Inspection on 26/08/08 for Osbourne Grove Nursing Home

This is the latest available inspection report for this service, carried out on 26th August 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOMES FOR OLDER PEOPLE Osbourne Grove Nursing Home 16 Upper Tollington Park Finsbury Park London N4 3EL Lead Inspector Tony Brennan Announced Inspection 11:00 26th August 2008-29 August 2008 th 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 Osbourne Grove Nursing Home DS0000071547.V370276.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. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Osbourne Grove Nursing Home Address 16 Upper Tollington Park Finsbury Park London N4 3EL 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) 020 7272 0118 020 7281 2496 London Borough of Haringey Sybil McKenley Care Home 32 Category(ies) of Dementia (32), Old age, not falling within any registration, with number other category (32) of places Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP 2. Dementia - Code DE The maximum number of service users who can be accommodated is: 32 N/A Date of last inspection Brief Description of the Service: Osborne Grove is a modern purpose-built nursing home. It is owned and managed by Haringey Council. The home aims to provide nursing care and accommodation for thirty-two people. The home is also registered to care for people who have been diagnosed with dementia. The home is located in a residential area in easy walking distance of shops and public transport links. The home is divided into four living areas and there are sitting rooms in each of these areas. There are adapted bathrooms and toilets in each on the living areas. All bedrooms are single occupancy with an en suite toilet with wash hand basin. The current fees as stated in a statement of purpose are in the range of £750 to £900 per week. Copies of this report are available from the Commissions website. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This announced key inspection is the first inspection of the service since its registration by the Commission. Prior to the inspection the home had completed its Annual Quality Assurance Assessment. The Annual Quality Assurance Assessment provided us with information about the home and how it was seeking to provide the best outcomes for people. We also looked at any other information we had received about the home. This included any information regarding incidents that the home had told us about. The inspection took place over two days. We were assisted by the registered manager, Sybil McKenley, with the inspection. We spoke with five people who live at the home, three relatives and three members of staff. We observed care practice and interaction between staff and people living at the home. Two comments were received from professionals regarding the care provided by staff at the home. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the inspection feedback was given to the registered manager, and areas for improvement were discussed. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the people who live at the home who discussed their views of the service they receive. What the service does well: The home provides good outcomes for people. We found that the needs of the people case tracked were within a range of those specified in the statement of purpose. The home provides a statement of purpose that is specific to the home and the resident group that they care for. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 6 The statement of purpose confirmed that the cultural and religious needs of people would be respected. People are supported to maintain their cultural and religious identity. A person who lives at the home said, “The manager visited me and asked what help I needed.” Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for people. A person spoken to told us “staff are kind and caring.” Care plans make sure that people’s needs are addressed in a person centered way. Detailed nutritional, tissue viability, falls and manual handling assessments have been put in place. Management of risk ensures that safety issues are addressed whilst at the same time improving the quality of life for people living at the home. People spoken to told us that activities are provided regularly. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. There were policies on handling abuse and protection. People feel safe and well supported by the home, which has their protection and safety as a priority. People spoken to felt that staff had the necessary skills to meet their needs. Staff are supported through training to meet the individual needs of people. The registered manager has extensive experience of managing a service for older people. The registered manager has a clear understanding of how to deliver good outcomes for people living at the home. We discussed health and safety issues with staff and they demonstrated their understanding. Health and safety checks, procedures and training make sure that people living in the home are safe. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 7 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. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 8 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 Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 9 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): 12345 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents and relatives are helped to decide if Osborne Grove is the right home for them by the quality of the information (including a visit to the home) they are given about the service. People’s needs are assessed prior to admission to the home to make sure they receive the care and support they need. People benefit from having contracts in place that set out the terms and conditions for people living at the home. National minimum standard number six is not applicable to this service, as the home does not provide intermediate care. EVIDENCE: As part of the registration process the statement of purpose and service user guide were found to contain all the necessary information. People and Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 10 relatives with whom we spoke said that they had received a copy of the service user guide. The registered manager explained that she encourages potential residents and their relatives to visit before deciding to come to live at the home. A relative said, “ I came with mum to see the home and they gave me a copy of their brochure.” The home make sure that people have sufficient information to make a positive decision about coming to live at Osborne Grove. We found that the needs of the people case tracked were within a range of those specified in the statement of purpose. The statement of purpose identified the skills and staffing resources available to meet the needs of people. The statement of purpose stated that the home would meet the needs of people who need general nursing care and dementia. Records we looked at showed that the aims and objectives as set out in the statement of