Care Home: Orchard Lodge Nursing Home

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well During this inspection, observations of care and interactions between staff and residents were very positive. Staff were treating residents respectfully, offering personal choices when delivering care. The whole staff team interacted continually with the people using the service. The home ensures that prospective residents are fully assessed prior to moving into Orchard Lodge. This means that any additional equipment can be sourced and all staff can be made aware of any care needs. Personal care and support is responsive to the varied individual needs and preferences. Care plans are specific in detail and promote continuity of care in a person centered way. External healthcare facilities and services are readily resourced when required. Residents in this home are involved in meaningful daily activities and have the opportunity to join in local community events. People are encouraged to make personal choices about their lives. One resident said. " It s great here, every one wants to have a laugh". The menus provided a wide variety of choice of home cooked meals, which included home made soups daily, made with fresh ingredients. The complaints procedure is accessible to everyone living in the home. Staff working at the home understand the procedures for safeguarding, and know when incidents need to be reported externally. This service recognizes the importance of staff training, and there are sufficient competent and experienced staff to meet the needs of the people who live here. Recruitment procedures are fully adhered to so that residents are protected. The manager demonstrates a clear understanding of the key principles and focus of this service. She is enthusiastic and is striving to make continuous improvements to promote the health, safety and welfare of the residents who live in this home. Supervision records were examined, and indicated that staff are receiving regular 1:1 sessions with their line manager. Quality assurance is addressed annually in this home, and a report is generated that is available to residents, relatives, staff or any other interested parties. What has improved since the last inspection? This home provides a clean, comfortable and homely environment for the people who live here. Care plans are specific in detail and promote continuity of care in a person centered way. Resident`s finances are managed via the company`s Head Office. A substantial petty cash float is maintained in the home, and if residents require funding for any personal purchases, it is provided by the petty cash, and the residents are then invoiced each month, with an itemised statement. CARE HOMES FOR OLDER PEOPLE Orchard Lodge Nursing Home Stanbridge Road Tilsworth Bedfordshire LU7 9PN Lead Inspector Ms Louise Trainor Key Unannounced Inspection 14th January 2009 05:30 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 Lodge Nursing Home DS0000064670.V373557.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 Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Lodge Nursing Home Address Stanbridge Road Tilsworth Bedfordshire LU7 9PN 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) 01525 211059 01525 210585 orchardlodgenh@aol.com Mr Mukesh Patel Mrs Judith Dennis Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Orchard Lodge Nursing Home DS0000064670.V373557.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 with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 28 22nd January 2007 Date of last inspection Brief Description of the Service: Orchard Lodge is situated in the village of Tilsworth, near to the market town of Leighton Buzzard. The home provides accommodation and general nursing care for 28 people over the age of 65 years, within an extended Victorian country house and former vicarage. The resident’s rooms are on two floors accessed by either a shaft lift or stairs. The building also has accommodation for administration, and services including laundry room and a kitchen. There are two large communal rooms on the ground floor with lounge and dining facilities. Access to the home is via a driveway with adequate parking for staff and visitors on the forecourt. There are substantial grounds and the gardens were well tended with fish pool, decking and out door seating areas. The fees for this home range from £450.00 to £710.00 per week. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was carried out in accordance with the Commission for Social Care Inspection’s (CSCI) policy and methodologies, which require review of the key standards for the provision of a care home for older people that takes account of service users’ views and information received about the service since the last inspection. Evidence used and judgements made within the main body of the report include information from this visit. This was the first Key Inspection since January 2007. Regulatory Inspectors Mrs Sally Snelson and Mrs Louise Trainor carried it out on the 14th of January 2009, between the hours of 05:30 and 11:00 hours. The timing of this inspection was scheduled following concerns raised relating to issues relating to night staff. There was no evidence found to support these concerns. We spent the first part of the inspection, following up concerns, which had been raised prior to the visit. The two night staff that were on duty were very accommodating and assisted us as necessary. The home Manager came on duty at approximately 07:15 hours and was then available to assist throughout the rest of the inspection. During this inspection we tracked the care of two residents in detail, this involved reading their records and comparing what was documented, to the care that was being provided. We also looked at specific details in two other resident’s files. One had been recently admitted to the home. Documentation relating to: staff training and supervision and medication administration, complaints, quality assurance and health and safety in the home were also examined. We also spent some time in the communal areas of the home, talking to staff and residents and observing the care practices that were carried out during this five and a half hour inspection. We would like to thank everyone involved for their support and assistance during this visit to the home. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 6 What the service does well: During this inspection, observations of care and interactions between staff and residents were very positive. Staff were treating residents respectfully, offering personal choices when delivering care. The whole staff team interacted continually with the people using the service. The home ensures that prospective residents are fully assessed prior to moving into Orchard Lodge. This means that any additional equipment can be sourced and all staff can be made aware of any care needs. Personal care and support is responsive to the varied individual needs and preferences. Care plans are specific in detail and promote continuity of care in a person centered way. External healthcare facilities and services are readily resourced when required. Residents in this home are involved in meaningful daily activities and have the opportunity to join in local community events. People are encouraged to make personal choices about their lives. One resident said. “ It s great here, every one wants to have a laugh”. The menus provided a wide variety of choice of home cooked meals, which included home made soups daily, made with fresh ingredients. The complaints procedure is accessible to everyone living in the home. Staff working at the home understand the procedures for safeguarding, and know when incidents need to be reported externally. This service recognizes the importance of staff training, and there are sufficient competent and experienced staff to meet the needs of the people who live here. Recruitment procedures are fully adhered to so that residents are protected. The manager demonstrates a clear understanding of the key principles and focus of this service. She is enthusiastic and is striving to make continuous improvements to promote the health, safety and welfare of the residents who live in this home. Supervision records were examined, and indicated that staff are receiving regular 1:1 sessions with their line manager. Quality assurance is addressed annually in this home, and a report is generated that is available to residents, relatives, staff or any other interested parties. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: The MAR sheets were generally well completed with signatures and omission codes where appropriate. However there were several entries of ‘O’, on the MAR sheets. This indicated ‘other’; however there was no actual reason for the omission identified anywhere. We also found that medication stocks that were being carried over from one month to the next were not being recorded, nor were variable doses being recorded accurately. Therefore reconciliation of the stock was impossible. The automatic bedpan washer had been out of action intermittently since September 2008. The owner, who is the Responsible Individual, has not been completing Regulation 26 visits. These are visits that the owner, or a person on his/her behalf, is required to do monthly on an unannounced basis. The person must, talk to staff and service users about the standard of care at the home, inspect the premises and prepare written report. This home has a large garden to the rear of this property. It consists of mainly grass, however the ‘pathway’ and the unlevelled surfaces are not suitable for anyone who maybe a little unsteady on their feet or wheelchair bound. Therefore it is out of bounds for many residents in this home. We are also aware that there were concerns raised, by families about this matter in Summer 2008 with the Health and Safety Executive. We were surprised to see this had not been addressed. Please contact the provider for advice of actions taken in response to this Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 8 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 Lodge Nursing Home DS0000064670.V373557.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 Lodge Nursing Home DS0000064670.V373557.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, 4, 5, 6 People who use this service experience good quality outcomes in this area. The home ensures that prospective residents are fully assessed prior to moving into Orchard Lodge. This means that any additional equipment can be sourced and all staff can be made aware of any care needs. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home had a Statement of Purpose and Service Users Guide that were available in the front entrance of the home and to individuals. Also available in the entrance porch was a copy of the last inspection report. The Statement of Purpose and the Service Users Guide had been updated to reflect any changes within the home. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 11 People using the service were provided with a contract that detailed the room they had been allocated, the fees, and what the fees covered. There should be a breakdown of the fees in the Service Users Guide that makes it clear how much is paid toward accommodation, nursing care and personal care. We sampled the file of a person who had moved into the home two days previously. The manager had assessed this person and care plans had been formulated from the information provided. This person told us that she had been provided with information about the home before moving in and her family had visited to look around on her behalf. The home did not offer intermediate care. Orchard Lodge Nursing Home DS0000064670.V373557.