Care Home: Orchard Manor Transition Service

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What the care home does well Within the relatives` surveys we received the following comments: (the resident they are linked with) "...seems very happy so (they) must be well cared for." Another of these surveys said "They really make this ...home...."We are fully confident in the care (my relative) receives and have no concerns at all about (their) well-being." Another relative wrote, in their survey, "Orchard Manor has a holistic approach to (my relative`s) care." Prospective residents have a good standard of information to assist them in their decision where to live and there are good systems in place to ensure the home is a suitable place for them to live in. People are protected by an excellent standard of record keeping and are supported to live the life they choose within a framework of risk. People are provided with a wide range of opportunities to live an excellent quality of life.People are safe as their personal and health care needs are met to an excellent standard. People can be confident that they are listened to and safe from the risk of abuse. People live in a comfortable and clean home. People can be confident that they receive safe and proper care from staff who are well-recruited and generally well trained. People benefit from a well-managed home. What has improved since the last inspection? All of the three recommendations have been considered. Overall the quality of the service has improved from being assessed as a good service to become an excellent service. What the care home could do better: We must be notified of any untoward incident occurring in the home that affects the well-being of any resident. We have made no requirement on this occasion as we expect appropriate action to be taken by the home. The names of any person, who has attended a fire drill exercise, should be recorded. CARE HOME ADULTS 18-65 Orchard Manor Transition Service Manor Road, Fenny Lane Meldreth Royston Hertfordshire SG8 6LG Lead Inspector Elaine Boismier Unannounced Inspection 29th July 2008 9:55 Orchard Manor Transition Service DS0000067372.V369037.R03.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 Manor Transition Service DS0000067372.V369037.R03.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 Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Manor Transition Service Address Manor Road, Fenny Lane Meldreth Royston Hertfordshire SG8 6LG 01763 268030 01763 268026 chris.callaby@scope.org.uk www.scope.org.uk SCOPE 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) Miss Christine Callaby Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2007 Brief Description of the Service: Orchard Manor currently provides 20 places for a service specifically aimed at young adults leaving education. An application to increase the number of these places has been received and this is now under consideration. The service offers structured opportunities to learn and develop a variety of skills, as well as taking part in a range of social and leisure activities. The service provides support to a range of residents with complex health and physical care needs. The service is based in the village of Meldreth, close to the Cambridgeshire/Hertfordshire border, but within easy reach of all amenities. Current fees range between £1842 and £3265 per week depending on the assessed needs of the resident and the level of support that is required. Additional costs include those for clothing, toiletries and contributions to holidays. Further information about the fees can be obtained from the home. Copies of CSCI inspection reports are available on request or via our website at www.csci.org.uk Orchard Manor Transition Service DS0000067372.V369037.R03.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 3 stars. This means the people who use this service experience excellent quality outcomes. We, The Commission for Social Care Inspection, carried out an unannounced key inspection, by two Inspectors, between 9:55 and 14:00 and it took just over 4 hours to complete. We looked around the premises, spoke the staff, observed what was happening in the home, including activities of both the residents and the staff and we looked at documentation. Most of the residents were engaged in activities or out of the home and one person we spoke with was able to tell us their view about what they had done that morning, by non-verbal communication. Before the inspection we received a completed Annual Quality Assurance Assessment and surveys from residents, relatives/visitors and care staff. We also spoke with a relative, via the telephone. For the purpose of this inspection report people who live at Orchard Manor Transition Service are referred to as “people”, “person” or “resident/s”. For the purpose of this report the Head of Service and the Registered Manager are referred to as the Management Team. What the service does well: Within the relatives’ surveys we received the following comments: (the resident they are linked with) “…seems very happy so (they) must be well cared for.” Another of these surveys said “They really make this …home….”We are fully confident in the care (my relative) receives and have no concerns at all about (their) well-being.” Another relative wrote, in their survey, “Orchard Manor has a holistic approach to (my relative’s) care.” Prospective residents have a good standard of information to assist them in their decision where to live and there are good systems in place to ensure the home is a suitable place for them to live in. People are protected by an excellent standard of record keeping and are supported to live the life they choose within a framework of risk. People are provided with a wide range of opportunities to live an excellent quality of life. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 6 People are safe as their personal and health care needs are met to an excellent standard. People can be confident that they are listened to and safe from the risk of abuse. People live in a comfortable and clean home. People can be confident that they receive safe and proper care from staff who are well-recruited and generally well trained. People benefit from a well-managed home. 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 Manor Transition Service DS0000067372.V369037.R03.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 Manor Transition Service DS0000067372.V369037.R03.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): 1 & 2 Quality in this outcome area is good. Prospective residents have a good standard of information to assist them in their decision where to live and there are good systems in place to ensure the home is a suitable place for them to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four of the residents’ surveys said that the person knew about the home before they moved in. (The other 4 residents’ surveys did not ask for this information). In the main reception area information about the home was available. The AQAA told us “Residents visit the service early on to choose the service and usually follow up with a residential assessment prior to an offer of placement. This assessment is carried out by at least the registered manager or usually by the interdisciplinary team which includes support workers, skills tutors, speech and language therapists, physiotherapist and O.T. The team establish that we can meet the individuals care/support needs and then use this assessment to aid the initial placement and the initial person centred support plan, including care and development plans and therapy input. Where an individual would find it difficult to attend Orchard Manor, a team of staff would visit them to assess.” Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 9 Staff described the pre-admission process and this included visits to the home, before the person moved in, so that everyone involved could assess if the home was suitable to meet the needs of the prospective resident. Orchard Manor Transition Service DS0000067372.V369037.R03.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): 6,7& 9 Quality in this outcome area is excellent. People are protected by an excellent standard of record keeping and are supported to live the life they choose within a framework of risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two recommendations were made with regards to people’s care records and both of these recommendations have been considered: there were details of visits and appointments with healthcare professionals and there was recorded evidence that staff signed when they had read individual care plans. The AQAA told us “We have a very person centred approach which is based on a respect for the individual resident. All residents have clear care plans which are devised by the interdisciplinary team which includes social care staff, skills tutors and therapists. Work is undertaken with residents to ensure that the residents wishes and aspirations lead the plan.” Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 11 The care plan that we examined was detailed, person centred and presented in an easy read and pictorial format for the person to understand the contents of their care plan. Discussion with the staff and examination of the person’s care files indicated that the person was actively consulted about their care and this care included both their physical and socials needs and wants. During our discusssions with staff we were provided with evidence that staff were knowledgeable about the wishes and needs of the people that they looked after as recorded in the person’s care records. Although a multidisciplinary review of the person’s needs exceeded the recommended 6 monthly interval (the review was carried out in October 2007) the record of this was detailed and provided contributions from the music and drama department, the skills development department and physiotherapist and occupational therapist. Detailed risk assessments were in place for activities and these included any activity that the person might have taken part in, such as when on holiday (e.g. swimming, having a shower, being in bed with no bed rails provided and going to a night club with strobe lighting-that could trigger a seizure). All of the residents’ surveys and surveys from relatives, said that the person was able to make decisions and live the life they choose, as much as they were able to, and at any time, including evenings and weekends, with the support from care staff. Discussion with staff, observation of people’s activities and examination of a person’s care plan indicated that people’s choices and needs are valued and respected. Orchard Manor Transition Service DS0000067372.V369037.R03.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): 12,13,14,15,16 & 17 Quality in this outcome area is excellent. People are provided with a wide range of opportunities to live an excellent quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: According to the Management Team no person currently living at the home attends any external educational facility. However the home provides skills training facilities. We saw some of the people in this part of the home, being supported by staff. According to the AQAA “We are reviewing the Skills Development Centres session content to better reflect what the young people wish to do, so the focus will be on the exciting, more active sessions with course style themes such as music, drama, media, personal growth and development (including communication and community interaction, including mobility).” Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 13 The AQAA also told us “Residents are involved in the local community and use the facilities that most people use such as restaurants, pubs, sports and leisure facilities, libraries, public transport, cinemas and theatres”. Four of the residents’ surveys said that there are “good” activities provided. (The other 4 residents’ surveys did not ask for this information). Another resident’s survey said that the person listened to music and watched television programmes that they liked. Other times they went on the train to a local town and they went swimming. We saw people returning from a trip to a local library and a person had expressed their enjoyment of having had a horse riding session in the morning. Records of activities were seen and these included a wide range such as going shopping, swimming, visiting tea rooms and watching a film. Some of the people were out of the home, on holiday with their families. Records, including personal photographs, and discussion with the staff indicated that people are well supported in maintaining contact with their families and friends. All of the 5 surveys from relatives said that the home met the needs of the resident that they were linked with. One of these said that the home supports the person as they do …”most of the things that a young person does but with a lot of help from (their) carers.” Another of these surveys said that the home does well as it” Provide(s) good social experiences.” The 5 surveys from residents’ relatives said the home supports residents in keeping in contact with their family, to include sending birthday cards and father’s and mother’s day cards, on behalf of the resident, to their parents. One of the surveys, from staff, said that the home does well as it ”…is very supportive of service users and their families, helping them to maintain close relationships and bonds.” Two of the 4 residents’ surveys said that the person liked the food; one of these surveys said that the person “sometimes” liked their food; the remaining survey said that the person had their food by artificial methods. (The other four surveys did not ask about people’s views about the food). We saw from our examination of the four week-menu that people have a range and choice of food, including “traditional” English food, such as beef with vegetables to curries and Italian food. A cooked option was available at both the lunch time and at tea/supper time with a desert to follow. During our visit to the kitchen/dining area of Flat 2 we saw there were individual eating plans for people, providing clear guidance for the staff in what people’s individual dietary and feeding needs were, including any specialist Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 14 equipment that the person needed to help them with their food. According to the Management Team this guidance was compiled in conjunction with the speech and language therapist (who is responsible for assessing and providing advice for people with difficulties in swallowing). Some of the people were unable to eat their food by normal methods and had their food via artificial methods i.e. via tubes. Each person’s feeds and nutritional supplements were stored in individual cupboards and on shelves that were labelled with people’s individual names- thus ensuring that the person receives the correct food that they had been prescribed. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20Quality in this outcome area is excellent. People are safe as their personal and health care needs are met to an excellent standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three of the 4 residents’ said that the person liked living at the home; the other survey said that the person “sometimes” liked living at the home. (The other 4 residents’ surveys did not ask for this information). All of the relatives’ survey said that the home provided the support to the person they were linked with. One of these surveys said that the resident, they were linked with, was…”well-looked after” and that the person “…seems very happy so (they) must be well cared for.” Another of these surveys said “They really make this …home….”We are fully confident in the care (my relative) receives and have no concerns at all about (their) well-being.” Another relative wrote, in their survey, “Orchard Manor has a holistic approach to (my relative’s) care.” Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 16 Four of the residents’ surveys said that the person felt they were well cared for. (The other 4 residents’ surveys did not ask for this information). We saw from our observations, discussion with the staff and examination of a person’s care records that people are provided with the support and care to promote a good sense of well-being of the residents. Discussion with the staff and examination of a person’s care records indicated that the person had access to a wide range of health care professionals including dentistry services, hospital out patient clinics, district nursing and GP services, speech and language therapy, occupational therapy and a private chiropractor. The Management Team told us that there are “in-house” services to include those for speech and language therapy, physiotherapy and occupational therapy. People are weighed each month as we saw in two people’s care records and there was evidence that these these were satisfactory, including intentional weight gain in a person who was admitted to the home who was considered underweight (i.e. less than 30 kilogrammes). We assessed medication practices in Flat 2. Medication is administered by staff who have attended training in safe adminstration of medication and have been assessed as competent to carry out this personal care tasks. The staff responded appropriately to the questions we asked them e.g. labelling of medication and no medication, prescribed for a person, was to be used for any other person. According to the staff none of the current residents are able to take their own medication. Medication records, including those for receipt, adminstration and for medication going out of the home, were satisfactory. Although the air temperature of the rooms, where medication is stored, is not recorded, the air temperature was satisfactory (it was a warm day) and, according to the staff, the rooms are the coolest part of the building. Stock levels were satisfactory. We saw no reported incidents of medication errors in the record of accidents. