CARE HOMES FOR OLDER PEOPLE
Oban House 9-11 Victoria Drive Bognor Regis West Sussex PO21 2RH Lead Inspector
Jennifer Wright Unannounced 27 April 2005, 08:00 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 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. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Oban House Address 9-11 Victoria Drive, Bognor Regis, West Sussex, PO21 2RH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 863564 Ms Eve Kent Mr Ronald Peter Rook Ms Eve Kent Care Home (CRH) 30 Category(ies) of Old age, not falling within any other category registration, with number (OP), (30) of places Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9 December 2004 Brief Description of the Service: Oban House is a care home registered to accommodate up to 30 reidents (2 of whom may be day care) in the category of older adults. Oban House is a large property consisting of two separate detached houses being linked in the middle to form one establishment. Oban House is situated near the sea and local shops, in the coastal town of Bognor Regis. The service is privately owned by Ms. Eve Kent and Mr R. Rook, and the registered Manager is Ms. Eve Kent. Both Mr. Rook and Ms. Kent have successfully undertaken a Criminal Record Bureau check. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. This was an unannounced inspection made at 8 o/clock in the morning, in order for the Inspector to see how the residents are helped to get up, and washed and dressed, where necessary. A second inspection, which will be announced, will be undertaken later in the year. During this inspection the Inspector toured the building, visiting every room, and joined the residents for lunch. As well as talking the Manager and the deputy Manager, the Inspector spoke at length to 17 of the 24 residents plus a District Nurse. Three staff members were also spoken to on the day of inspection about how they find working at Oban House. The Inspector examined records about care being provided to residents; as well as records of any accidents or concerns or complaints, to make sure that the residents at Oban House were being taken care of. What the service does well: What has improved since the last inspection?
Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 6 All the radiators have now been covered to ensure the safety of the residents. A new walk-in bath has been installed, which, residents told the inspector, was “really good” and “makes me feel safe”. Many of the bedrooms have been redecorated as part of an ongoing maintenance programme. The residents that were spoken to told the Inspector that they liked living in a home that was well cared for. And they “always went to Mr. Rook whenever anything needed sorting”. What they could do better:
The majority of residents spoken to said that they could think of nothing that Oban House could do better, but two residents thought that they would like to have the opportunity to go out more, “perhaps for a drive and a nice cup of tea somewhere”. The Manager told the Inspector that she had arranged for all those who wished to, to go for a drive the following week-end to see the bluebells in local woods, and for someone to come to the home weekly to undertake craft some activities, including flower arranging. A District Nurse spoken to on the day of inspection told the Inspector that there had never been any problems or concerns, as far as she was concerned, with regard to the care given by the staff of Oban House The Inspector would like to thank everyone who cooperated with her on the day of this inspection. 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. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 5 and 6 Prior to moving into Oban House people were given sufficient information about what the home offers to enable them to make a choice as to whether or not they want to live there. Before moving into the home, people are assessed, by a member of staff, to make sure they are suitable. People know exactly what they can expect from Oban House and what is expected from them. EVIDENCE: All the residents spoken to on the day of inspection confirmed that they had been given information all about Oban House, and that they had been invited to visit the home before they came to stay. Several residents also told the Inspector that they knew what to expect from Mrs. Kent and her staff members and had no complaints whatsoever about the way they were being looked after. The Inspector met with a District Nurse who said that she had found the staff to be welcoming and friendly. The Inspector looked at the care records of four of the residents, and found them all to be satisfactory. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10and 11 Where possible residents are involved with the drawing up of their care plans. All residents are informed of all services available under the National Health Service, and specialist equipment is provided where necessary. Correct medication procedures were seen to be in place, to protect the people living at Oban House from harm, and from the comments made by many residents and a District Nurse, it would appear that the staff respect the privacy and dignity of the people living at Oban House EVIDENCE: Where resident are not able to be involved with the drawing up of their care plans, then the residents relative or advocate is involved. This was confirmed by many of the residents who the Inspector spoke to on the day of inspection, who said, “they felt that they were consulted about things to do with them”. A new walk-in bath has recently been installed to assist people who are less mobile, and residents told the Inspector that they enjoyed having a relaxing bath, and “were no longer anxious”. Records of drug administration and the inspection of the drugs cabinet demonstrated that the correct procedures, relating to medication, were being adhered to. Staff members spoken to by the Inspector confirmed that they had received the appropriate training. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 10 The Manager informed the Inspector that family or friends are offered a spare bedroom, if available, or a comfortable chair in the residents room, at the end of the residents life. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 People living at Oban House are able to make the day-to-day decisions about how they want to live their life. There is a range of activities for those who wish to participate, and residents are encouraged to maintain contact with all their old friends and family, wherever possible. The food is of an extremely high standard, and offers a choice of menu, with people able to eat either with other residents or in their own room should they prefer. EVIDENCE: Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 12 There were a variety of activities on offer at Oban House, and although the majority of people told the Inspector that they felt that there was enough to do, should they wish it, two ladies said that they would “like to go out more”. The Manager informed the Inspector that now that the better weather was here, more outings to local beauty spots on a regular basis was going to be arranged, “starting with a trip to the bluebell woods next weekend.” On the day of inspection the Inspector shared a meal with the residents, which was very tasty, attractive in appearance, plentiful, and clearly enjoyed by all. The inspector noted that the meal was served on hot plates, and in a way to encourage appetites. One resident told the Inspector that she “really looked forward to mealtimes” and another said that she was “never disappointed with the food”. From direct observation, the Inspector noted that the mealtime appeared to be unhurried, with residents being afforded sufficient time to eat their meal. Where it was necessary staff members were seen to help residents in a sensitive and unobtrusive manner. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Regular training sessions for staff, a complaints/concerns book, plus policies and procedures regarding abuse, ensure that, as far as is possible, the people who live at Oban House are protected from bad practice. EVIDENCE: A copy of the homes Complaints Procedure was available for residents and visitors, should they wish to complain, although the Manager said that she “encouraged people to talk to her, or a member of staff about any concerns they might have”, in order that they may be addressed before they become a complaint. Residents spoken to confirmed that Mrs. Kent and Mr. Rook were “very good at sorting things out”. The current West Sussex Multi-Agency Policy and Procedure for protecting vulnerable adults from abuse was seen to be available in the home, which also have their own policies available, to safeguard residents from abuse. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,22,23,24,and 26 On the day of inspection Oban House appeared clean and well maintained, and the location of the home is suitable for the residents who live there. Oban House was seen to provide aids, ramps and assisted bathing facilities. EVIDENCE: During the course of the inspection the majority of rooms were visited to ensure that the environment was safe and comfortable for people who live there, and it was noted that many residents had brought personal possessions into the home, including small items of furniture, ornaments and photographs. Records showed that hot water from the taps of sinks, used by residents, is tested at appropriate intervals to ensure that people are not put at risk from scalding. On the day of inspection, Oban House was seen to be clean, and free from offensive odours. Policies and procedures were available for staff regarding control of infection, and the safe disposal of clinical waste. Residents told the inspection how much they liked their bedrooms, and said that “if I need to ring the bell then someone always comes to help me, and nothing is too much trouble”. Two residents, who had chosen to share a
Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 15 bedroom, had the use of the second bedroom as a sitting room, and said, “this suited them very well”. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29,30 Oban House is adequately staffed with employees who appear competent to care for older people. National Vocational Qualification is on going and further development training is expected. All training is recorded on staff member’s files. EVIDENCE: The Inspector was informed by the Manager that two care workers have almost completed their NVQ 3, four more care workers are due to start their NVQ 3 shortly, and that the Deputy Manager is currently undertaking her NVQ 4. Many of the staff has worked at Oban House for a long time. Staff members told the Inspector that the Manager of Oban House supported them; they enjoyed their work, and felt that “we all work well together as a team”. Residents told the Inspector that there appeared to be enough people on duty to assist them when they needed it. A visiting District Nurse confirmed this. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32, 33,35 and 38 Mrs. Kent, the registered Manager, is qualified, and experienced in working with older people. Records needed for the safe running of a care home are kept up to date. Policies and procedures are available for staff members to refer to, to ensure the safety of the people who live and work at Oban House. EVIDENCE: Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 18 All the residents confirmed to the Inspector, that both Ms. Kent and Mr. Rook are extremely approachable and supportive. The staff members that the Inspector spoke to echoed this. Residents told the Inspector that they liked the way Oban House was run. One resident told the Inspector that he was “independent, and yet taken care of very well”. Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 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 4
COMPLAINTS AND PROTECTION 3 3 x 3 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 x x 3 Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 20 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. 1. 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 Good Practice Recommendations Oban House H60-H11 S14649 Oban House V222902 270405 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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