Care Home: Orchard (The) - Leonard Cheshire Disability

What the care home does well Residents are able to take part in pursuits that they enjoy and a wide range of activities is provided by the Activities Co-ordinator/Volunteer Organiser, other staff and volunteers. Staff from a local further education college visit the home to provide courses for service users. Everyone has the chance to be involved in the running of the home and take part in the recruitment of new staff. Several residents also act as volunteers themselves. The Orchard has an active staff training programme and nearly all care staff now have an appropriate NVQ. The catering staff make sure there are choices at mealtimes; the people who live there help to choose the menu and told us that they enjoy their meals. The home was built specifically to be used by disabled people and has a high standard of equipment and accessibility. The Orchard is bright and spacious and everyone has their own individual room. What has improved since the last inspection? The programme of redecoration and refurbishment has continued. Yet more volunteers have been recruited to support the people who live at The Orchard to take part in activities that they enjoy.Orchard (The) - Leonard Cheshire DisabilityDS0000025360.V376003.R01.S.docVersion 5.2 What the care home could do better: The recording of medication still needs to be improved. The service user guide should be reviewed. Key inspection report CARE HOME ADULTS 18-65 Orchard (The) - Leonard Cheshire Disability Woolton Road Liverpool Merseyside L25 7UL Lead Inspector Peter Cresswell Key Unannounced Inspection 16th June 2009 09:00 Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard (The) - Leonard Cheshire Disability Address Woolton Road Liverpool Merseyside L25 7UL 0151 428 8671 0151 421 1356 www.s.maxwell@nw.leonard-cheshire.org.uk www.LCDisability.org Leonard Cheshire Disability 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) Michelle Maxwell Care Home 27 Category(ies) of Physical disability (27) registration, with number of places Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability - Code PD The maximum number of people who can be accommodated is: 27 8th June 2009 Date of last inspection Brief Description of the Service: The Orchard is a care home for 27 disabled adults, owned by ‘Leonard Cheshire Disability’, a well established charity that provides a variety of services for disabled people in the United Kingdom and Europe. The home is in the suburbs of south Liverpool, a short drive from Woolton Village where there are shops, pubs, banks, a post office, cinema and many other amenities. The Orchard is purpose built, standing in its own well-maintained and accessible grounds. All residents’ accommodation and facilities are on the ground floor. Everyone has a single bedroom though one bedroom can be shared if required. Four bedrooms have en-suite facilities. There are three lounges, one of which has a wide range of games, activities, a computer with internet access and kitchen equipment. The breakfast/coffee bar, where residents can make drinks and snacks, is linked to the dining room. The home employs a full time activities co-ordinator/volunteer organiser who, with the support of residents, volunteers and staff, plans and supports a varied range of activities and entertainment within and outside The Orchard. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.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 three star. This means the people who use this service experience excellent quality outcomes. This inspection included a visit to The Orchard. We did not tell anyone that we were going and went back a few days later to see the manager, who was not in when we first called, and look at some additional documents. On our first visit we spoke to a number of people who live at The Orchard, the activities organiser and several other staff. On our second visit we spoke to the registered manager and the regional manager who was visiting the home. We toured the home, visiting all of the shared areas and most of the bedrooms. We examined admission documents, care plans, medication, fire safety records, staff recruitment files training records and the menu. The manager had completed an Annual Quality Assurance Assessment (AQAA) for the Care Quality Commission some weeks before the site visit. The AQAA includes the service’s own assessment of how it is meeting people’s needs as well as statistical information about the home. What the service does well: What has improved since the last inspection? The programme of redecoration and refurbishment has continued. Yet more volunteers have been recruited to support the people who live at The Orchard to take part in activities that they enjoy. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 6 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are thoroughly assessed before they move into The Orchard, using nationally agreed procedures, so the home can meet their needs. EVIDENCE: The service user guide was on display by the signing in table at the main entrance. It was last reviewed in 2007 and there are now some minor inaccuracies so the guide should be reviewed again. We looked at the files for two people who had been admitted since the last inspection. They had been assessed by a local authority social worker, the Registered Manager and the Care Services Manager (deputy manager in effect). We spoke to one of them, who confirmed that she had visited the home before she decided to move in. One of the assessments was missing and the manager explained that it was currently with the regional office as some contractual discussions were being discussed. When this sort of thing happens a copy should be kept in the home. Care plans and an Individual Service Plan (ISP) were on the file. Fees for The Orchard are negotiated individually with commissioning bodies and depend on the needs of each particular person. They range from £595 to £870 a week. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide staff with the information they need to care for the residents, who are involved as far as possible in every aspect of the home’s life. EVIDENCE: When we visited the home we looked in detail at three individual case files. Each had a detailed Individual Service Plan (ISP) and a care plan summary that had been drawn up from it. These describe the care that the person involved needs. The ISPs and care plans are reviewed every three months, with a major review once a year. The files also contain pen pictures that give a useful overall impression of the person concerned. These are usually drawn up with the residents and, where they wish, their families. The daily reports file is kept separately, though the entries are rather functional. Residents make their own decisions unless there is good reason for any limitations, which are then carefully recorded on the ISP. People who live at The Orchard have regular meetings and also take part in interviewing applicants for jobs. They are also invited to complete questionnaires on how the home is running and Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 10 the results are published every year, though the latest report was not yet ready when we visited. People are encouraged to take appropriate and proportionate risks and risk assessments are in place. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 11 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): This is what people staying in this care home experience: 11, 12, 13, 14, 15, 16, 17. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Orchard has excellent links with the community and people are enabled and supported to pursue activities and pastimes that they like. Some residents assist in this as volunteers, increasing their capacity for personal development. People receive a balanced diet which most of them enjoy. EVIDENCE: The Orchard has a full time activities organiser/volunteer co-ordinator who, with the support of other staff, residents and volunteers, arranges a wide range of activities, both inside and outside the home. The home normally has two full time overseas volunteers staying at The Orchard during a ‘gap year’ and there were two from Australia when we visited. Some of the residents are also volunteers and they receive the same training as external volunteers. The Orchard has a greenhouse and raised plant beds in the central courtyard so wheelchair users can plant and care for plants. Much of the produce is used Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 12 in the kitchen – lettuce and potatoes were growing when we visited. Staff from Hugh Baird Further Education College provide a life skills course on the premises, and a qualified volunteer is training people in Powerpoint presentation. Some of the residents have been carrying out research locally to form the basis of presentations. Some people also go out to courses in local colleges. Staff (usually key workers), volunteers and staff from outside voluntary groups accompany individual residents on individual social days, which are activities they choose themselves. This includes shopping and one person was getting ready to go out with a voluntary agency worker when we went round the home. He told us that he was looking forward to getting a new magazine at the shops. The home has a vehicle with a hoist which can cope with wheelchairs. It is rather old and the home is trying to raise funds for a replacement. The system for recording individual activities did not give the full picture of the activities in which people take told us they take part and the manager said that this was mainly because of the limitations of the IPL records. She is trying to change the system to make a better record possible. Activities within the home include gardening, crafts, baking, board games, movies (large screen in the lounge) and coffee mornings. The home has a substantial library. The activities room has computers installed and many residents also have their own computers, televisions and radios. Many people make some of their own arrangements for leisure activities; one person told us ‘I tend do my own thing’. Many people prepare their own breakfast at the breakfast/drinks bar, though cooked breakfasts are often available. Several were getting their breakfast when we arrived. The main meal is served at lunchtime, which people say they prefer. On the first day we called the main lunch was ‘sausage plait’ which people seemed to enjoy. The menu for the rest of the week included chicken curry, fish and chips, lasagne and roast lamb. The regional service manager told us that after a recent complimentary newspaper article on the food at The Orchard, some members of the public arrived under the impression that it was a restaurant! Most people eat in the main dining room and are helped discreetly if necessary. Some people occasionally order individual takeaways to be delivered to the home. The people who spoke to us said that they enjoyed the food and felt they had a choice. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal care in the way that they prefer and their physical and emotional needs are met. EVIDENCE: The care plans we looked at set out how people wanted their personal needs to be met, including, for instance, a section on ‘gender care’ where people say if they mind people of the opposite sex caring for them. Several people at The Orchard look after their own medication and the manager told us that this has increased over the last year. The manager’s self assessment report for the owners says that she hopes to be able to continue to safely further increase the number of people looking after their own medication during coming year. All medication is securely stored, whether self administered or not. We looked in detail at the medication for three people. On the whole the administration was accurately recorded. However, there were several instances for each person where no entry had been made for a particular medication episode. These were still in the blister packs but it was not clear if the resident had refused to take them or there was some other reason. Where a medicine has been prescribed there needs to be a record of whether or not it has been taken, and if not, the reason why. One medicine to be taken ‘as required’ had Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 14 no information about the circumstances in which it was to be taken. The member of staff who was with us clearly understood when it was to be taken but this needs to be recorded in writing for the guidance of staff. Some creams and medicated scalp treatments were not signed for individually when they had been applied. Each medication episode should be recorded and if it is not taken the reason should be on the MAR sheet so that there is a complete record. The fridge where some medication is stored must always be kept locked when staff are not using it; we did see it left unlocked when we visited. The home deals with the death of residents sensitively and we discussed two sad recent deaths with the manager. Residents are encouraged and enabled to visit their friends if they are in hospital and, if they want, to take part in funerals. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has satisfactory complaints and safeguarding procedures that protect the interests of the people who live there. EVIDENCE: Leonard Cheshire Disability, the owners, have clear procedures for dealing with complaints and allegations of abuse. Staff receive training on safeguarding procedures. