of Vulnerable Adults check. The application form did not have enough space on it to give details of previous employment. This is necessary to make sure that prospective staff have the right experience and that any reasons for gaps in employment can be explained. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 22 The manager makes sure that all the required documentation is in place before an employee starts work. This was confirmed by the staff spoken with, who told us that they could not start until they had all the paperwork in place. There was evidence of staff training, including induction and the staff spoken with confirmed that they had received recent training in moving and handling, medication, dementia, safeguarding of vulnerable adults and first aid. The staff have been booked to complete training in the Mental Capacity Act. The residents and the families spoken with felt that the staff were well trained to do their job. A member of staff told us ‘ I have had a lot of training’ All of the staff either hold a National Vocational Qualification (NVQ) at least at level 2 or are in the process of completing it. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38. Quality in this outcome group is good. This judgement has been made using available evidence including a visit to the service. The residents have a management that is committed to their safety, care and needs. EVIDENCE: The registered manager, who is an experienced manager and who has managed the home for many years, accompanied us throughout the visit. The manager has completed the registered managers’ award and is registered with the Commission for Social Care Inspection. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 24 There are regular meetings held for the residents and for their families as well being seen on an individual basis, to discuss activities and menus in addition as to how the home is meeting their needs. There is an annual quality questionnaire sent to the residents and their families and the questionnaires that we saw on the visit confirmed this. The families and the residents told us that they had completed the questionnaires. We received positive comments from the residents and the families amongst which were that there was good communication with the home and that the staff were very supportive of them and their relative. The residents’ accounts were seen and all in order with two signatures on entries and receipts obtained for purchases. There was very little evidence in the records or from staff spoken with that formal staff supervision is taking place, although they regularly talk with the manager. Formal supervision of the staff gives them and their ‘line manager’ the opportunity to discuss work and training issues and needs. The manager works as part of the care staff and has limited time to complete her management role. There are regular staff meetings held, confirmed by records held and by the staff spoken with. All the areas of health and safety such as hot water temperatures and fire drills and alarm testing were found to be in order. Orchard House DS0000001702.V371029.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? None STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. Refer to Standard OP1 OP1 OP7 OP16 OP19 OP31 OP36 Good Practice Recommendations That the Statement of Purpose contains all the information shown in schedule 1 in the national minimum standards. Consideration could be made to include the results of the annual questionnaires in the Statement of Purpose. That the daily record of care is expanded to give a thorough description of the residents, day and night. That the contact details for social services are included in the complaints policy. That maintenance of the home is completed regularly and quickly. That sufficient supernumerary time is given to the manager to enable her to complete her management duties. That the registered manager arranges formal supervision at the recommended intervals. Orchard House DS0000001702.V371029.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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