Inspection on 15/11/06 for Ogilvy Court

This inspection was carried out on 15th November 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

Ogilvy Court 07/08/07

Ogilvy Court 06/01/06

Ogilvy Court 21/06/05

Ogilvy Court 25/02/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOMES FOR OLDER PEOPLE Ogilvy Court 13-23 The Drive Wembley Park Wembley Middlesex HA9 9EF Lead Inspector Mr Ram Sooriah Key Unannounced Inspection 15th November 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 Ogilvy Court DS0000059961.V319947.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. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ogilvy Court Address 13-23 The Drive Wembley Park Wembley Middlesex HA9 9EF 020 8908 5311 020 8908 5807 manager.ogilvy@careuk.com 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) Care UK Michelle Sampang Care Home 57 Category(ies) of Dementia - over 65 years of age (45), Learning registration, with number disability (12), Learning disability over 65 years of places of age (12), Mental Disorder, excluding learning disability or dementia - over 65 years of age (45) Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user category LD is to include only service users of age 45 and over. 6th January 2006 Date of last inspection Brief Description of the Service: Ogilvy Court is a care home, which belongs to Care UK, a national care homes provider. It is situated in The Drive, which is a small road off the main busy Forty Lane. It is easily accessible by buses, which pass on the main road and is about 5-10 minutes walk from local shops and local amenities. More extensive shopping facilities are found in Wembley which is a short bus ride away. The home also has a large car park in front of the home easily accommodating about fifteen cars. Ogilvy Court is a care home specialising in providing nursing care for elderly service users over the age of 65 years with mental illness and for service users with a learning disability from 45 years of age. It is purpose built and provides accommodation in mostly single rooms with en-suite facilities. It has three double bedrooms also with en-suite facilities. There are three units in the home. Ivy accommodates twelve service users with a learning disability, Dahlia accommodates fifteen male elderly service users with mental health needs and Bluebell accommodates thirty mostly female elderly service users also with mental health needs. The management structure in the home normally consists of the manager and three unit managers. The home provides all the other necessary ancillary services such as laundry and catering. The home charges the local Primary Care Trust, the main purchaser of beds in the home, a weekly fee of about £587 for one of the contracted beds. Other authorities or privately funded service users are charged about £728 a week for a placement. At the time of the inspection, there were fifty service users in the home. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection started at about 10:15 on Wednesday 15th November. It finished at about 17:15 and continued on the Thursday 16th November from about 14:15 until about 19:45. The home has had a random unannounced inspection on the 27th April 2006 to monitor the progress of the home with regard to meeting past requirements. During the course of this inspection the inspector observed care practices, toured a sample of the premises, spoke to some service users, the manager and some members of staff and looked at a sample of care records both on the computer and on service users’ files. He also observed mealtimes, looked at some health and safety, personnel and other records kept in the home. It was difficult to get the views of service users about the service because a large number of service users who are accommodated in the home were not able to express themselves because of the level of their needs and abilities. The inspector is very grateful to all service users who spoke to him and to the manager and her staff for their flexibility to accommodate the inspection and for their cooperation and support. What the service does well: What has improved since the last inspection? There has been some improvement in the content of care records. There is however an issue with regard to ease of access of the care records, as part of Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 6 the records is on paper and part is on the computer. The computer system for records keeping is not yet fully operational. Risk assessments are more comprehensive and now covers areas where service users might be placed at risk by the behaviour of other service users or when there are limitations to the freedom of some service users by not providing them with call bells or with keys to their doors as these might pose more risks to them. Staff have had training on abuse and on safeguarding adults. They were more aware of the action to take in cases of allegations or suspicions of abuse. Recent allegations were appropriately dealt with by staff in the home. The home has a redecoration and refurbishment plan. Some areas of the home such as corridors and communal areas have been redecorated and there are plans for further redecoration and refurbishment. The grounds of the home are maintained. Efforts are being made with regard to addressing the cultural, religious and ethnic backgrounds of service users and incorporating this information in the care plan to provide holistic care for service users. There is however more improvement to be made in this area. The management of the end of life care and death of service users is addressed in care records, bringing into perspective this sensitive aspect of care. The home now has a training and development plan and there is evidence that appropriate training is being provided to members of staff. Equipment that are provided from the financial resources of service users are first agreed with the representatives of the service users or with the funding authorities for those service users who do not have representatives. What they could do better: It is well documented that a ‘person-centred care approach’ should be adopted for the care of service users with dementia. This is based on ensuring a comprehensive assessment of the needs of service users while focussing on the strengths of service users and areas where the service user needs assistance. Because a comprehensive assessment of the needs of service users was lacking on some occasions then the care plan cannot be tailored around the individual needs of the service users and there is