Inspection on 24/11/06 for Oban House (42-46)

This inspection was carried out on 24th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Oban House (42-46) 03/10/07

Oban House (42-46) 07/12/05

Oban House (42-46) 12/05/05

Oban House (42-46) 08/12/04

Oban House (42-46) 21/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Oban House (42-46) Oban House 42-46 Bramley Hill South Croydon Surrey CR2 6NS Lead Inspector Michael Williams Key Unannounced Inspection 24th November 2006 9:45am 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 Oban House (42-46) DS0000019035.V319574.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. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oban House (42-46) Address Oban House 42-46 Bramley Hill South Croydon Surrey CR2 6NS 020 8649 8866 020 8649 8811 oban.house@ashbourne.co.uk 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) Apta Healthcare (UK) Ltd Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: Oban House was trading as APTA Healthcare UK Limited, a subsidiary of Ashbourne Healthcare Ltd., but is now owned and managed by Southern Cross, a large company with homes across the country. Oban will nevertheless keep the company name Ashbourne. Oban is a purpose built home for older people who require nursing care and was first opened in 1997. The home admits service users both privately funded and through placement agreements with the local authorities. The home is arranged over three floors. Each room has an en-suite shower and there are toilets and bathrooms located on each floor. Each floor also has its own communal living room, kitchenette and dining room. There is a main kitchen in the basement of the building and a laundry service is provided for the service users. Fees from £522 to £850 as at November 2006 Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based upon an unannounced inspection carried out from 10 am on 24th November 2006. The lead inspector was accompanied by a second inspector; the new Home’s Manager and an Operations Manager were present during the inspection. In order to monitor all aspects of care the inspector ‘tracked’ the care provided to a sample number of residents and cross-checked the information by examining the documentation supporting that care, and by observing the meals provided, checking the arrangement for medication, handling money, and by examining the records of complaints and accidents. Staff providing care were interviewed, and where possible the inspector met with relatives as well as interviewing or observing the residents themselves. What the service does well: What has improved since the last inspection? What they could do better: The building does need some refurbishment in many areas; wallpaper is rather tired looking and there are areas of minor damage throughout the home. Staffing levels need to be kept under review as the needs of residents change; in particular the home\ must provide a Registered Nurse on each of the three floors for night shifts and will need to deploy staff during the days so as to meet peak demand for example when there are extra activities. Security must be reviewed, for example no fire or final exit door must have key to exit. Window security must also be reviewed to ensure the hoe is safe from Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 6 unauthorised entry. The Nurse call system also needs attention especially that all staff on each floor must have a pager so they can all monitor calls and respond if need be to calls for assistance. When recruiting staff the home must contact the Commission before using the shortened form of character checks referred to as ‘POVAFirst’. 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. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 3: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are in place for each service user and these form the basis of the initial care plan and risk assessment. This ensures the care, including health care, needs of the service user is made clear from the outset. EVIDENCE: A sample of case notes of those residents being ‘case-tracked’ in order to monitor care was checked. The manager, the Operational Manager, some staff and relatives were interviewed during the course of this and the previous inspections; they and the service users themselves advised the inspector of their experiences at the time of admission. The Administrator advised inspectors that an information pack is prepared for each service user and include the Service User Guide (located in each bedroom), a summary of the Statement of Purpose and two copies of the Contract. Care staff then start compiling the care planning documentation. The pre-admission assessments include general information about each service user, details of their background medical and social history and comprehensive details of specific issues such as mobility nutrition, diabetes, continence, medication and Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 9 diversity needs or choices. Service users, with their representatives, assist in the compilation of these case notes. Areas of strength are depth and range of pre-admission assessment and information provided on admission and as no matters requiring improvement arise this section, about choice upon admission, is assessed as good. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 10 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): NMS 7 8 9 10: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans of care plans are in place for all service users and regularly updated. Medication policies, procedures and administration practices ensure the safety of service users. Service users care treated with respect and their dignity maintained at all times. EVIDENCE: The most important aspect of this section is that the residents said they were very happy Oban House. More than one person said the home was very good and couldn’t be faulted. A sample of residents case files were read to track care provided to group of residents. To do this residents and relatives were interviewed; staff and visiting professionals notes were read new the manager also explained how they aim to met the social and health care needs of all residents. The administration in this home is very good and the case files were in good order Pre-admission information is in place and this helps direct the in-house assessments and care planning. A range of new and comprehensive documents are required to be maintained for each service user including items such a Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 11 photograph, basic personal data, health assessment and monitoring and social care needs, professional and family involvement and so forth. Care plans and reviews are in pace for each service users and the daily notes indicate that staff are providing suitable care and support for each service user. During the inspection it was noted that the home’s staff make prompt