Care Home: The Orchards

Similar services:

• Fairfields Country Rest Home
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well Comments received from people using the service were very complimentary about the staff and highlighted that staff provide a very good standard of care, both residents and relatives commented that the staff are friendly and caring. Comments received included "Everything is wonderful" and "the care and support is good" The home is clean and had no malodour with surveys confirming that this is always the case. The management of service users with nursing interventions appears well managed with the supporting involvement of visiting healthcare professionals. People using the service spoken with all confirmed that the quality, quantity and variety of food is always good, there was evidence that individual preferences are catered for. Relatives confirmed that they are made welcome and kept informed of changes in their relative`s condition as necessary. What has improved since the last inspection? The storage of oxygen cylinders is now secure to prevent injury or accidents by the cylinders falling over. Recruitment records are now robust and protect the people using the service from the risk of abuse. Care plans are being reviewed and a plan for further over view is being developed by the recently appointed Deputy Manager. Further recording of social care is being undertaken. Recording of creams in the Social Care Wing is now taking place to ensure that all prescribed creams are administered as prescribed. Both bathrooms are now repaired and working in the Social Care Wing. What the care home could do better: No Requirements or recommendations have been made as a result of this inspection.Good practice recommendations remain in place relating to an ongoing maintenance plan in place and the review of accident audits to document any plans to prevent further accidents. CARE HOMES FOR OLDER PEOPLE The Orchards Orchard Lane Crewkerne Somerset TA18 7AF Lead Inspector Gail Richardson Unannounced Inspection 6th November 2007 09:30 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 The Orchards DS0000060598.V353317.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. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Orchards Address Orchard Lane Crewkerne Somerset TA18 7AF 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) 01460 76267 01823 323270 Somerset Redstone trust Mrs Christine Roberts Care Home 66 Category(ies) of Old age, not falling within any other category registration, with number (66) of places The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Older persons, who require general nursing care, up to a maximum of 31 people. Nursing placements are permitted only in the `nursing wing` The `nursing wing` will have a named first level nurse, on part 1 or 12 of the NMC register leading the management of nursing care. The named nurse must have available no less than two shifts, supernumary to this rosta, for the purpose of strategically managing the nursing care. If this member of the management team leaves or is absent for more than 28 days, the CSCI will be informed of alternative arrangements. The Somerset Redstone Trust will give the CSCI copies of the CV, references and qualifications of the first level nurse leading the management of nursing care. A maximum of 33 places are permitted in each of the two units Only rooms 4 & 5 of the Nursing Wing may be used for intermediate care`. Service users in these rooms (up to a maximum of 4) are subject to the following conditions:(a) not less than 50 years of age (b) maximum duration of any single admission - 56 days. 10th July 2007 3. 4. 5. Date of last inspection Brief Description of the Service: The Orchards consists of two separate units, one for personal care and one for nursing care. The Orchards is owned by Somerset Redstone Trust, a charity that also manages five other units for older people throughout the counties of Somerset, Devon, Hereford and Worcester. The Orchards is situated in the small town of Crewkerne and is within easy walking distance of the town’s amenities, including shops, banks, pubs, dental surgery and small community hospital. The majority of the home’s bedrooms are for single occupancy. There is a passenger lift in each of the two units. The home has a large lawned garden to one side and there is a patio area off the dining room of the nursing unit. The gardens are well maintained and easily accessible. The range of fees for residential care is £373.00 to £600.00, the range of fees for nursing care is £504.00 to £700.00 and does not include hairdressing and chiropody. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 5 The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over 1 day on the 6th November 2007 by inspector Gail Richardson. A tour of both units, the nursing unit and the social care unit, took place and a sample of the bedrooms and communal areas were seen. There were 59 people currently residing at the home, 30 in the nursing wing and 29 in the social care wing. The inspectors spoke to 8 people using the service and 7 members of staff, the Acting manager was available on the day of inspection. The inspection undertaken was in response to requirements made at the last key inspection on the 10th July 2007, where some areas of concern were raised about recruitment. At that time the inspection outcome was seriously affected by that requirement. Due to the last key inspection being 3 month previously not all areas have been re-examined at this inspection and therefore reference has been made to areas of the previous inspection. Prior to the key inspection 10th July 2007, the manager completed an Annual Quality Assurance Audit requested by CSCI, which detailed how the home had improved and plans for future developments. Records relating to care, staff, finances and health and safety were examined at inspection. This was further used at this inspection. The inspectors noted that people using the service appeared settled and comfortable and there was a pleasant, calm atmosphere within both of the units. The people using the service looked well cared for with an attention to detail of personal care evident. All people spoken to were complimentary about the staff and the care they are receiving. Staff spoken to were happy to be working in the home and time spent by the inspector observing staff, evidenced that they were kind and caring towards service users and spoke to them at all time with support and reassurance. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: No Requirements or recommendations have been made as a result of this inspection. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 8 Good practice recommendations remain in place relating to an ongoing maintenance plan in place and the review of accident audits to document any plans to prevent further accidents. 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. The Orchards DS0000060598.V353317.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 The Orchards DS0000060598.V353317.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and evidence from the previous key inspection on the 10th July 2007. The home continues to provide prospective residents and relatives with sufficient information in the format of brochures, the Service User Guide and Statement of Purpose for them to make an informed decision about the home. All prospective residents receive a pre admission assessment to ensure the home can meet the assessed needs identified. EVIDENCE: The home supplies CSCI with a regularly updated Statement of Purpose and Service User Guide which is detailed and comprehensive. The homes Annual Quality Assurance Audit states - No service users moves into the home without a pre-assessment to ensure their needs will be met.For The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 11 individuals referred through social services a copy of the SAP report is obtained before the Home does there own assessment.For individuals who are self funding a full assessment is done covering all aspects of daily living. The inspector examined one care plan which included the pre admission assessment and SAP assessment had been supplied. Four relatives and 3 people using the service, confirmed by survey that they had received enough information about the home prior to admission.One comment was “I came for a short visit and was well looked after so decided to stay” another stated “All information was good”. One contract was seen which contained the relevant details outlining the terms and conditions of residency. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and evidence from the previous key inspection on the 10th July 2007. Each person using the service has a care plan, the assessed areas of need were reflected in this plan of care and the detail recorded ensures that staff can provide a good standard of care. Staff were observed to treat service users with dignity and respect at all times and residents felt well cared for. EVIDENCE: The previous key inspection on 10th July 2007 examined care plans in both units in detail, at this inspection one care plan was examined which supported the continuation of improved practice. The Annual Quality Assurance Assessment states -The care plan is generated The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 13 from the pre-assessment before admission, and reviewed monthly. A recent person admitted had a care plan completed within a week but evidenced that 2 areas of monitoring had not yet been completed Previous inspection highlightedCare plans identify personal needs and abilities of residents and evidence of relatives involvement was seen. The care plans on the Social Care wing were noted to be detailed and personal and care plans on the nursing unit showed good detail and information for specific nursing interventions. Social care plans in both units were not fully completed and lacked documentation of social choices and preferences. Some dependancy levels and screening tools had not been completed and risk assessments for medication allergies were not in place. Residents requiring regular supervision due to the changes in health condition were being observed every 30 minutes and this was being recorded appropriately.It was noted that appropriate measures were being taken to ensure that the people using the service were re-assessed as health needs changed for the environment that would suit their specific needs. At this inspection, discussion with people using the service evidenced that this had continued. People using the service commented that this continues to be the case and they “felt well cared for in every way.” The previous inspection noted that -All residents are registered with a G.P. Regular appointments are upheld for visual, dental, chiropody, speech and specialist care requirements. For this inspection,when visiting health professionals were asked if there was always a member of staff to confer with, 9-yes and 1 said no. 9 stated that they had not received any complaints about the home. One health professional stated that there is some difficulty in staff accompanying the doctor to see the patient in the Social Care wing. This was discussed with the acting manager at inspection. One comment received from a visitor was related to some communication difficulties with staff with strong accents. The relative however was very clear that this did not affect the care and experience within the home. This information was passed to the acting manager at inspection. A further comment received was “The home does well, helps to make the home feel like a home for the patient, relative and staff”. The management of the medication systems were good at the previous inspection and so were not examined at this inspection, previous evidence stated that; There were no gaps in the Medication Administration Records. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 14 The home has written protocols in place for the administration of all medications. The manager of the Social Care Unit is recommended to implement a system to record the administration of all prescribed creams. Residents have the option to self medicate should they want to. Suitable documentation was in place in respect of these residents and medication was safely stored within their rooms. A homely remedy policy is in place with signed consent on agreed protocols by the relevant GP’s. All medications were stored safely and securely with systems in place for ordering and disposal. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and evidence from the previous key inspection on the 10th July 2007. There is a wide range of opportunities for social stimulation and residents are supported to join in with organised activities or pursue their own interests. The meals in the home are of a good quality and a wide range of choice is available. EVIDENCE: These standards were not examined in detail at this inspection, previous inspection stated that The activities organisers produce a regular activities programme, this enables individuals to participate and enjoy activities of their choice. The home employs 2 activity organisers for a total of 45 hours per week not inclding weekends. The week starts with the shop being taken around and then activities are planned and posted on the board in each unit for the rest of the week. There are a variety of activities and residents stated that there were no strict The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 16 routines in the home and that they were free to decide how and where they spent their time. Activities included bingo, quizzes, arts and crafts and use of the garden. The recording of activites undertaken is good but has not been undertaken for all residents and this is recommended to be commenced. Surveys for this inspection indicated that activities are available 2-always and 1 sometimes.On the day of this inspection there was a trolley shop being taken around the home in the morning by one staff and the other activity coordinator was undertaking a one to one session with a person using the service. A Bible Class was planned in the nursing unit for the afternoon and 2 people were being escorted out of the home for sepate trips out. The care plan examined and discussion with the acting manager and head of the Social Care wing confirmed that Social Activities are now being recorded. People using the service were seen to be enjoying a relevant TV programme with discussion with staff and daily newspapers were seen in both units of the home. The previous inspection noted that Service users rooms were decorated in a manner, which reflected their tastes and lifestyles. Evidence was seen of people’s own furniture in their bedrooms This was also noted to be the case at this inspection. Lunch observed was appetising and plentiful. Care staff spoken to had a good understanding of people using the service dietary needs. The menu offers a choice and people using the service were satisfied with the meals provided. Special diets were seen for diabetic and vegetarian service users and pureed diets were served separately. Meals were served both in the dining room and in service users bedrooms if preferred. The kitchen was seen to serve to the residents in bedrooms first and the process appeared well organised. On the day of inspection lunch consisted of sausages in onion gravy with mashed potato, broccoli and cauliflower or salmon and broccoli bake. Dessert was a choice of treacle sponge and custard, orange cheesecake , sago pudding, tinned fruit salad, ice cream and yogurt. All people using the service spoke positively about the standard of the food and mealtimes appeared to be a pleasant dining experience. Comments received included ”the meals are very good” and “The chef is open to suggestions sometimes and the meals are very good”. The Orchards DS0000060598.V353317.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 17 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and evidence from the previous key inspection on the 10th July 2007. Staff and residents are confident that the homes management team would appropriately deal with any complaints or concerns. Policies, procedures and training are available to staff to ensure they have the knowledge to prevent people using the service from the risk of abuse Recruitment procedures protect people using the service from the risk of abuse. EVIDENCE: The complaints policy and records of the home was examined previously and confirmed that all complaints were investigated and outcomes reached within an agreed timescale. CSCI has not received any complaints regarding The Orchards. Four relatives surveys and 3 people using the service surveys, confirmed that they knew how to make a complaint and surveys confirmed that people knew who to speak to if they were unhappy. Previous inspection evidenced that The homes Annual Quality Assurance Audit states -Our policy is to be open and to welcome suggestions,and where relevant to complain.Whether formal The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 18 or a concern it is dealt with promptly and effectively.The complaints policy is in place and taken seriously. Staff,residents and relatives are aware of the procedure to voice that complaint or concern. The home has policies and procedures in respect of challenging behaviour, making a complaint and whistle blowing, staff training in abuse awareness also takes place at induction and some staff have recently received POVA training. The homes procedures during recruitment to ensure that people using the service are protected from the risk of abuse have been reviewed and the processes now in place ensure that all recruitment checks are undertaken prior to the prospective staff working in the home. 5 staff files were examined in detail and were seen to contain the correct recruitment checks and evidence of employment histories. Where gaps in employment history were noted, written explanation of the gaps was contained in the staff file. All staff files examined had a Criminal Record Bureau check received before staff began work in the home. The Orchards DS0000060598.V353317.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 20 21 22 23 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and evidence from the previous key inspection on the 10th July 2007. The home is two large buildings with some parts of the buildings with evidence of wear and tear that would be typical of a building of similar age and usage. The gardens are attractively laid out and suitable for people using the service use. EVIDENCE: A tour of the home was made and the inspector visited all public rooms, some private bedrooms and some staff areas. All areas of the home were clean, tidy and free from unpleasant odours. The previous inspection report noted that The Acting Manager confirmed in the Annual Quality Assurance Audit that a plan of maintenance and decoration is underway. Some areas have been The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 20 decorated to a high standard and the lounge of the nursing unit has been redecorated and is now light and airy. Some areas of the Social Care Wing were in need of re decoration and corridor areas of the nursing unit are in need of redecoration. It was noted that the Social care Wing has two bathrooms which are in need of repair. At this inspection both bathrooms in the Social Care Wing were in working order, the Head of the Social Care Wing explained that finances were available to upgrade the lounge areas and 3 bedrooms. On the nursing unit corridors were being repaired and painted during the inspection. Previous inspection noted- Bedrooms are attractively decorated and furnished with residents enjoying their own personal possessions within the space available.The home has a programme of regularly maintaining and redecorating bedrooms when they become vacant. The grounds around The Orchards are attractively laid out and are well planted and maintained. Various aids and adaptations have been put in place to assist people using the service to maintain their independence. Specialist pressure relieving cushions and mattresses were seen where there was an assessed need. All wheelchairs were seen to be clean and maintained. The Home is kept clean and hygienic with policies and procedures in place for control of infection. Surveys received had comments which included “The home is very clean “ and “The cleaners work very hard “. A link nurse is in place who is responsible for control of infection and on the day of inspection the home was clean and only some rooms had a mild malodour. Laundry systems are in place to ensure clean linen is available and clothing is returned cleaned and ironed. No malodour was evident at this inspection. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and evidence from the previous key inspection on the 10th July 2007. Staffing levels at the home appear adequate to meet the assessed needs of people using the service and staff training is promoted to support people using the service. The induction process for staff has been developed to meet the Skills for Care, Common Induction Standards. The recruitment procedures within the home protect the people using the service from the risk of harm. EVIDENCE: Staff at the home confirmed that they feel they have sufficient staff to meet the needs of people using the service, agency staff are used when required and the home uses the same agency staff when possible to ensure continuity. Further recruitment of qualified staff for the nursing unit has taken place and the acting manager expects to have full staffing levels by December 2007. A new Head of Care has been employed in the nursing unit and intends to commence her Deputy Manager role by December 2007. On the day of inspection there were, on the Social Care Wing:1 Shift leader, 1 senior carer and 4 care staff and on the nursing unit 1 qualified nurse and 6 The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 22 care staff. Further ancillary, maintenance, activity and administrative staff were also on duty. People using the service spoken with, all confirmed that the staff were kind and looked after them well, comments received on the surveys included “The staff are very attentive” and “The care and support is good”.One relative commented “They give every needed care in my relatives situation” All three staff surveys recieved confirm that induction takes place and they feel well supported.Staff training is ongoing and records support that manadatory training is being undertaken by all staff in fire training, manual handling, infection control and basic food hygiene.One staff commented that “various videos were shown plus verbal information, a lot of information was given to cover all eventualties”.Another staff commented that “Training in house is given regularly”. Staff meetings take place regularly and staff confirmed that this is an opportunity to discuss any concerns, they felt listened to and issues acted upon by the management of the home. Five recruitment files were examined and all contained the required employment history and recruitment checks needed to protect the people using the service from the risk of abuse. Significant improvements had taken place in the way the home records and manages the documents related to recruitment. Systems are now in place to ense that any recruitment issues are dealt with promptly. The Orchards DS0000060598.V353317.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): 34 36 37 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and evidence from the previous key inspection on the 10th July 2007. The home is effectively managed and benefits from the positive and proactive management style of the acting manager and the head of each unit. Systems are in place to ensure the health and safety of service users whilst encouraging and promoting independence. EVIDENCE: The previous report stated that At the time of report the home does not have a registered manager in post and therefore standards 32 and 33 cannot be assessed. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 24 The home has recently employed an office manager to oversee the administration of the Home.This will help to ensure that the residents financial interests are safeguarded. There are established systems in place for dealing with service users finances. The inspector evidenced that each service users personal monies were stored in individual envelopes with a running total of deposits and withdrawals. All service users records are stored confidentially in line with the Data Protection Act. Quality assurrance checks and feed back from questionnaires provide opportunity to address points of constructive critisism or suggestions. This process was last undertaken in June 2007 and the outcomes and resulting actions are pending. 5 staff files examined evidenecd that supervsion is ongoing and covers all the areas outlined in the National Minimum Standards. A member of staff from the Social Care Wing has undertaken the 4 day Fire Trainers Training and is now a fire trainer for both units of the home.A full fire assessment has been undertaken by an external company. Fire records were examined for the nursing unit and confirmed that weekly fire alarm tests were taking place. Monthly emergency lighting checks are maintained. Staff have annual fire training and all service recpords for fire equipment were within the last year. Accident records were viewed and were seen to be audited monthly for trends and regular occurrences. The acting manager confirmed that these audits are reviewed by herself and action taken as required. Maintenance records were examined at previous inspection and these included* * * * * * * * * * * Fire Extinguishers Hoist Servicing Emergency lighting Boiler servicing COSHH Hot water temperatures Wheelchair maintenance Electrical Hard Wiring Fire System Lift servicing Nurse call servicing The Portable appliance Testing records were not available and are to be forwarded on to CSCI. The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 25 The Orchards DS0000060598.V353317.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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 18 3 3 3 3 3 3 3 3 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 X X X x x 3 3 3 The Orchards DS0000060598.V353317.R01.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. 1. Refer to Standard OP21 Good Practice Recommendations The inspectors recommend that the home continues the on going maintenance programme. The management of the home is recommended to use the information from the monthly accident audit to promote improved practice and document changes to the home to reduce the risks of further accidents. 3. OP38 The Orchards DS0000060598.V353317.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 The Orchards DS0000060598.V353317.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!