a danger that the needs of the service users may not be met. This equally applies to the assessment of the social and recreational needs of service users, which was also lacking at times. Documentation with regard to the management of pressure ulcers must be more comprehensive. Photographs or wound mapping must be used and regular wound progress reports must be completed. Records kept must include Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 7 the pressure relief equipment in use. Service users who are at high risk of pressure sores must be provided with pressure relief equipment according to their individual risk assessment. At the time of the inspection, it was noted that service users in the home had been offered the flu vaccine. Staff in the home administered the vaccine, but it was not clear if they have had the training to administer the vaccine and if there were any emergency medicines in place should service users develop an adverse reaction to the vaccine. A procedure for the management of vaccines in the home was also not in place. Although meals provided by the home are in the main appropriate to meet the needs of service users, more attention can be given to the provision of meals to ensure that these are suitable for the individual needs of service users, including for the needs of vegetarians. Service users who are losing weight must be referred to the relevant healthcare professional as soon as possible. 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. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 8 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 Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 9 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): 1-4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive most information about the service prior to moving onto the home except for information about the range of fees that the home charges. The manager ensures that all the necessary information is available prior to accepting prospective service users to ensure that the home is able to meet the needs of the service users. EVIDENCE: The inspector was informed that prospective service users of the home receive a service users’ guide (SUG) at the point of admission. The SUG was noted to have been updated, but it does not yet contain information about the range of fees charged by the home, such as how much service users who are publicly funded pay and how much do privately funded service users pay. It is however acknowledged that the home accepts mostly publicly funded service users as Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 10 most service users have needs which most likely would make them eligible for public funding. Inspection of a sample of service users’ files showed that all service users had received the terms and conditions of the placement, including those who are publicly funded and that these have been signed and agreed by the next of kin of the service users. New service users in the home had a copy of a pre-admission assessment in their files. These were carried out by the unit managers or by the home manager. In cases where service users with complex needs were referred to the home, then the needs assessments were carried out by the home manager and by the manager of the unit where the service user would be placed. Copies of the needs’ assessments of the funding authorities were also available on file. The home has a group of staff who are not always representative of the client group but that is probably linked to more complex issues with regard to the work force in care homes in the Brent area. However service users from ethnic minorities are relatively well represented in the work force. It was noted that the care plans of service users from ethnic minorities contained some information about the cultural and ethnic needs of the service users and there were specific care plans in place addressing these aspects of care. This was a marked improvement from the last inspection and showed that staff in the home have made efforts to address these issues. However the cultural and ethnic issues could have been further explored and addressed in the care plan. For example likes and dislikes of service users with food could have been more comprehensively identified and incorporated in the care plan addressing nutrition. Similarly religious beliefs and cultural practices could have also been incorporated in the care plans addressing activities, death and end of life care. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 11 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): 7-11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans of service users were not always clear about the actions to take to meet the needs of the service users. As a result there was no guarantee that the needs of service users would be met. Most of the healthcare needs of service users were met. There was however some deficits with regard to the management of pressure ulcers. Few issues were noted with the management of medicines in the home. One of the issues, which was about the management of Flu vaccines in the home, could have adversely affected the health of service users. The end of life care and the death of service users is managed sensitively and appropriately by the home. EVIDENCE: The home has introduced a computerised system for records keeping in the home. The aim is that all records would be computerised eventually. At the time of the inspection, the home did not have all the records on the computer. The needs assessments and all other risk assessments were on paper files and the care plans and all the progress notes were on the computer. This was Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 12 because the format used for the assessment of needs on the computer was not comprehensive enough and there were sections in the format, which were not relevant to the care of the service users that the home accommodated. For example it did not yet have a section for the assessment of the mental health needs of the service users, which was relevant for the category of service users accommodated in the home. As a result the care records were not as accessible as they could have been. The assessments of needs on the paper files were on the whole appropriately completed and contained some information about the mental health needs of service users, although it was noted that a specific format for the mental health needs assessment was still not in place, even in a paper format. The manager has incorporated prompts in the format