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, 11 People who use this service experience good quality outcomes in this area. Personal care and support is responsive to the varied individual needs and preferences. Care plans are specific in detail and promote continuity of care in a person centered way. External healthcare facilities and services are readily resourced when required. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Care plans were written in detail and gave precise instructions about care needs. For example the personal hygiene plan for one of the people we were tracking, not only recorded information about the persons preferences for Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 13 bathing, but also included extra detail such as:- give mouth care using lemon and glycerine sticks and apply cream to lips. Keep legs moisturised with E45 cream. These details provide staff with the information they need to ensure that the people using the service receive continuity of care in a way that they have chosen and prefer. We noted that care plans had been reviewed regularly, and that as care needs altered so the care plans were updated to reflect the changes in the care needs. There was some evidence that the people using the service or their relatives had been involved in the care planning process, but this could be improved upon. All of the residents that we spoke to were complementary about the care provided. One person told us. “They (referring to staff) are always so helpful and kind. I never have to ask for anything extra”. In addition to the care plans staff had produced a ‘plan of daily routine’. This was a summary of the care that each individual using the service needed. Because this was written on one page, it was easy to use, and would give clear instructions to staff who were not familiar with a particular resident, such as new staff or agency staff. Staff completed a daily progress log at least twice a day for every person using the service. These logs were in great detail. During the inspection we saw people being moved safely, and moving and handling equipment being used appropriately. It was clear that people were provided with pressure relieving equipment, and the correct moving and handling equipment following an assessment of needs. We also noted that associated risk assessments were in place. Those people that needed fluid or turning charts had these in place. However these were not always being completed as tasks were carried out. We reminded the manager that these sheets should not be completed either prior to care being carried out or in retrospect, as they are legal documents. It was the manager’s opinion that these charts were only completed to provide evidence, and she felt confident that her staff were providing the correct care. At the time of this inspection, none of the residents in this home had any pressure sores. This suggests that the care is being carried out as described in the care plans, despite irregularities in record charts. Both of the files we looked at had the wishes of the person or the family about the arrangements that should be made at the time of sudden illness or death. The GP and the home manager had also been involved in signing ‘resuscitation orders’. Care must be taken that there is sufficient evidence that these documents fit with the Mental Capacity Act. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 14 We examined the Medication Administration Records (MAR) sheets for all the residents in this home. They were generally well completed with signatures and omission codes where appropriate. However there were several entries of ‘O’, on the MAR sheets. This indicated ‘other’; however there was no actual reason for the omission identified anywhere. We also found that medication stocks that were being carried over from one month to the next were not being recorded, nor were variable doses being recorded accurately. Therefore reconciliation of the stock was impossible. The Controlled Drugs (CD)’s were stored appropriately, and all administrations and stock levels were clearly recorded. These all reconciled correctly. Orchard Lodge Nursing Home DS0000064670.V373557.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 People who use this service experience good quality outcomes in this area. Residents in this home are involved in meaningful daily activities and have the opportunity to join in local community events. People are encouraged to make personal choices about their lives. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home employed an activity co-ordinator who has planned a programme of group activities that included; visits from local religious leaders, outside entertainers, quizzes, film afternoons and reminiscence. The home was also one of the local libraries mobile stops. At the time of the inspection the home was having some major refurbishment work carried out. As a result there were a number of empty beds the activity co-ordinator had told the manager that with reduced numbers, group activities Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 16 were not so easy. The activity co-ordinator also spent time doing one-to-one activities with residents, and would take individuals out if they wanted it. Residents told us that they could have visitors when they wanted and that they could take them to their bedrooms or meet with them in one of the communal rooms. We witnessed one resident having a visit from great grandchildren, which pleased her and others in the home. During this inspection we observed the breakfast service. It was very apparent that people were treated as individuals. Some residents chose to have their breakfast in the dining room, while others choose to stay in their bedrooms. Two housekeeping staff and the activity co-ordinator helped with mealtimes. We saw people having whatever they requested for breakfast. This ranged from cereals and toast, to porridge (that had been cooked slowly overnight), croissants, bananas and yogurts and prunes, served in various combinations. We also overheard a member of staffing talking to a resident about his likes and dislikes and suggesting that as he had a particular liking for mushrooms, he might like to have them on toast one day for breakfast. The menus provided a wide variety of choice of home cooked meals, which included home made soups daily, made with fresh ingredients. Orchard Lodge Nursing Home DS0000064670.V373557.