and direct contact with health care professionals such as a Nurse or Doctor if the need. No errors were identified in the procedures for recording, storing, administering and returning medication. In most instances staff assist residents with their medication but for those residents intending to return home the care staff can support residents in looking after their own medication in their rooms. One recommendation is made to secure the medication due for disposal. The privacy of residents was compromised a little by not having suitable bedroom door locks. It was noted and is commended that any bedroom doors held open at the request of residents are held by magnetic door holder that responds to the fire warning system and will therefore close automatically. Areas of strength are the well managed documentation to support care practices and the residents’ views that they are well cared for and as there are no matters requiring improvement this section, about health and social care, is assessed as good. One recommendation is made to improve security for unwanted medicines awaiting collection. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 12 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): NMS 12 13 14 15: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users appreciate the comfort and lifestyle provided in this care home. They maintained contact with their families and are given every opportunity to exercise choice and control commensurate with their health and abilities. Service users were unstinting in their appreciation of the meals provided. EVIDENCE: During the examination of a sample of case files the very detailed care plans and multiple assessments were noted; they were clearly laid out and easy to follow and made clear the specific health care needs of each service user. The life-story element was missing in most instances and recommendation is made to develop better understanding of residents life story where it is appropriate to do so. So that they make known to staff the background and personal history as described by the residents themselves. We have suggested a checklist of the service users’ wishes and preferences be added as part of life-story notes - this will help to guide the activity coordinator in providing opportunities tailored to services users’ specific expectations of the home. The daily routines in this home are reasonably flexible, within the constraints of a large service. Service users are being supported and Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 13 encouraged to maintain links with family, friends and to exercise choice and control over their lives in so far as they wish and are able to do so. Service users are receiving a wholesome, appealing and well balanced diet in a congenial setting in accordance with their recorded requirements and preferences. Residents in this home are very dependent as a result of their age and frailty; their capacity to control their lives and make significant decisions and choices is therefore somewhat constrained. The initial assessment and information provided by family and friends helps staff gauge residents’ wishes and preferences. The daily routines in this home are reasonably flexible, within the constraints of a large service, and the range of activities available, including social, religious and recreational opportunities is varied to suite the service users’ expectations, preferences and capacities. Community contact: Service users are being supported and encouraged to maintain links with family, friends and the wider community as they wish. It was noted on the day of the inspection that there were a wide range of visitors including family and friends, and church visitors as well as professional health carers. The visitors’ book, a required record, confirm this social and professional contact with the wider community. Service users are receiving a wholesome, appealing and well balanced diet in a congenial setting in accordance with their recorded requirements and preferences. Areas of strength are excellent care plan documentation that now needs to be completed in greater detail to achieve its best results. No matters requiring improvement but a recommendation is made about holistic care so this section, about daily life and social activity, is assessed as good. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 14 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): NMS 16 18: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective policies and procedures are in place to deal with complaints. Service users and their representatives are confident that their complaint or compliment will be listened too and responded to in a timely manner. Staff training and the home’s policies and procedures for the protection of vulnerable adults ensures the safety of service users. EVIDENCE: The record of complaints was in place and two are recorded as having been dealt with since the last inspection. Documentation was in place to demonstrate that a thorough complaints procedure is in place and executed by the manager. The manager and staff are also clear about the procedures to be followed if abuse is suspected. Service users confirm that with arrangements in place to complain or make representations and they are confident their opinions and concerns are dealt with in a professional and thoughtful manner. A record of complaints is in place. No complaints arose during the course of the inspection. In contrast several complimentary comments were made by those people interviewed. The home has a copy of the local authority’s procedures for dealing with allegations of abuse but no such issues have arisen since the previous inspection. Staff were aware of their responsibilities to protect service users and report allegations of misdemeanours. Whilst no complaints were made during this inspection or the previous inspection two suggestions were made to the CSCI, one was about hearing aids and the other was about improving door signs for partially sighted service users. Both suggestions were passed on to Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 15 the person in charge and recommendations were made to pursue these ideas and on this occasion the person in charge confirmed that these two suggestions have been followed up. Staff were aware of their responsibilities to protect service users and report allegations of misdemeanours but not al staff recalled the importance of referring such maters to the local authority care management team before making anything other than brief enquiries to clarify the allegation. Areas of strength are the clear systems in place for complaining or making concerns known in the home or where needed to other agencies such as Social service or the Commission and as no matters requiring improvement arise this section, about complaints and protection, is assessed as good. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 16 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): NMS 19 26: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, clean, warm and well-maintained and comfortable environment. This is a purpose built care home and is subject to ongoing refurbishment. EVIDENCE: The layout of the home and the manner in which it is being maintained means that this is a safe, comfortable and suitable environment for the service users. There were however a number of matters requiring attention and they are outlined here; wallpaper is beginning to suffer wear and tear but still makes the Oban House look homely, wall damage often caused by wheelchairs needs attention. Tiles are missing or damaged in a number of locations and at least one small area of a ceiling has water stains. The premises are being kept clean, hygienic and free from offensive odours and systems are in pace to control the spread of infection. Residents and relatives commented how clean the home is so domestic staff are to be commended. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 17 Areas of strength are general quality of the premises and matters recommended for improvement are wear and tear so this section, about environment, is assessed as good. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 18 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): NMS 27 28 29 30: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has for the most part adequate numbers of staff and the staff recruitment procedures, induction, training, support and a supervision regime is in place so this will ensure they are competent in their jobs ensuring service users are in safe hands at all times. EVIDENCE: During the previous inspection there were adequate numbers of staff shown on the staff duty roster that is, for 51 service users in total there were to 3 Nurses and 10 carers plus the manager who is also a nurse; in addition there are numerous ancillary staff including catering, cleaning and maintenance staff. Whilst staffing levels are within the levels advised by the previous regulatory authority (Health Authority) the home has increased staffing levels to ensure service users’ needs can be fully met. A sample of staff files including police checks (CRB) was examined to ensure compliance with good practice and the relevant legal requirements in respect of the recruitment of staff. The manager and staff confirmed that induction and ongoing training is in place, including standard courses such as first aid, moving & handling, health & safety and so forth as well as courses related to the health and social care needs of service users. One issue of concern arose during the course of this inspection; at night there are only two registered Nurses and there must be one at least on each of the three floors. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 19 Areas of strength are well motivated staff team that is well trained and supported. One matter requiring improvement is the need for three nurses at night. The home must also notify the commission if it intends using the abbreviate checks when initially employing new staff referred to as the ‘POVAFirst’ check. This section, about staffing, is assessed as good. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 20 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): NMS 31 33 35 37 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There is an acting manager and new Deputy manager in post. This is a well managed care home that ensures the health, welfare and safety of service users is paramount. A small number of potential health and safety hazards were identified but are easily remedied. EVIDENCE: The acting manager will need to register and at that time will be assessed as to her qualifications skills and experience to run Oban House and to demonstrate how she will run the home and meet its stated purpose, aims and objectives. Based upon the views of service users it is clear to the Commission that this home is being run in the best interests of the service users. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 21 Systems are in place to ensure that the property and money of service users (held by the home) can be held securely and is safeguarded. Provision is also made for service users to control their own money. The home is ensuring that in so far as it is reasonably practical to do so, the health, safety and welfare of service users, and staff, is being promoted and protected but a small number of matters of safety need to be addressed and they are listed in the requirements table below. Fire doors must be available without the use of key. Conversely, Managers must have access to the home unannounced. Windows must be secured against unauthorised intrusion. Areas of strength are commendations by residents and relatives of the high standards achieved in the care home and matters requiring improvement are fire safety (door locks) and window security. This section, about management and administration, is assessed as good. Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 22 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 2 Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP27 Regulation 18(1)(a Requirement Staffing levels: The registered person must ensure that at all times there are adequate numbers of staff for the health and welfare of service users, including 3 qualified Nurses at night so as to have one Nurse on each floor of the home. Timescale for action 30/01/07 2. OP29 19 Staff recruitment: If the home 30/01/07 intends to employ staff who have applied for but not received the police [CRB] check but completed the ‘POVAFirst’ check the Commission must be informed in accordance with Department of Health Guidance. Final exits and fire doors: All final exits including those used as fire exits must be available without the use of a key. 30/01/07 3. OP38 23(4) Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 24 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 OP9 Good Practice Recommendations Medication: It is strongly recommended that unwanted` medication awaiting collection is held more securely, for example in locked units and not just a locked clinic room. Expectations of service users; It is recommended that the personal history or ‘life-story’ element of the residents’ case notes in completed in greater detail including a ‘wishes and preferences’ list. Premises: it is recommended that a programme of refurbishment is developed to ensure all parts of the home are well maintained and kept good decorative order. Window security; it is recommended that window security be reviewed to reduce the risk of unauthorised access at ground level or accidents above ground level. 2. OP12 3. OP19 4. OP19 Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Oban House (42-46) DS0000019035.V319574.R01.S.doc Version 5.2 Page 26 - 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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