CARE HOME ADULTS 18-65
Godfrey Olson House Yonge Close Eastleigh Hampshire SO50 9ST Lead Inspector
Gina Pickering Unannounced Inspection 12thJuly 2007 10:00 Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 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 Godfrey Olson House DS0000012171.V338704.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 Adults 18-65. 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. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Godfrey Olson House Address Yonge Close Eastleigh Hampshire SO50 9ST 023 8062 9610 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) www.scope.org.uk SCOPE Post Vacant Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th May 2006 Brief Description of the Service: Godfrey Olsen house is a small care home set in a large apartment building on the outskirts of Eastleigh. The home provides personal support and accommodation for six younger adults with physical disabilities and is owned by SCOPE. The building is owned by Swaythling housing association. The home comprises of four separate ground floor flats. There is also a small communal garden and allocated parking spaces including disabled parking are available. Annual fees for residency and care at the home are in the region of £35,000. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection considered information received by the Commission about the home since the last key inspection in May 2006, including information contained with in the Annual Quality Audit Assessment (AQAA) that was received by the Commission on 6th July 2007. An unannounced visit was undertaken on the 12th July 2007. The inspector spoke with five of the service users, four staff members and the independent advocate who was visiting service users. The service presently does not have a registered manager; it is being run by the registered manager of another SCOPE home who is managing the two homes at the same time. The inspector had conversations with this manager during the visit to the home. Service users spoke with satisfaction about the care and support they receive at the home but all expressed concerns about the management situation at the home. This is explained within the body of the report. What the service does well:
A good admission process gives prospective service users a good understanding about the running of the home and ensures that a person needs can be met at the home. Service users are involved in the development of their care plans; one service users stated that it is ‘ his care plan and his decisions’. Service users are encouraged and supported to lead an independent life as possible within a risk assessment framework. The service supports service users to retain good contacts and relationships with family members and other friends. Good medication practices promote the welfare of the service users. Service users live in an environment that has the suitable adaptations to allow them to be as independent as possible, as well s being homely and decorated in a manner they like. Staff have a good understanding about the safeguarding of adults to protect them from the effects of abuse. The service operates a robust recruitment procedure protecting the welfare of those living there. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 6 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. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user’s move into the home confident that the service will meet their needs and with an understanding about the running of the home. EVIDENCE: One service user has been admitted to the home since the previous inspection in May 2006. This service user told the inspector that he visited the home twice meeting staff members and other service users before making the decision about whether he wanted to live at the home. He confirmed that he had received information about the service that allowed a good understanding about the service provided and the running of the home. He also confirmed that a statement of terms and conditions of residency at the home had been signed. Assessment forms in service user files evidence that a comprehensive assessment is made of the person’s social, health and personal needs before moving into the home. All service users move into the home on a three-month trial basis during which further assessments assist the decision as to whether the home is able to meet that persons needs. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to have an independent life style where they are able to make their own choices EVIDENCE: Service users that the inspector had conversations with said that they are involved in the development of their care plans. One service user told the inspector ‘it is my plan and my decisions’. Care plans are kept in the office but all service users said they can look at them when they want to. Care plans are reviewed on a monthly basis and amended as required. Discussions with service users evidence that they are able to make choices about their lives. This includes choices about meals, rising and retiring times, how to occupy themselves during the day, the décor of their flats, and to some extent the staff member they have to support them. Service user spoke about how they can be involved with the recruitment of staff. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 10 The present manager has introduced an independent advocate that visits the home on a weekly basis. Staff, service users and the advocate agreed that this is further supporting the service users to make their own decisions. The service acknowledges that by encouraging service users to lead an independent lifestyle they have the potential to be exposed to some risks. Risk assessments are in place and actions to be taken detailed to reduce the effects of any risks posed to service users. Risk assessments are reviewed and amended during the review of care plans. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service promotes lifestyles tailored to meet the recreational, educational and social needs of those living at the home as well as allowing for individual choices at meal times. EVIDENCE: Service users are encouraged and supported to enrol for courses at the local colleges and to find employment if they wish. During the inspectors visit to the home two of the service users spoke about college being closed for the summer holidays and about the courses they had enrolled on for the next term. One service user spoke about how he had achieved his life time dream by becoming a DJ on a local radio station. Another service user spoke about how he is able to carry on his involvement in the local church and his chosen political party. Another service user spoke proudly about wheelchair dancing and the plans to perform at a local tourist attraction in the summer. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 12 Service users access the local community either independently or with the support of a member of staff. The town centre of Eastleigh is nearby where service users are able to access the shops and leisure facilities. Discussion with service users evidenced that their families and friends are an important aspect of their lives. Discussion with staff members evidenced that they respect the relationships between service users and their families and encourage and support these relationships. All service users are able to contact their friends and families at any time by telephone or electronically. Meals are planned by the individual service user with the support of their key worker. Dependant on the ability of the service user meals are prepared by the care worker or the service user with support from the care worker in the kitchen in their flat. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident their health care and personnel care needs will be met in a manner in which they prefer. Good medication practices support the well being of the service users. EVIDENCE: Care plans detail the support a service user needs in respect to personal care. Each flat has it’s own bathroom with toileting and bathing facilities that have the adaptations to meet the needs of those living in the flats. There is also a large bathroom with an assisted bath in the home that is not located in the flats that can be used by all service users. Service users spoken with confirmed that staff assist them with personal care in the manner they wish and that they are able to make choices about who assists them with their care. Service users are registered with a local GP service through which they can access other health care professionals. Contacts with health care professionals are documented in the service users documents. One service user spoke of
Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 14 how his walking is continuing to improve with the support of a physiotherapist. There is evidence in service users documents that their emotional health is cared for as well as their physical health. Good policies and procedures are in place for the management and administration of medications that includes the opportunity for service users to manage their own medications. Samples of medication administration record sheets were looked at. These clearly detail the medications administered to service users. Service users said that they receive their medications when they need them. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The organisation does not consider concerns or complaints from service users as important. Service users are protected form the effects of abuse by a staff group that has a good understanding about safeguarding adults. EVIDENCE: The procedure for making a complaint is displayed in the entrance hall to the home as well as service users receiving copies of it in information given to them when moving into the home. The independent advocate stated that she believes the service users have become more confident in expressing concerns since she has been supporting them. Staff members stated that they are aware that the service users have been expressing their concerns more readily since the support of the advocate had been introduced. Both the advocate and service users indicated that that although some concerns were directed at the home many of the concerns and complaints have been about other support services. Service users said that they were confident that the home will respond to any concerns or complaints promptly. But service users and staff have complained to Scope about the present management situation. Several letters of complaint have been made and the area manager made aware of these. Staff told the inspector that he had said that he would pick these letters up, but he has yet to collect the letters. The
Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 16 letters were dated June 2007, the complaints will therefore not be able to be responded to within the 28 days as indicated in the company’s complaints procedure. Staff agreed that they would now post the complaint letters to the area manager. Training records detail that all staff have received training about the protection of vulnerable adults. Discussion with staff members evidenced that they have a good understanding of safe guarding procedures and will take the correct action should they suspect an act of abuse has occurred. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is well maintained, and provides the aids and equipment to met their care needs. The home is decorated and furnished to the wishes of the service users. The home is kept clean and good hygiene practices protect the welfare of the service users. EVIDENCE: Godfrey Olsen House is located in a residential area of Eastleigh with good access to the town centre. The home consists of four flats, two of which are single bedrooms flats and two are two bedroom flats. Each flat has it’s own lounge/diner and kitchen area and it’s own bathroom. All of the service users are wheelchair dependant and the home and flats are adapted to meet their needs with wide corridors and door openings, overhead tracking hoists and low surface kitchen areas. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 18 The flats and bedrooms are decorated in the manner the service users like. Individual bedrooms are decorated and furnished to meet individual tastes and interests such as motorbikes, football teams and music. The home was clean and tidy with no offensive odours on the day the inspector visited. Care staff with the assistance of the service user clean home with. These duties are included in the staffing hours and do not impact on the support given to the service users. Service users said they are happy with cleanliness of home. The home has it’s own laundry facilities that allow for the washing and drying of service users clothes, bedding and other items. Procedures are in place for reporting environmental and maintenance issues to Swaythling Housing Association. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The welfare of service users is protected by the use of robust recruitment procedures and by a workforce which numbers at least 50 NVQ level 2 qualified in care. But records do not confirm that staff receive the required training about health and safety issues which has the potential of not protecting the wellbeing of service users. EVIDENCE: Service told the inspector that they are always sufficient staff on duty to give them the support they need. They stated that staff are flexible meeting their requests for support to go out. There is a staff rota that clearly indicates the staff on duty at any one time. The home is committed to having at least 50 of the work force with a minimum of NVQ level 2 in care. At the present time 50 of the work force have this qualification with another member of staff working towards NVQ level 2 in care. Staff records evidence that a robust recruitment procedure is followed, with all the necessary checks such as CRB and POVA clearance and two satisfactory
Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 20 written references being obtained prior to a person commencing employment. This practice protects the welfare of the service users at the home. Service users told the inspector that they can be involved in the recruitment of staff by being on the interview panel and their opinions being considered if they wish. But the service users expressed the opinion that SCOPE had not considered their feelings, wishes and well being during the recent review of management of the home, which has resulted in the present manger being made redundant from her post. Several service users felt that their options about the present manager should have been sought during this process. Service users said that they had not yet been informed about what is happening about the managers post and that they are waiting for responses from their letters of complaint to SCOPE. Training records detail the training all staff have received. Records do not indicate that staff have received updated training about moving and handling. The service needs to make urgent arrangements, as this requirement is outstanding from the previous inspection, to ensure that the training is provided within the given timescale detailed in the requirement section of this report. It is not clear form fire safety records when each staff member has received training about fire safety. Two new staff members discussed the induction training they have had since commencing work at Godfrey Olsen. It was unclear from this discussion, discussion with the manager or from training records as to whether this induction training complies with the guidelines set out by Skills for Care for induction training. Staff confirmed that they receive regular supervision; records of supervision are kept in staff files. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. An unstable management of the service does not fully promote the welfare of service users. Service users do not feel that the registered provider considers their needs in the running of the home. Records do not confirm that the health and safety of all at the home is fully protected. EVIDENCE: The home has been without a registered manager for 12 months. The registered manager of another SCOPE home has run the home, resulting in her managing two homes. The Commission was informed by this manager in the AQAA that SCOPE has been reviewing the management of all its homes. This
Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 22 has resulted in her being made redundant from the middle of August 2007. At the time of the inspection the Commission had not been informed by SCOPE about the management arrangements it intends to put in place at the home. All staff and service users spoke highly of the present manager and expressed their concern about the future management of the home. Since the present manager has been running the home the independent advocate has been implemented at the home that has given service users further support to voice their opinions and exercise their rights. Service users meetings are held during which service users are able to express their opinions and influence the running of the home. Many of the service user said that since the introduction of the advocacy service they feel they are able to influence the running of the some more effectively. But all service users that the inspector had discussions with felt aggrieved that their opinions were not canvassed by SCOPE about the review of the management structure. Health and safety policies and procedure are in place; these include corporate policies and procedures and those that are local to the homes own environment. Risk assessments are in place for the environment and working activities. Certificates evidence that services and equipment are serviced at the manufacturers recommended intervals promoting the safety of all at the home. The fire logbook evidences that fire safety checks are done in accordance to fire and rescue guidelines. But records do not clearly detail when staff have had fire safety training and some staff were unable to remember when they last had fire safety training. The safety of service users and staff members is also potentially compromised by the lack of training in moving and handling as detailed in the training records. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 1 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 X 2 X X 2 X Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 24 Yes 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. 1. Standard YA22 Regulation 22(3 & 4) Requirement The registered person must ensure that an investigation into any complaint received is carried out and a response to the complaint is given to the complainant within 28 days. A manager must be appointed and must submit an application to the Commission for registration. Staff must have training in health and safety areas including moving and handling and fire safety that follow the current guidance from the relevant organisations. Records of this training must be kept up to date. A requirement that all staff must have moving and handling training was made on 16th May 2006. This requirement has not been met. Timescale for action 31/08/07 2. YA37 8(1) 31/08/07 3. YA42 18(1c) 30/09/07 Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 25 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 YA35 Good Practice Recommendations The induction programme meets the requirements for induction programmes set by Skills for Care. Godfrey Olson House DS0000012171.V338704.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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
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