purpose were being met. We observed how staff supported people with dementia, they demonstrated an awareness of good dementia care practice. A person who lives at the home told us, “ Staff treat me well.” The home provides a statement of purpose that is specific to the home and the resident group that they care for. Both the statement of purpose and the service user guide confirmed that the cultural and religious needs of people would be respected. Records showed that people were supported by the home to maintain contact with their church or other community groups. We spoke with the registered manager who told us that cultural and religious needs would be addressed and identified through the initial assessments and care planning. People are supported to maintain their cultural and religious identity. People living at the home have varying degrees of disability and dementia. The environment has been adapted so that it is accessible. We observed that people were able to move about the home safely. The homes environment is adapted to meet peoples diverse needs. People living at the home and relatives told us that they had been given a contract. They said that this had been agreed with them prior to their admission. We found that the contracts clearly outlined their rights and responsibilities. People told us staff had discussed the contract with them. This meant that it was assessable to people who live at the home. Copies of these contracts were signed by people living at the home or their relatives to show they agreed and understood them. A person told us, “ They told me how they would help me.” People have agreed and understand how the home will meet their needs. A person who lives at the home said, “ staff here are very understanding.” The annual quality assurance assessment stated, “ before admission to the home service users are assessed and all information recorded on an assessment form.” The people case tracked had both assessments from placing authorities, and ones carried out by the home. These identified the Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 11 individual’s needs for support and care. The initial assessment included information on the dementia care needs. This included any behavioural issues that the individual might have. As part of the assessment process information on the needs of people had been obtained from health professionals. The annual quality assurance assessment confirms that, “ access to multidisciplinary services such as physiotherapist, speech and language therapist are available.” records for the people tracked contained examples of assessments from these health professionals. This had been used to inform the home’s own assessment. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for people. Initial assessments recorded the involvement of people and their representatives in identified areas where they needed support. Both relatives and people living at home told us that they had been actively involved in the initial assessment process. Initial assessments were found to contain reference to peoples religious and cultural needs. Detailed initial assessments are carried out with the involvement of people and their representatives to make sure their needs are identified. A person told us, “Staff are very caring.” Care staff spoken to were able to explain the individual needs and preferences of the four people case tracked. We observed the interaction between staff and people who have dementia. We found this supported their continued well-being. Admissions to the home only take place when staff have the necessary skills to meet the assessed needs of prospective residents. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 11 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s personal, social and medical care needs are fully planned for. People who use the service are fully protected by safe procedures for handling medication. Peoples right to privacy is supported. EVIDENCE: The annual quality assurance assessment told us that the home seeks to make sure that peoples needs are identified and planned for. One person said, “ Most staff are helpful, and they do look after you well.” We found that the care plans of all the people case tracked were detailed and clearly identified how the needs of people would be met. Care plans were based on initial assessments of the people case tracked. For example, a person who was identified in their initial assessment as having a PEG feed had a detailed care plan for this. There were clearly defined actions highlighted in the care plans Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 13 to meet the needs of people. We found that people’s choices and preferences are recorded in their care plans. This included the preferences and personal care and also how they wish their death to be handled by the home. When people die family and friends are supported with making arrangements if this is what the resident had agreed to. People commented that they had been asked about how they wish to be supported by staff. Staff were observed to interact respectfully and sensitively with people living at the home. People said that staff respected their privacy and treated them with respect. People we spoke to told us that they felt staff understood their needs. We saw examples where staff members did relate well with people living at the home, for examples speaking to people in a way that was appropriate given their age. A key worker system is in place. Care plans were personalised, and referred to the cultural needs of people. For example, if the person wished to take part in religious activities or if they had specific dietary preferences. One person said, “ The priest comes here to see me and gives communion.” People are involved in the planning of their care that affects their lifestyle and quality of life. Detailed nutritional, tissue viability, falls and manual handling assessments are in place. The people case tracked all had nutritional assessments. People were being weighed regularly and action taken if their weight changed. The annual quality assurance assessment stated, “Advice from a dietician is sought when necessary.” We found that peoples care plans outlined the advice obtained from dieticians to make sure that people who had nutritional needs are addressed. Each care plan includes a manual handling risk assessment. Equipment had been provided to assist people to mobilise safely and independently. Management of risk ensures that safety issues are addressed whilst at the same time improving the quality of life for people living at the home. The annual quality assurance assessment confirmed that all people who live at the home are registered with a general practitioner. People have access to domiciliary medical services to meet their chiropody and dentistry needs. Diary notes showed that appropriate medical attention and advice is sought. Diary notes also confirmed that the people case tracked had access to their General Practitioner when necessary. We observed that people were alert and able to