Care Home: The Cherries

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What the care home does well The registered manager and staff continue to provide excellent standards of care and support for people living in a `home from home` environment. All previous requirements and good practice recommendations had been put in place. People living at the home benefit from improvements to their environment, such as, new bedroom furniture and furnishings, new domestic equipment, cutlery and crockery, washer and dryer, new patio doors, ongoing redecoration and a new hoist. There are comprehensive assessments of each person`s needs prior to admission. Information is used to develop person centred care plans, which provide staff with guidance to meet each person`s needs. We are told us that people are always made welcome, food is excellent and staff are caring and friendly. We saw a cooked meal, which was appetising and nutritious. The organisation`s policies demonstrate a positive attitude to complaints and the protection of vulnerable people. The home is very clean, free from any offensive odour, appropriately decorated and well maintained with high quality furnishings and furniture. There is an appropriate skill mix of staff and an excellent Registered Manager. There is a strong commitment to staff training and development, which benefits people using theservice. Recruitment and selection procedures are robust and safeguard the people living at the home. Health and safety is proactively managed, with records of fire drills and an accident analysis and evaluation to minimise risks. What the care home could do better: A good practice recommendation is made that an up to date medication reference guide should be obtained so that staff have access to information about medicines prescribed for people at the home. Random inspection report Care homes for older people Name: Address: The Cherries 2b Beechcroft Road Kingswinford West Midlands DY6 0HJ three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jean Edwards Date: 0 3 0 6 2 0 1 0 Information about the care home Name of care home: Address: The Cherries 2b Beechcroft Road Kingswinford West Midlands DY6 0HJ 01384291100 01384291100 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Daveda Joy Chitima,Mr Ngonidzedenga James Chitima Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 8 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 8 Date of last inspection Brief description of the care home The Cherries is a converted, detached domestic property situated on a residential housing estate just outside the small village of Wall Heath, and adjacent to a green belt area. The home was originally registered in 1986 and was purchased by the Care Homes for Older People Page 2 of 10 Brief description of the care home present owners in 1989. Access to the front of the home is via a small parking area. The home has installed electronic gates to improve security and safety for service users. There is a large, secluded garden to the rear of the property, which has well established flowerbeds, trees and a lawn. There are four single bedrooms and two double bedrooms situated on the first and ground floors. There is a bathroom and toilet on the first floor and two toilets on the ground floor. A separate laundry is located on the first floor. The home has a chair lift for access to the first floor. There is a lounge/dining area on the ground floor. The decoration and furnishings reflect a homely domestic environment. The service is registered to care for eight elderly persons one of whom also has a physical disability. The Cherries provides a range of organised and spontaneous leisure activities for residents, and has an active relatives and friends committee called The Friends of the Cherries, which meets regularly and assists with organising outings and events. The manager is one of the two joint providers and leads a small staff team of care staff and a cook. People are advised to contact the home for up to date information about the range of fees. Care Homes for Older People Page 3 of 10 What we found: We, the Care quality Commission (CQC) undertook this random inspection visit to monitor standards of care at the home, which had been rated as excellent at the last key inspection on 19 June 2007. This random inspection was unannounced, which meant the home was not given notice of our visit. We spent part of a day at the home and looked at the medication systems and health care records and how peoples healthcare needs were being managed. We also looked at how people were supported and given assistance to promote their health and well being. We briefly looked around the premises, including communal areas and a sample of bedrooms. We spoke to people who were able, and to staff and visitors. We observed interactions with people without verbal communication. We looked at a sample of the medication held at the home. We noted that staff had received medication training and were knowledgeable. There were areas of good practice with medication well organised and we saw that medicines were administered to people in a timely manner, with appropriate records. There were photographs with the MAR charts, which reduced the risk of medication being given to the wrong person. We noted that handwritten entries on MAR (Medication Administration Records) charts had been signed and witnessed by two trained staff, which demonstrated good practice and reduced the risk of errors. The registered manager had put in place a signature list with the photographs of staff trained and competent to administer medication, which demonstrated excellent practice. There were also photographs with the MAR charts, which reduced the risk of medication being given to the wrong person. There were comprehensive care plans and protocols for the administration of as and when needed (PRN) medicines. This meant people received their medication appropriately to promote their health and well being. We looked at the storage and administration of controlled drugs, which was satisfactory, with all records and balances of medication accurate. This meant that people requiring these powerful medicines were receiving them as prescribed by their doctor. Overall the systems in place for administering medication were very well managed. We made one good practice recommendation for the home to be provided with an up to date medication reference guide, so that staff had easy access to information about the medicines prescribed for people living at the home. We looked at a sample of care records for people living at the home. The care plans were very well organised and reflected the assessed needs. They were up to date and provided essential information to ensure each persons needs where understood and met. Care plans had monthly evaluations and comprehensive daily records were maintained by each shift. We saw that people had good access to health care professionals such as GPs, dentist, ophthalmic and chiropody