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is spacious, clean, well maintained, and on the whole well decorated. People have access to a wide range of the specialist equipment that they need. EVIDENCE: The Orchard is purpose built and has a range of comfortable communal spaces. These include a spacious dining room/coffee bar and a large, attractive internal courtyard where there is seating and raised planting beds. The building is surrounded by attractive gardens. The corridors are wide, allowing independent wheelchair users to move around freely. Residents have spacious single bedrooms and four of them have en suite facilities. Most of the bedrooms have built in electric ceiling hoists. Since the last key inspection one extra bedroom has been created from a former staff room. Most of the bedrooms have been personalised by the occupant, with individual signs outside the doors. On the whole the rooms are adequately decorated and furnished. There is one bedroom that can be shared if two people chose to do so. Door surrounds receive very heavy wear from the wheelchairs and some of the décor on the doors and corridors is a bit difficult to keep in pristine Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 17 condition and the home has a ‘lived in’ appearance. The Orchard has sufficient baths, assisted bathing facilities and toilets. Some of the bathrooms and toilets have been modernised but others still look a bit old fashioned and would benefit from modernisation. The bedroom doors are due to be replaced and upgraded soon, with automatic openers and closers. The home was clean and odour free. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment and training systems help to ensure that well trained care, support and ancillary staff are available to meet the needs of the residents. Staff are supported by volunteers who are fully checked before recruitment, providing additional support for the people living at The Orchard, especially with activities. EVIDENCE: The home is adequately staffed. In addition to the Registered Manager there is always a team leader and between four and six care staff on duty. As well as this there is a Care Supervisor (in effect the deputy manager), Activities Organiser/Volunteer Co-ordinator, domestic staff, kitchen staff and administrative staff. This level of staffing means that care workers can concentrate on care and support. At the moment there are 42 volunteers who help with activities such as driving, befriending, escorting, gardening, assisting with meals and fundraising. Some funding authorities (local authorities and Primary Care Trusts) pay for additional hours for particular residents. In some cases this pays for staff from specialist agencies to help to provide one-to-one support for activities and one Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 19 resident was on his way out with such a worker when we talked to him. 95 of the care staff have at least NVQ2 and the others can go on the course and are encouraged to do so. Leonard Cheshire has an extensive training programme. In the last two months training has included POVA awareness (done every two years), Disability and the Law, Infection Control, Food Safety, Keyworking and Moving and Handling. Training is recorded on a matrix kept in the regional office but it is accessible to management at the home. Staff receive regular one to one supervision every two months and records are kept on their files. Six new staff had been employed since the last inspection. All of the necessary checks had been carried out before they were able to start work. When agency staff are employed it is important to make sure that they have an acceptable CRB and POVA clearance. Records of the interviews are kept on file. Residents attend all staff interviews. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The owners have quality assurance procedures in place to ensure that the residents’ views are taken into account in reviewing and improving the service provided. The home takes steps to ensure that everyone’s safety is protected. EVIDENCE: The Registered Manager is qualified and experienced. Leonard Cheshire carries out an annual quality assurance audit on The Orchard. In addition the manager completes an exhaustive Self Assessment report on the service every year and we looked at a copy of the most recent assessment. This helps the manager and the regional manager to identify the strengths of the service and areas where it can be improved further. Other managers carry out regular visits to the home to monitor the quality of the service. The national organisation carries out an annual survey of residents/service users in all of its Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 21 services and the findings are broken down for individual homes, though the most recent survey had not been compiled when we visited. This represents a powerful combination of quality assurance tools in addition to the normal line management procedures. The manager has also volunteered to work with Liverpool City Council on a city-wide quality assurance pilot scheme. Fire safety procedures were up to date and staff are trained in how to deal with the risk of fire. The home has adequate fire safety precautions as it is split into four self-contained fire zones, each protected by automatically closing fire doors. Accidents are properly recorded and the temperatures of all fridges and freezers, including the medication fridge, are regularly taken and recorded. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000025360.V376003.R01.S.doc 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 4 3 3 4 N/A 3 N/A N/A Version 5.2 Page 23 Orchard (The) - Leonard Cheshire Disability Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13 (2) Requirement The registered person must make adequate arrangements for the safekeeping of medicines and must therefore ensure that the medications fridge is kept locked whenever it is not in use. Timescale for action 01/07/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The Registered Manager needs to again remind staff who administer medication of the importance of accurate recording, in particular recording each medication episode, including if a particular dose has been refused. Where prescribed medication is to be taken ‘as required’ (PRN) there should be detailed information to ensure that staff can administer the medicine safely. The medication refrigerator must be locked when not being used by a member of staff. 2. YA20 Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 24 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Orchard (The) - Leonard Cheshire Disability DS0000025360.V376003.R01.S.doc Version 5.2 Page 25 - 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!