interact with staff. When we checked the medication we found that the people case tracked were not on large amounts of sedative medication. Where the General Practitioner had recommended specific medical interventions these were followed up. People’s health is promoted to ensure their continued well-being. The records of medicines received, administered and returned to the pharmacist were all complete. We were able to confirm that people were getting their medication as prescribed by their general practitioners. We found Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 14 where the General Practitioner had made changes to peoples medication this was signed to confirm the change had been made. We found that the medication for each of the people case tracked was accurately recorded. Medication records are fully completed, contain the required entries, and are signed by appropriate staff to ensure people’s safety. Records showed that no one at the home administers their own medication. Appropriate procedures and a risk assessment processes were in place if people wished to administer their medicines. However, when we looked at peoples care plans these did not contain evidence that they or their representatives had agreed to staff administering their medication. This was discussed with a registered manager. People or their representatives should be consulted about how their medication is administered. Medicines were stored safely. All medicines are stored at the appropriate temperature. Separate records were maintained for controlled drugs. We found these were complete and the amount of medication held corresponded with those recorded in the controlled drugs books. The management team monitor staff to make sure that the correct procedures are followed when administering medication. Regular management checks are carried out to make sure that medication is administered safely to people. Training has been provided on the safe administration of medicines. Training records confirmed that this training had taken place. We were able to observe staff administering medication, and confirmed that this was done safely. Staff understand how to administer medication safely to people living at the home. There were detailed care plans regarding peoples palliative care needs. The registered manager explained that the nurses would be attending training on the Gold Standard in palliative care. Nursing staff spoken to had a range of experience and understood how to meet peoples palliative care needs. The home seeks guidance to care for individuals who are dying to support their well being Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are provided with varied activities to meet their needs. People living at the home are supported to maintain contact with relatives and other representatives of their choice. The menu reflects the preferences of people living at the home and offers them a balanced diet. EVIDENCE: We spoke with people who live at the home who told us that they are provided with activities. One person told us, “There are things to do here.” The annual quality assurance assessment highlighted that, “An activity plan has been formulated to reflect peoples wishes and personal choice.” A range of activities were recorded in peoples care plans, this included massage and manicure and regular visits from an aroma therapist. The registered manager explained that an activities officer has been recruited. The registered manager plans to work with the activities officer to increase the variety of activities being offered to Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 16 people. We observed that activities were taking place at various times throughout the day. Peoples’ interests were recorded as part of their care plans. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. We observed that staff spend time talking with people who live at the home and listening to what they had to say. Staff spoken to understood the importance of one-to-one contact for people. Relatives commented that there were no restrictions on visiting the home. A relative told us, “ the staff are always friendly and know what is going on.” The home has a visitors’ room where people can meet in private if they wished. People told us that they could see visitors in private if they wished. Diary notes showed that people had regular contacts with family, friends and the wider community. People who live at home have the opportunity and are supported to maintain important personal relationships. The menu showed that options are offered at each meal. This included meal options reflecting the cultural and religious backgrounds of people living in the home. The menu is varied offering a number of choices of meals. We spoke with people who were generally pleased with the quality of the food provided. A person who lives at the home said, “ I like the food.” We observed that people are asked whether they preferred the first or second choice on the menu. Another person commented about the choice of food offered and that staff, “ do ask you what you would like to eat.” People are offered a variety of meals that reflect their personal preferences and meet their dietary needs. The registration report highlighted that food prepared at the home was to be refrigerated and then reheated. The registered manager explained that this practice has ceased and the home now has a working kitchen offering a variety of meals. The menu had been checked by a nutritionist to make sure that it offered a balanced diet. People’s dietary needs are recorded as part of their care plans (for example if they were diabetic or needed a puree meal). We observed that meals were well presented in a warm and friendly way. We saw that people were supported to eat. We observed that this was done at the pace of the people being assisted. People are able to enjoy the food they prefer and like. Osbourne Grove Nursing Home DS0000071547.V370276.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported to express their concerns having access to an effective complaints procedure and are protected from abuse. The home protects peoples rights. EVIDENCE: The annual quality assurance assessment confirmed that a clearly defined complaints policy with agreed timescales for managing complaints was in place for people to use. We found that the detailed policy was in place. People living at the home told us they had received a copy of the complaints policy. No complaints had been referred by the Commission to the home since the home has been registered. A complaints book is available to record all concerns, allegations and complaints. We found that the complaints book recorded the actions that had been taken to address issues. The complaints record showed actions taken to resolve complaints. The annual quality assurance assessment highlighted that, “Details of the complaints procedure are provided in the welcome pack for residents and their families. People with whom we spoke confirmed that they knew how to make a complaint. A person told us, “ I know who to complain.” Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 18 The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. The registered manager explained that she has brought in advocates to work with people regarding how they want the home to be managed. People spoken to said that they understood their rights. They had been registered to vote. The registered manager was able to show us minutes to confirm that she had held meetings with relatives to discuss issues relating to the management of the home. People are encouraged to be involved in decision-making that affects their local community. There were policies on handling abuse and protection. We saw that the registered manager had obtained a copy of Haringeys guidance on adult protection. People living at the home felt confident that any concerns they raised would be handled sensitively and appropriately. A person told us, “ I can tell staff if I am worried.” We found that staff had received training on adult protection. Staff spoken to could recognise the signs of potential abuse, and explained how they would respond to it. People feel safe and well supported by the home, which has their protection and safety as a priority. Osbourne Grove Nursing Home DS0000071547.V370276.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is designed to enable residents to live in a safe well maintained comfortable environment that supports their independence. EVIDENCE: The home is situated in a residential area, and is in easy reach of shops and public transport links. Osbourne Grove is newly built and is of modern design. As part of the registration process the home had to show that it complied with fire and building regulations. We found that the home is designed to ensure the safety of people who live there. We walked round the home and found that it was accessible for people. A passenger lift provided access for people to both floors. We observed that Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 20 people were able to access all areas in the home safely. The home has the necessary adaptations to support people to move around safely. There are adapted bathrooms and toilets on each floor. These are accessible to people who have mobility difficulties. The bathrooms on the ground floor have tracking hoists installed to assist people. Hoists were available on both floors. Records showed that these had been maintained. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is divided into four living areas, two on the ground and two on the first floor. There are dining and sitting rooms in each of four living areas for the use of people. These are well furnished. One person said that the sitting room was, “A nice place to relax.” The registered manager explained that she was discussing with people who live in the home how they would like it to be furnished. The registered manager is also consulting residents and relatives about possible names for the four living areas. The four living areas provide an environment in which people can live together in a non-institutional way. All bedrooms are single occupancy and have en suite facilities. Bedroom doors had the names of people on them. This supported people to recognise their bedrooms. One person commented, “Ive got pictures and other things that are brought in with me.” We saw that bedrooms were personalised with pictures and other items belonging to people. People are encouraged and supported to personalise their bedrooms. Appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. There is a separate laundry and sluicing facilities. Staff have received training on infection control measures. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. Effective infection control measures are in place to ensure the safety of people living at the home. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 21 Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient staff are always available to meet the needs of people who live at the home. Staff have most of the skills to meet all the assessed needs of people who live at the home. People who live at the home are protected by the home’s recruitment practices. EVIDENCE: As part of the registration process it was highlighted that the registered manager would need to keep the staffing level under review. This would make sure the needs of people are met. The registered manager explained that since the home had become operational she has reviewed the staffing level. The rota showed that the staffing level had been increased as more people had come to live at the home. The registered manager has begun to develop teams for each of the living areas. The rota showed that a consistent staffing level was being maintained in the home. The registered manager showed us that she had developed a bank of staff to make sure that there will always be enough staff to meet peoples needs. A person who lives at the home said, “No problem with staff, theres always enough staff.” Staff said that the current staffing level allowed them to meet the needs of people. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 23 We observed that the composition of the staff team reflected the diversity of the people who live at the home. Sufficient staff are always available to meet the needs of people who live in the home. The annual quality assurance assessment highlighted that staff had been on a range of courses. People spoken to felt that staff had the necessary skills to meet their needs. One person said, “ Staff are ready to help.” Training records showed that staff had been on a range of courses relating to the needs of people who live at the home. We found that this included training on dementia. There were certificates available to confirm this. We observed that staff understood how to respond and communicate with people who have dementia. Staff spoken to were able to explain how they supported people in a person centred way. Staff are supported through training to meet the individual needs of people who live in the home. The registered manager was able to show 50 of staff have achieved the National Vocational Qualification in care. Training records we examined confirmed this. Staff training records showed that staff had done training in the essential areas, such as food hygiene, health and safety, administration of medication and infection control and first aid. Training records showed, however, that not all staff had fire training. Fire training should be provided to make sure the staff have the necessary skills to ensure people’s safety in the event of fire. We observed that staff demonstrated that they knew how to support and care for people. The home make sure that staff receive relevant training that is focused on delivering improved outcomes for people. Nurses had received the relevant ongoing professional development. Discussions with the registered manager and records seen confirmed that further training on palliative care had been identified. The registered manager explained that she worked closely with the health authority to ensure that nurses have access to the relevant professional training to meet the needs of people who live at the home. We looked at five staff files. These contained all the necessary documentation to ensure that these members of staff were safe to work with people who live at the home. Their employment record had been checked. Two references and a POVA first/CRB check had been obtained prior to them starting work at the home. This showed that the home followed a clear recruitment procedure that ensures the safety of people. The annual quality assurance assessment highlighted that all recruitement followed a comprehensive equal opportunities framework. The staff group reflect the cultural backgrounds of people living at the home. We found the recruitment record showed that a fair and consistent approach is taken throughout the recruitment process. People living in the home said they felt that staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of people. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 34 35 36 37 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate management structures are in place to ensure that people receive the care they need. People who live at the home are consulted about the quality of the service, and encouraged to make suggestions for improvement. People who live at the home have their financial interests protected by the home’s procedures. People who live at the home and staff are protected by the home’s health and safety procedures. EVIDENCE: Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 25 As part of the registration process the registered managers qualifications and experience were checked. This confirmed that the registered manager has the necessary skills and experience to manage a nursing home in the best interests of people. The registered manager explained that she has arranged her own support and supervision from the Community Matron. The registered manager has extensive experience of managing a service for older people. The registered manager has maintained and updated her skills regularly. She has a clear understanding of the key principles and focus of the service to make sure that people receive the care they need. We observed that the registered manager spent time talking to people who live at the home. Both staff and people told us that they felt the registered manager was approachable and supportive of their needs. A person who lives at the home said, “The manager comes in and talks to you, she is someone you can rely on.” The registered manager has a clear understanding of how to deliver good outcomes for people living at the home. The registered manager works to continuously improve the home and provide an increased quality of life for people who live at the home. She has completed a detailed annual quality assurance assessment and this provides a clear picture of how the service will be developed for the benefit of people. The registered manager was able to show that she had involved advocates to help people living at the home to express their views of the service they receive. There were minutes of relatives and residents meetings that have been used to make sure that there were continual improvements to the home. People and relatives are encouraged to participate in determining the future development of the service. The home has a system for consulting people about the quality of the service they receive. As the service has only been operational for six months a quality assurance survey has not yet been carried out. The registered manager explained that she would be doing this in the near future. A system is in place to make sure that people’s views of the service are sought to improve the service to people. The home has the necessary accounting and financial management procedures to ensure that it remains viable. This was checked as part of the registration process. The registered manager explained that she is continuing to identify the resources that she needs to further develop the home. Insurance certificates were available to show us that the necessary insurance was in place. The financial management of the home make sure that sufficient resources are available to meet the needs of people. The home does not hold money for people who live at the home. The home invoices their families or the relevant social service department for any Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 26 expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. People who use the service can have confidence in the home’s procedures for handle their money safely. The registered manager explained that she makes sure that staff receive regular supervision. Supervision records were available to confirm that staff are receiving regular supervision. Staff spoken to told us that the supervision they receive supported them to effectively meet the needs of people. Effective supervision of staff makes sure they are supported to meet the needs of people. As part of the registration process all procedures were checked. It was found that all the relevant policies were in place. The registered manager explained that since the home has been registered she has reviewed policies where necessary. People and relatives spoken to told us that they had been given copies of relevant policies. All the necessary records were found to be in place. Records that were examined provided detailed information on how the needs of people would be met. Staff spoken to understood the importance of maintaining accurate records. Effective procedures and record-keeping make sure that the home is run in the best interests of people. The home has a consistent record of meeting the relevant health and safety requirements and closely monitors its own practice. Fire drills had taken place and the fire alarm was tested regularly. We found that the fire risk assessment includes an assessment of all the potential fire risks in the home. We questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. We discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents to ensure the safety of people who live and work at the home. The temperatures of the fridges and freezers were recorded and within safe limits. Health and safety checks, procedures and training make sure that people living in the home are safe. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 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 3 3 3 3 3 3 3 3 Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 28 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. 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 2 Refer to Standard OP9 OP30 Good Practice Recommendations People and their representatives should be consulted about how their medication is administered. Fire training should be provided to make sure that staff have the necessary skills to ensure people’s safety in the event of fire. Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Osbourne Grove Nursing Home DS0000071547.V370276.R01.S.doc Version 5.2 Page 30 - 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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