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. People can be confident that they are listened to and safe from the risk of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA told us “We have a proactive approach to working with residents and their families. This has meant that issues are resolved prior to them becoming complaints. This has meant that we have had no complaints in the last 12 months.” We have received no complaint made against the home since our last inspection, in September 2007. Four of the residents’ surveys said that staff listened to the person and acted on what was said to them. (The other 4 residents’ surveys did not ask for this information). All of the 8 residents’ surveys said that the person knew who to speak to if they were unhappy about something and 4 of these surveys said the person knew how to make a complaint. (The other 4 residents’ surveys did not ask for this information). Seven of the 8 relatives’ surveys said that the person knew how to make a complaint. The remaining relative’s surveys said that the person could not remember if they knew what to do if they wanted to make a complaint although the person was confident that the home had such a policy and procedure. The person added, “To be honest, this situation hasn’t arisen.” Another of these residents’ surveys said that every time the person visited the Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 18 home they were asked if they had any suggestions to improve “…regarding my (relative’s) care, and/or the service in general”. Any concerns that have been made, the respondents of the surveys that this was applicable to, were responded to in an appropriate way. Three of the 4 staff surveys said that the person knew what to do if any person, including visitors, had concerns about the home. The AQAA told us that the last review of the safeguarding policy was November 2002. Since we received the AQAA the home has received a 2008 safeguarding policy from both the local authority and from SCOPE. (Safeguarding was previously referred to as protection of vulnerable adults against abuse or POVA). All of the residents’ surveys said that staff treated the person well and that staff respected the person’s privacy and 4 of these surveys said that the person felt safe. (The other 4 residents’ surveys did not ask for this information). Staff told us what they would do, should they witness any incident of abuse against any resident, and the information they provided demonstrated that these staff were aware of safeguarding procedures. The staff training records indicated that 32 of the 33 staff have attended training in safeguarding awareness. An examination was carried out of the record of a person’s personal allowances and receipts of their money that had been spent; findings indicated that this person’s personal monies were safeguarded by the home. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,29 & 30 Quality in this outcome area is good. People live in a comfortable and clean home that is generally well-maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA told us that currently there are two flats with the intention of increasing this accommodation to three. According also to the AQAA “We have our own cinema, a large skills development centre, access to a hydro pool and trampoline as well as extensive gardens.” Improvements within the last 12 months include “…refurbished the residential aspect of the service providing two spacious flats which are light and airy. The flats have been rewired, redecorated, new window have been installed” and “ We have installed our own cinema system. We have also installed significant amounts of hoisting systems, both ceiling and mobile units.” During our tour of the premises we were able to confirm that what the AQAA told us was the case. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 20 The Management Team has considered ways to improve some of the bedroom carpets and the damaged areas of some of the walls and some of the door frames. Bedrooms were decorated and furnished to reflect the people’s individuality. All of the 8 residents’ surveys said that the home was always clean and fresh and we found the home to be airy, light, clean and fresh smelling. The laundry provides sluice facilities for soiled linen and clothes and the location of the laundry room is away from food preparation areas. The AQAA told us that 54 of care staff have attended training in the prevention of infection control and the management of infection. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 &35 Quality in this outcome area is good. People can be confident that they receive safe and proper care from staff who are well-recruited and generally well trained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Of the current care staff 35.29 have an NVQ level 2, or equivalent, in care with 29.4 working towards this qualification. Within the staff surveys there was a range of views about the number of staff to meet the individual needs of the people. These views ranged from there were “always” a sufficient number of staff to “sometimes” there was enough staff. One of these surveys said, “We have enough staff for personal care areas, but not so much for activities.” Another of these surveys said staff cover ”… can sometimes be difficult to find cover at short notice. Also changing needs of some residents has meant they require 1:1 staffing…” The staff we spoke with considered that there was enough staff on duty with the exception of unplanned leave such as sickness when agency staff might be used. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 22 We saw people receiving individual care and activities, such as going to a local library in the mini bus with the escort of two staff. Two staff files were examined and all the required information about the person had been obtained before they started working at the home. All of the 4 surveys from staff said that the person had received an induction programme that covered everything the member of staff needed to know to do their job and that the home provides up to date training opportunities, for staff, to ensure that they can meet the individual needs of the residents. One staff survey said, “Training very good and lots of it.” The staff training records and discussion with the staff indicated that staff have attended ongoing training to include the Mental Capacity Act and care of a person with epilepsy and care of people needing their food given by artificial methods. On the day we were at the home staff were attending training in how to care for a person needing to have their food via a naso-gastric tube. A recommendation made has been considered as there was a clear record of training that staff have attended. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. People benefit from a well-managed home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Head of Service and the Registered Manager manage the home. The AQAA told us “The registered manager has a Level 4 NVQ in care and a Level 4 Registered Managers Award.” She has 29 years experience of working with people, including children, with a learning disability. The overall rating of the home has improved from good to excellent quality outcomes for residents, indicating that the home is well-managed to achieve this improved rating. Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 24 From our examination of the record of accidents for June and July 2008 we noted that we had not received information about some of these incidents. We have made no requirement on this occasion as we expect the home to respond appropriately to this issue. As part of the home’s quality assurance the policies and procedures have been reviewed within the last 12 months. People visiting the home are asked to write their views in the surveys and we saw some of these. The AQAA was completed in a detailed manner and it identified areas that the home does well in, what has improved within the last 12 months and areas that the home could improve upon, which had been identified by the home’s internal quality assurance systems. Discussion with the Management Team indicated that there is an ongoing review of the service and what areas the home wished to improve upon e.g. staff recruitment, staff retention and staff training. Information provided by the AQAA told us that service checks are in date for hoists and lifts and portable appliance tests and we saw this was the case. Information also provided by the AQAA told us 75 of catering staff and 54 of care staff have attended training in safe food handling. Two of the three food fridges, in the Flats, had cheese not completely covered, and no date of when it was opened. Immediate action was taken by the home. Staff told us, and examination of the staff training records indicated, that the majority of staff have attended training in first aid and health and safety (97 ). All staff have attended training in safe moving and handling and on the day staff were attending training in moving and handling. Records for fire alarm tests and checks of the temperatures of hot water in baths and showers were satisfactory. Although the current records for emergency lighting tests were not available for inspection the Management Team reported that these checks are carried out at the same time as the fire alarm tests. An environmental health officer awarded the main kitchen a four star rating in January 2008. We saw that the records of the cleaning timetables and records of the temperatures of this kitchen’s food fridges and freezers were, recently, not consistently recorded. According to the Manager this issue currently being addressed. The record of fire drills indicated that these are carried out on a regular basis although there were no names of any person, who had attended these fire Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 25 safety exercises, entered on the records. We expect the home to manage this as part of good practice. Orchard Manor Transition Service DS0000067372.V369037.R03.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 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 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 3 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 3 13 4 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 3 x 3 x x 3 x Orchard Manor Transition Service DS0000067372.V369037.R03.S.doc Version 5.2 Page 27 NO Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations Orchard Manor Transition Service DS0000067372.V369037.R03.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 Manor Transition Service DS0000067372.V369037.R03.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. 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