services. We noted that the home provided appropriate care for people vulnerable to pressure ulcers and diabetes. We noted that a person with weight loss had been referred for advice and support from the doctor and community dietician. We noted that when people could no longer be weighed there was an alternative method Care Homes for Older People Page 4 of 10 used to monitor their weight, such as the Malnutrition Universal Screening Tool (MUST) and the Mid Upper Arm Circumference (MUAC) measured and monitored. We saw that people looked well presented and were dressed appropriately according to their preference. There was very good interaction between staff and the people living at the home, with conversation at a level and pace appropriate for each person. We saw results of surveys from health professionals, relatives and visitors, which told us they felt the home was very well managed and provided excellent care. Comments included, the GP, Residents seem happy and needs met; Chiropodist, welcoming, everyone seems happy here; visiting activities organiser, lovely atmosphere, caring, clean, and residents seem happy; Visitors, X is happy and enjoys the company of others; and relatives, very happy with care; friendly atmosphere, M has greatly improved, and M has reached her age (101) due to the care and dedication of the staff. People living at the home were complimentary saying, the food is lovely, the owners and staff are wonderful. There are lots of activities and parties for birthdays, with everyone involved. We looked at the homes systems to deal with complaints. We saw that there was a complaints procedure displayed in the home, included in the Service User Guide, and displayed in each bedroom. The registered manager told us that there had been no complaints in the last 12 months. Any minor concerns were investigated immediately and resolved to peoples satisfaction. This demonstrated a proactive approach to improve the service, where the management encouraged people to raise any issues of concern. The registered manager told us there had been no safeguarding referrals in the past 12 months. The home had policies and procedures to inform staff about abuse and responsibilities for reporting suspicions or incidents. All staff were receiving robust training, mainly from the Local Authority training provider, so that they understood the lead agencys procedure Safeguard and Protect to protect vulnerable adults. We spoke to people, who told us they had no complaints but could tell the staff or manager if they wanted to complain. We looked briefly around the premises and noted maintenance was being carried out to high standards. There were improvements such as ongoing redecoration and provision of new furniture, as it became necessary. We saw that there were 8 people accommodated at the home with a range of needs. We looked at copies of staff rotas and discussed the staffing levels with the registered manager in relation to occupancy and dependency levels. She was able to give us detailed information about the people accommodated, to identify what were their diagnosed conditions were and confirm the numbers of care staff to meet their needs. We looked at a sample of two personnel files of staff recently employed. The files were well organised with a recruitment checklist. The recruitment process was robust and provided safeguards for people living at the home. The Registered Manager, Daveda Chitima, a well qualified and experienced registered nurse and manager, was the joint owner at the home for 21 years. She holds the Care Homes for Older People Page 5 of 10 Registered Managers Award, Level 4 National Vocational Qualification in Care and other related qualifications. We received very positive comments about the owners and management. There were quality assurance checks and rigorous audits, with remedial actions for improvements. Examples were the management and administration of medication, the standards of the premises and the rigorous recruitment to safeguard people at the home. Communication systems were excellent with regular staff meetings and a committee called Friends of The Cherries with an independent chair person and published minutes of meetings and regular newsletter in colour. The most recent edition had photographs of a special party for everyone living at the home with their names and ages and the combined age, which totalled 735 years iced on a cake. There was robust supervision system and the registered manager ensured that each person received six supervision meetings each year, which were linked to observations of practice and competency assessments. These were used to support staff development to the benefit of people living at the home. The fire safety records appeared satisfactory and we noted that there were regular fire drills. There were incidents and accident records with accident analysis and evaluation, which was good practice to identify trends and identify risks, which nurses used to revise and update individual risk assessments to control or minimise hazards. What the care home does well: The registered manager and staff continue to provide excellent standards of care and support for people living in a home from home environment. All previous requirements and good practice recommendations had been put in place. People living at the home benefit from improvements to their environment, such as, new bedroom furniture and furnishings, new domestic equipment, cutlery and crockery, washer and dryer, new patio doors, ongoing redecoration and a new hoist. There are comprehensive assessments of each persons needs prior to admission. Information is used to develop person centred care plans, which provide staff with guidance to meet each persons needs. We are told us that people are always made welcome, food is excellent and staff are caring and friendly. We saw a cooked meal, which was appetising and nutritious. The organisations policies demonstrate a positive attitude to complaints and the protection of vulnerable people. The home is very clean, free from any offensive odour, appropriately decorated and well maintained with high quality furnishings and furniture. There is an appropriate skill mix of staff and an excellent Registered Manager. There is a strong commitment to staff training and development, which benefits people using the Care Homes for Older People Page 6 of 10 service. Recruitment and selection procedures are robust and safeguard the people living at the home. Health and safety is proactively managed, with records of fire drills and an accident analysis and evaluation to minimise risks. 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 set out on page 2. Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 An up to date medication reference guide should be obtained so that staff have access to information about medicines prescribed for people at the home. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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