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 People who use this service experience good quality outcomes in this area. The complaints procedure is accessible to everyone living in the home. Staff working at the home understand the procedures for safeguarding, and know when incidents need to be reported externally. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The Home has a clear complaints policy that is displayed in the entrance to the home. We looked at the complaints file. There was a flow chart diagram at the front of the folder, which identified a clear ‘pathway’ for all complaints and allegations. There had been several complaints filed over the past year. Each was clearly dated, and a letter of response had been sent within the policies specified time frame. Where appropriate, copies of statements and meetings, which formed part of investigations were clearly filed, as were any actions, which resulted from investigations, such as additional training sessions. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 18 There were cards of gratitude and thanks displayed in the nursing office, and we read one letter that read. “Mum was very happy there, and received the best care that anyone could have given her. I cannot commend the staff at Orchard Lodge enough”. There is a safeguarding policy in place, which is easily accessible to staff. The latest Local Protocols are also available for reference if required. These had been reviewed in July 2008, and clearly identified what incidents should be reported to whom, and which would be escalated for a higher investigation. Staff files that we looked at indicated that staff had all attended training to support their Safeguarding knowledge. Orchard Lodge Nursing Home DS0000064670.V373557.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): 19,26 People who use this service experience adequate quality outcomes in this area. This home provides a clean, comfortable and homely environment for the people who live here, however some areas of the home have ongoing building work, which can be periodically disturbing to the environment. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: During this inspection a full tour of the premises took place. Since the previous inspection, there has been some major building work, and the home has now increased its’ occupancy to a maximum of twenty eight residents. However at Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 20 present there are twelve rooms empty. It has also got a second communal lounge area, which is very bright and spacious. The final phase of the building work is ongoing and at present the front driveway of the home does present a potential hazard for any visitors to the home. We were also concerned that the room that has been allocated as the laundry room, is very small and has no windows or ventilation. This is not acceptable and will present a health and safety risk to staff. The home was clean throughout, and there was no evidence of any offensive odours during this visit. The communal areas were clean and tidy, and provided comfortable seating and dining areas large enough to accommodate the residents in this home. Bedrooms were decorated and furnished according to personal taste, and photographs and personal assets in the rooms reflected the personal life histories of the individual residents. One bedroom displayed a decorative certificate that had been awarded to the resident for a school project in 1933. The kitchen area was absolutely spotless and a credit to the staff. In the past there had been as assessment of the building by an occupational therapist. This report assisted staff in the positioning of aids throughout the home. This home has a large garden to the rear of this property. It consists of mainly grass, however the ‘pathway’ and the unlevelled surfaces are not suitable for anyone who maybe a little unsteady on their feet or wheelchair bound. Therefore it is out of bounds for many residents in this home. We are also aware that there were concerns raised, by families about this matter in Summer 2008 with the Health and Safety Executive. We were surprised to see this had not been addressed. Orchard Lodge Nursing Home DS0000064670.V373557.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 People who use this service experience good quality outcomes in this area. This service recognizes the importance of staff training, and there are sufficient competent and experienced staff to meet the needs of the people who live here. Recruitment procedures are fully adhered to so that residents are protected We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: During this inspection we examined the files of three members of staff. Each of these files contained fully completed application forms that included an employment history, references that had been obtained from appropriate referees, Criminal Records Bureau (CRB) and POVA first checks, that had been confirmed prior to commencing employment. There were various forms of identification including a coloured photograph and numerous documents providing proof of address, health questionnaires and contracts that had been appropriately signed and dated. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 22 Staff appraisals and supervision records were completed, and there were certificates in all files to indicate that staff are attending training as and when it is required. Discussions with the manager revealed that she is very aware of the one or two staff that are not as forthcoming attending training, and she is managing this situation. One file that we looked at also contained correspondences relating to a disciplinary matter, and clearly identified actions that were taken. During this inspection, observations of care and interactions between staff and residents were very positive. Staff were treating residents respectfully, offering personal choices when delivering care. Moving and Handling techniques that we observed were being done in a competent and confident manner. Although we did not speak with any staff in depth, as they were too busy, we did talk to one or two in passing. They said they felt well supported by the manager, one said. “She’s a great boss”. Some staff were however a little concerned that due to having only sixteen residents presently living in the home, instead of the registered twenty-eight, they were having some of their hours cut. This was a little worrying. A list on the wall in the office identified the authenticity and renewal dates of the qualified nurses Personal Index Numbers (PIN) s. There was also a list in the office that informed all staff on duty of emergency telephone numbers and the senior member of staff on call. Orchard Lodge Nursing Home DS0000064670.V373557.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, 32, 33, 35, 36, 37, 38 People who use this service experience good quality outcomes in this area. The manager demonstrates a clear understanding of the key principles and focus of this service. She is enthusiastic and is striving to make continuous improvements to promote the health, safety and welfare of the residents who live in this home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager of this home has been working here for sixteen years and is very committed to this home. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 24 From this inspection it was very evident that she is very focused on an individual approach to care and individual’s choices and preferences are a priority in care delivery. She spends time working with her staff ‘on the shop floor’, which allows her to constantly monitor the standard of care being delivered in the home. An administrator supports her one-day a week, and all the documentation that we examined was very organised and generally well presented. However there are presently twelve empty beds in the home, and we are concerned that if the occupancy was to increase suddenly, this may not be sufficient administrative hours to maintain these standards. Residents and staff are all kept well informed about changes, and progress in the home through, meetings, and a manager who is visible and freely accessible to them. Supervision records were examined, and indicated that staff are receiving regular 1:1 sessions with their line manager. There were notices throughout the home warning people of the weekly fire alarm tests. These are carried out by the maintenance man. He also checks all other fire equipment, emergency lighting and water temperatures as necessary. The last fire authority report was satisfactory. Moving and handling and fire equipment was labelled to identify that it had been tested within the last year. There were infection control procedures in place. We witnessed staff using gloves and aprons appropriately. The automatic bedpan washer had been out of action intermittently since September 2008, and this is being addressed. However despite this, the home had no unpleasant odours or indication of infection. Accidents and incidents are being recorded and reported appropriately. Quality assurance is addressed annually in this home, and a report is generated that is available to residents, relatives, staff or any other interested parties. The owner was not completing Regulation visits. These are visits that the owner, or a person on his/her behalf, is required to do monthly on an unannounced basis. The person must, talk to staff and service users about the standard of care at the home, inspect the premises and prepare written report. Resident’s finances are managed via the company’s Head Office. A substantial petty cash float is maintained in the home, and if residents require funding for Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 25 any personal purchases, it is provided by the petty cash, and the residents are then invoiced each month, with an itemised statement. Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 3 3 3 3 2 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 3 2 X 3 3 3 3 Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 27 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 OP9 Regulation 13(2) Requirement Timescale for action 30/01/09 2. OP19 23(2)(o) 3. OP33 26 People who live in this home must be protected by accurate records for medication administration. The external ground of this home 06/03/09 must be suitable so that residents can access them safely. The registered provider must 30/01/09 make monthly visits to the home, after which he will prepare a report summarising his findings. These reports must be sent to CSCI. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Orchard Lodge Nursing Home DS0000064670.V373557.R01.S.doc Version 5.2 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!