Inspection on 13/09/06 for Ocean Hill Lodge

This inspection was carried out on 13th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ocean Hill Lodge 10/06/08

Ocean Hill Lodge 29/01/08

Ocean Hill Lodge 12/06/07

Ocean Hill Lodge 16/03/06

Ocean Hill Lodge 22/09/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ocean Hill Lodge 4/6 Trelawney Road Newquay Cornwall TR7 2DW Lead Inspector Mike Stokes Key unannounced Inspection 13th September 2006 10:00 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 Ocean Hill Lodge DS0000063399.V306024.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. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ocean Hill Lodge Address 4/6 Trelawney Road Newquay Cornwall TR7 2DW 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) 01637 874595 Mrs Sandra Dunn John Howard Dunn Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (18), Old age, not falling within any other category (18) Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit one named service user under the age of 65yrs with dementia 16th March 2006 Date of last inspection Brief Description of the Service: Ocean Hill Lodge is a care home registered to offer personal care and accommodation to a maximum of eighteen service users over the age of sixtyfive, who may also have a mental disorder. The home is situated in the seaside town of Newquay, within walking distance of the shopping centre and Trenance gardens. The boating lake is near and service users are assisted to enjoy the walks and coffee shop. For service users who are unable to get to town, services such as hairdressing and chiropody are arranged at the home. On the ground floor there is a smoking lounge, lounge/dining room and patio garden area. There is a chair lift to the first floor. All rooms are singles, with the exception of two rooms, which have been combined for a couple. There is limited parking to the rear of the home and on street parking to the front of the premises. The Service Users are encouraged to take their meals in the dining room, although this is flexible depending on their wishes. Family and friends are welcomed to the home. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key unannounced inspection to review the standards of care at Ocean Hill Lodge. The inspection started on the 13th September and the registered person was on a training course that week. I returned to meet the registered person and complete the inspection process on the 20th September. During the inspection I was able to meet service users, staff, the registered person, tour the premises and inspect records held regarding the welfare of service users. What the service does well: 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. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 6 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 Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 7 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 the following standard(s): 1, 2, 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service, discussion and records. Service users have their needs assessed before moving into the home and receive information needed to choose a home that will meet their needs. This process may include advocates and the home should ensure it is inclusive of service users and maintain records. EVIDENCE: The registered provider has completed a statement of purpose and service user guide regarding the facilities and services available at the home. This information must be provided to all service users and their advocates to assist in the admission process. A recommendation is made for the registered person to note in the service users records when the guide was given, where this is not appropriate due to their mental disorder, a record of alternative arrangements with next of kin or advocate should be noted. The records of 3 service users were case tracked and this included a recent admission to the home. There is evidence of pre admission assessments that include liaison with social and health care professionals. This assessment detail is required to ensure that the needs of all service users can be met at Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 8 the home and forms the basis for a plan of care. The plan of care was not available for the service user admitted in March 2006. The previous report included a requirement to provide appropriate plans of care and this has not been complied with. A discussion occurred with the registered provider to clarify the process involved in these standards and a requirement with an extended timescale is made. The contracts of care were available on files for local authority and self-funding service users. There is a range of fees from £293.25 to £340.50 that reflects the varying dependency levels of care provided at the home. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service, discussion and records. The requirement to improve plans of care has not been met and a plan was not available for one service user. This presents as an unnecessary and potential risk and the registered provider must demonstrate how each service user’s needs in respect of health and welfare are to be met. EVIDENCE: The registered person has not complied with a previous requirement to improve the recording system for plans of care. During this inspection it is noted that a plan was not available for one service user. A requirement with an extended timescale is made and the registered person discussed plans to improve service user inclusion and review procedures urgently to meet these standards. A discussion with senior support staff showed that although the previous system needs amending it does provide details of service users needs and other communication procedures exist at the home to ensure service users receive appropriate care. Service users are registered with local surgeries and receive health care support services as required. The support staff were able to discuss the support received from external professionals e.g. district nurses, Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 10 general practitioner and Macmillan nurses. The registered provider has provided a palliative care training opportunity for the support staff to assist them in this role. The medication procedures are generally well maintained and the registered provider discussed plans to continue the development of these procedures and has organised staff training for the ‘safe handling of medication’. The home has a policy and procedure relating to the administration of medicines that staff are required to read and sign to demonstrate they have done so. Records are maintained of the local pharmacists involvement in the homes medication practices. A requirement is made to provide a signature on records to verify that all service user medication is checked into the home appropriately. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, discussion and records. Service users are able to engage in various social activity of their choice and maintain contact with relatives and friends. Service users receive a healthy, varied diet according to their preferred choice. EVIDENCE: Service users were observed to exercise their choice to enjoy the privacy of their own rooms or join other service users in communal areas for company or meals. I met a service user in a communal area that was pleased the home allowed her to bring her pet dog. Service users stated that they access community facilities with support and maintain contact with visiting relatives and friends at the home. Relatives were observed to visit the home and be made welcome by support staff. The home will organise occasional visiting entertainers, group activities and church services at the home. A hairdresser, chiropodist and mobile library also provide services at the home. The meals provided in the home are good with special diets and choice catered for. A discussion occurred with the cook on duty regarding the catering facilities, equipment, records of menus and consultation with service users. I accepted an invitation to have lunch at the home and was able to discuss various daily routines at the home and procedures with support staff and a service user. The registered provider stated that service users are enabled to Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 12 enjoy visits to places of local interest and a specialist vehicle has been purchased to promote the accessibility for all service users. A record of all activities is maintained of the service users involvement and enjoyment of the activity. Service users enjoy trips to the coastal areas, garden centres and the local boating lake and café. An activities co-ordinator attended the home during the inspection and service users were observed to participate with enthusiasm and enjoy the activities. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, discussion and records. Service users have access to a clear complaints process and are protected from abuse. EVIDENCE: The complaints procedure has been updated and includes the address and telephone number of CSCI and the timescales for complaint investigation. The home maintains a complaints log that includes the action taken to resolve the complaint. A further record is held on the individual file of the service user. The registered provider and some support staff have attended POVA training run by the County Council, with further training booked. Information has been cascaded to other staff within the home. The registered provider is investigating training provided by Truro College and plans to use the No Secrets video as a tool for updating the staff training – evidence of this must be available for future inspections within individual staff training profiles. There home provides policies and procedures relating to Whistle blowing, POVA and No Secrets. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, discussion and records. The design, layout and facilities provided, enables service users to live in a safe and comfortable environment. EVIDENCE: The senior carer assisted the inspector with a tour of the home. A large combined lounge with dining room and a separate television lounge are provided. Bedrooms are individually furnished, decorated and service users have small items of furniture and possessions to personalise their room. All rooms are for single occupation with some en suite facilities. The home provides adequate bathrooms and toilet facilities on each floor level. The home also provides appropriate equipment to support service users with a hoist, raised toilet seats, grab rails, hold open door devices and a call aid system throughout the home. The home is generally well maintained and provides a safe place for service users to live. A door alarm and pressure mats are used to monitor service users that exhibit wandering behaviour. Other safety measures in place Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 15 include radiator covers, window opening restrictors, hot water regulators and fire precautions. During the tour of the home an unpleasant odour was noted in a service users room. This situation had improved on my second visit. A recommendation is made that appropriate strategies or cleaning schedules are maintained to provide a pleasant environment for all service users. The laundry is small, with one industrial washing machine and a domestic tumble dryer. A general lack of storage areas is noted for wheelchairs, walking aids or other equipment. Laundry was being dried in the hallway and the registered provider is aware of the problems surrounding the laundry area, both with the location and facilities offered, and discussed future plans for an extension providing an improved storage, laundry and sluice area. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service, discussion and records. There is some evidence that staff are appropriately recruited and trained. These records were not complete in all areas and a requirement is made to develop these records to demonstrate that the home can meet these standards. EVIDENCE: On arrival at the home there were appropriate staff numbers and skills mix available to provide for service users welfare. The rota showed that 4 carers are on duty during the morning and this reduces to 3 for the afternoon and early evening. One waking and sleeping carer are provided for service users that may require attention at night. A cook, domestic and maintenance staff support these arrangements. The staff exhibited appropriate skills and attitudes in their interactions with service users. Service users stated their approval of staff and services received at the home. There has been some recent changes to the staff group and the registered person is providing staff training opportunities. A member of staff stated, ‘I like to do the NVQ and other training for my development and to keep service users safe’. The home maintains a good communication system at handover meetings where senior carers delegate daily tasks and responsibilities to carers. The records regarding recruitment, induction and staff profiles were inspected and discussed with the registered provider. These records were not complete in all areas and a requirement is made to develop these records to demonstrate that the home can meet these standards. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, 37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service, discussion and records. The registered provider must make appropriate arrangements to deliver the effective management and administration of the home. EVIDENCE: The registered provider manages the home on a day-to-day basis and has recently attended a ‘skills for care’ conference on management training. The registered provider has completed the NVQ level 4 in Care and has 2 units of the RMA to complete. A recommendation is made to inform this Commission of the proposed completion date. The records detailed in schedules 3 and 4 were discussed with the registered provider and various records were inspected. The previous inspection report noted that the registered provider would benefit from additional support to Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 18 complete the administrative role. Various requirements have been made regarding a lack of appropriate recording procedures at the home and the registered person must comply to prevent this commission from considering enforcement action. A range of health and safety checks and maintenance procedures are conducted appropriately at the home. Health and safety training is organised for October 2006. A requirement is made regarding the provision of a member of staff on duty at all times with a first aid qualification. The arrangements to complete structured staff supervision and maintain records has not been complied with and a requirement is made to develop these procedures. A quality assurance survey has been achieved and the registered provider discussed the intentions to develop these processes to consult with service users and visitors to the home. Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X 2 2 2 Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 Requirement Timescale for action 01/12/06 2. OP9 13(2) 3. OP29 19 The registered provider must develop the Service Users plan of care to incorporate health, personal and social care needs to enable it to inform and direct care. A service user plan of care generated from a comprehensive assessment (see Standard 3) must be drawn up with each service user and provides the basis for the care to be delivered. NOT PREVIOUSLY MET. The registered provider must 01/12/06 ensure that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. The registered provider must 01/12/06 maintain detailed records to demonstrate a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. DS0000063399.V306024.R01.S.doc Version 5.2 Ocean Hill Lodge Page 21 4. OP30 12 and 18 5. OP36 18(2) 6. OP37 17 7. OP38 12 The registered provider must maintain staff profiles to demonstrate that there is a staff training and development programme that meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. The registered provider must ensure that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice. The registered provider must ensure records required by regulation for the protection of service users and for the effective and efficient running of the business are maintained, up to date and accurate. The registered provider must ensure so far as is reasonably practicable, for the health, safety and welfare of service users and staff. A first aid box and qualified first aider must be provided at all times, including night duties. 01/12/06 01/12/06 01/12/06 01/12/06 Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 22 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 OP1 Good Practice Recommendations The registered provider should note in the service users records when the guide was given, where this is not appropriate due to their mental disorder, a record of alternative arrangements with next of kin or advocate should be noted. The registered provider should ensure the premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. The registered provider should consider the use of additional support, a review in the management role, time management skills and resources needed to ensure compliance with the responsibilities of a registered manager. The registered provider should inform this Commission of how the Provider/Manager role can inform this Commission of be a feasible one. The registered provider should complete the Registered Manager Award or equivalent within a short time scale and inform this Commission of the proposed completion date. 2. OP26 3. OP31 4. OP31 Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 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 Ocean Hill Lodge DS0000063399.V306024.R01.S.doc Version 5.2 Page 24 - 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!