This is the latest available inspection report for this service, carried out on 7th April 2010.
CQC found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Overbury House Nursing & Residential Home Staitheway Road Wroxham Norwich Norfolk NR12 8TH two star good service 15/07/2009 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: Jane Craig Date: 0 7 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Overbury House Nursing & Residential Home Staitheway Road Wroxham Norwich Norfolk NR12 8TH 01603782985 01603783425 admin@overburyhouse.healthcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Healthcare Homes Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 61 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: Date of last inspection Brief description of the care home 61 1 5 0 7 2 0 0 9 Overbury House provides nursing and residential care for up to 61 people who have dementia. The home is owned by Healthcare Homes Limited. Overbury House is a large detached building of traditional design with a number of modern extensions that have been added over the years. The residents accommodation is located on the ground and first floors. Some have en-suite facilities and there are ample toilet and bathrooms around the home. There are a number of communal lounges and dining areas. Fees are based on the assessed needs of the individual and their chosen room. Information about the home, including the latest inspection report is available from the manager. Care Homes for Older People Page 2 of 9 Brief description of the care home Extra charges are made for hairdressing, personal newspapers, chiropody and toiletries. Care Homes for Older People Page 3 of 9 What we found:
After our last key inspection on 15th July 2009 we judged Overbury House to be providing good outcomes for the people who use the service. Since then we have received a number of concerns about this service. These related to staff understanding of safeguarding procedures, the support and safety of people with complex behaviour and how the wishes of people using the service, with regard to end of life care, were documented and carried out. We carried out this random inspection to look at these areas of concern. We looked at the procedure, guidance and training for staff, which related to safeguarding people using the service. The safeguarding procedure had been revised and included clear information about how to escalate a concern outside the home. All staff had attended recent refresher training in safeguarding. Two staff told us that they found the training particularly good and thought provoking. Safeguarding issues were also discussed during staff supervision and staff meetings. The staff we spoke to said they would feel confident that they would be able to recognise if someone was the victim of abuse and they would report it to the manager or the director of quality. They also knew which agencies they could approach outside the company. The manager was completely clear about her responsibility to make safeguarding referrals to social services. We looked at care records for three people who had complex behaviour and spoke to staff about how they were supported. The director of quality for the company confirmed that, over time, a number of people with complex behaviour had been admitted to Overbury House. One of the pre-admission assessments we looked at indicated that the person regularly exhibited aggressive behaviour. However, there was no evidence that the assessment took into account how the admission might impact upon the needs and safety of other residents, or whether the staff had the necessary skills to support the person. All permanent staff had training in dementia care, which varied in depth and detail. Some staff were due to attend a further course in person centred care, which they would then cascade to other staff. One staff member said their training was very good and helped them to understand the needs of people with dementia. We found that only a small number of staff had specific training in supporting people who had complex or potentially harmful behaviour. A member of staff told us they felt they did not have sufficient training in supporting people with challenging behaviour. The company had recently trained a member of staff to provide a course for all staff in crisis intervention and non aggressive techniques for managing complex behaviour. This was due to be implemented over the next three months. We looked at the care records for three people whom we were told had complex behaviour. One did not have a relevant care plan to help to support him with regard to the behaviour that staff described. The other two had care plans relating to agitated and aggressive behaviour. One of the care plans gave staff clear directions about how to approach the person. The other was not individualised. It also instructed staff to use techniques that most did not have the relevant training to use. This care plan had not been updated for almost two years. Staff we spoke to told us that they knew the people with aggressive behaviour quite well but they all described different behaviours, triggers and ways to approach the person. This lack of consistency in approach could increase the
Care Homes for Older People Page 4 of 9 risk of the person becoming frustrated and aggressive. Staff also told us that they did not always have time to pass on in-depth information to agency staff. The care plan document in use at the home asked people using the service, or their families, about end of life arrangements. Two of the three care plans we looked at included some information but this was not clear or complete. There was insufficient evidence that wider consultation had taken place and a lack of clear directions to ensure that staff acted upon residents wishes. The Director of Quality was aware that there were shortfalls in this area and was working to improve the process for agreeing, recording and acting upon advance decisions. She had drawn up a procedure and recording documents that had been sent out to various stakeholders for consultation. What the care home does well: 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 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 There must be records of all 31/07/2009 medication given, this would include prescribed creams. This is to ensure that residents receive their medicines as they are prescribed. 2 19 13 There must be a suitable 31/08/2009 system for residents, who are able, to alert staff in the case of illness or emergency. This is to protect residents health and safety. Care Homes for Older People Page 6 of 9 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 1 7 14 Pre-admission assessments 30/04/2010 must take into account the effect the admission may have on the people currently using the service and whether the staff team have the appropriate knowledge and skills to meet the persons needs. This is to safeguard the safety of the people currently using the service and to ensure the needs of the person thinking of moving into the home can be met. 2 7 15 Risk assessments and care plans to support people with complex behaviour must provide staff with clear instructions in sufficient detail. This is to ensure that staff know the correct support to provide and approach people in a consistent way. 30/04/2010 Care Homes for Older People Page 7 of 9 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 18 Information about advance decisions should be agreed with the relevant agencies and be clearly documented on care plans. Care Homes for Older People Page 8 of 9 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - 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!