for the assessment of the activities of daily living to address the mental health needs of service users. It was noted that one service user who was recently admitted to the home did not have her needs’ assessment fully completed at the time of the inspection although the latter had been in the home for about one month. Some needs assessments were very well completed but some were not. Sometimes only a few words were used for the needs assessments, which were not adequate to describe complex needs of service users It is also generally accepted that the “Person-Centred Care approach” is suited to care for service users and to prepare their care plans, particularly for those with dementia and with mental health needs. The format used in the home could however benefit from a more “person-centred care approach’ with a greater focus on the strengths of the service user, understanding the background and life of the individual, to knowing the actual ‘person’. The inspector looked at the care records of five service users chosen for case tracking purposes. It was noted that while most information about the care of service users was available, there were a few instances when the information was not as comprehensive as it could have been. Care plans for incontinence were not always clear with regard to how the incontinence of service users was going to be managed. Words such as “ensure correct pads are used”, washed regularly and properly” and “change regularly” were used without an explanation of what these terms actually meant for each individual service user. The care plan for a service user who was vegetarian did not address this aspect of her nutritional need with emphasis on ensuring that she is provided with a balanced diet. Care plans of service users included a range of risk assessments to address the safety of service users. Apart from falls, nutrition, pressure ulcers risk assessments there were other individual risk assessments based on the needs of the service users. These included issues such as aggressive and other inappropriate behaviour, risk of self-injury and risk of absconding. There was also a manual handling risk assessment and a care plan to reflect the findings Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 13 of the risk assessment. It was noted that the moving of service users while in bed and the equipment to use for this purpose were not normally addressed in the care records. Evidence was available in the care records to suggest that service users or their relatives were involved in care planning. Some signatures were in place to show that relatives of service users had agreed to the care plans. In a few cases the involvement of service users happened when the care plans were drawn. There was however little evidence to show that service users have been involved in the review of the care records. Two service users in the home had pressure ulcers. It was noted that the service users had been referred to the tissue viability nurse and that they were being nursed on appropriate pressure relief equipment. There were however no photographs or wound mapping to give an indication about the condition of the pressure ulcers. Wound progress notes about the ulcers were also not being maintained at the appropriate intervals as indicated in the care plan. It was therefore difficult to make a judgement about whether the pressure ulcers were getting better, but comments from staff in the home suggested that the ulcers were getting better. It was also noted that a service user who was at very high risk of pressure ulcers, as per the Waterlow risk assessment, did not have any equipment for pressure relief in place. The inspector was informed of some difficulties with regard to accessing the relevant equipment from the local PCT. While issues about the provision of equipment in care homes is complex, the Care Homes Regulations (23(2)(n)) make clear that the registered person must ensure that the necessary equipment is in place as required, to meet the needs of service users. It was noted that one service user had lost about 10 of her body weight and that she had not been referred to the GP or the relevant healthcare professional. Her care plan did not also seem to address the weight lost and the actions to take to prevent the weight lost and improve the nutritional status of the service user. Hard copy records kept in the home showed that service users were seen by the GP and other healthcare professionals as required. Most service users in the home appeared appropriately dressed. However despite previous requirements the inspector noted that the ironing of service users’ clothes was not of a satisfactory standard. Service users were observed wearing blouses which were not ironed appropriately and the clothes of service users were placed in cupboards when they have not been ironed/poorly ironed and not always in a tidy manner. The inspector also noted that some female service users had facial hair. This is a sensitive issue about appearance, body image and sexuality of female service users. It was not very clear if the female Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 14 service users were offered a choice of whether they wished to have facial hair or if they were offered the opportunity to remove the facial hair. The care records of service users contained some information about the arrangements in place for the death and end of life care of service users. It was also noted that staff in the home were actively involved in getting this information from service users or their relatives to ensure that should the time come, then they would be prepared and would be able to care for the service users. A care plan was also in place for each service user dealing with this aspect of care. The home notifies the Commission of all death in the home as required by legislation. Medicines were inspected on the Daffodil and the Dahlia units. The management of medicines in the home continues to be of a good standard. The inspector was informed that weekly in-house audits take place in the home to ensure that medicines are managed to a high standard. All medicines were recorded when they were received, administered and when these were returned to be disposed of. Random checking on the amounts of medicines showed that medicines were administered appropriately and that the appropriate codes were used when medicines were not administered. It was noted that the home needed to clarify the use of a medicine as a homely remedy as it was not on the list of homely remedies seen by the inspector on one of the units and which has been approved by the GP. The inspector was also informed that service users had recently received their annual Flu vaccines, which were administered by the home’s staff. On further investigation it was noted that the home did not have a policy on vaccines administration, that staff who administered the vaccines have not had training on immunisation as recommended by the Nurses and Midwifery Council and that the relevant emergency medicines which should be on the premises in case of anaphylactic shock were not in place at the time when the vaccines were administered. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 15 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): 12-15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users were encouraged to take part in a range of activities which were provided by the home. The records about the social and recreational needs of service users could have been more comprehensive to ensure that the activities provided were suitable to the individual needs of the service users. More attention could have been given to the nutritional content of the meals provided by the home to ensure that the meals were suitable to the individual needs of service users. EVIDENCE: The home employed an activities coordinator for each of the units. Programmes of activities were noted on notice boards in each of the units and each unit had its own programme of activities. The inspector noted that the activities coordinators were engaging with service users and were carrying out activities with service users according to whether the service users wanted to take part in the activities. One service user proudly showed the inspector cards that he was making for Christmas. Another service user was reading a book and a few were involved in a reminiscence session. A few others were involved in one-to-one interaction with members of staff. Although there was evidence Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 16 that activities were being carried out in the home, it was not always clear if the activities were suited to the needs of the service users in the home of if these could be improved. The activities coordinators have also had not had training on the provision of activities to service users with dementia. This is a job which requires specific skills and knowledge. The inspector therefore still recommends that the home explores activities, which are suitable for the service users that the home accommodates, and that the activities coordinators are provided training in the provision of activities for service users with dementia and mental health needs. As mentioned in the previous sections, the information about the life histories and about the social and recreational needs of service users was lacking in a few cases. Without this there was a possibility that the needs of service users would not be understood and that the activities provided by the home might not suit the individual needs of the service users. The life history of service users also forms an integral and important part of ‘person centred care’. The inspector noted that a few service users were able to go out accompanied by members of staff in taxis. This mostly applied to service users on the Ivy unit. A few of them were also able to go to day centres. Service users also have the opportunity to go out to places of interest over the weekend when a mini bus is rented by the home and driven by a member of staff. The inspector was informed that this facility in mostly used in summer when it is warmer. The home has however already make arrangements to use this facility to see the Christmas lights in London The manager stated that representatives from the local churches regularly visit the service users in the home for spiritual support. A few service users also go to the churches with assistance from their relatives. In view that the home has a number of service users from ethnic minorities, the inspector was informed that service users were free to practice their faith and that the home would support them where possible. The inspector looked at the management of service users’ meals on the Dahlia and Daffodil units. The dining areas were prepared appropriately and most service users were encouraged to visit the dining room and to eat together. There were adequate numbers of staff during meal times on each unit to assist service users where that was necessary. The home had a four weekly menu. The menu on the board on one unit was for the previous week. This was changed to the current week when the inspector asked about it. The menu choices sheet was available on one unit but not on another unit. On the first day of the inspection the first choice for lunch consisted of mincemeat, sprouts, beans and mashed potatoes. There were also macaroni cheese and sandwiches as the other choices. Desert should have consisted of Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 17 fresh fruit salad and semolina pudding but apple pie and custard were provided and there were also yogurt and ice cream for those who did not want the apple pie. It was noted that the vegetarian option for lunch at times did not have a source of protein. The inspector was informed that beans are sometimes provided as part of the vegetarian meals, as a source of protein. It was also noted that the yogurt, which was provided for lunch, was a low-fat yogurt. The home should explore whether low-fat food products are suitable for elderly frail service users who may already be compromised nutritionally. The home is in Brent and as such has a relatively high proportion of AfroCaribbean service users, but there was little evidence that they were offered Afro-Caribbean meals. The inspector concluded that more must be done with regard to ensuring that service users from ethnic minorities receive meals which are culturally appropriate for them. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 18 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has robust procedures to deal with complaints and allegations of abuse with which members of staff were familiar. EVIDENCE: The home has not received any complaints since the last inspection. Copies of the complaints procedure were available on notice boards and were also provided in the service users guide. Staff were clear that if there were some element of dissatisfaction with visitors or service users, that they would report these matters to the nurse in charge of the respective unit or to the manager. The home has had three allegations of abuse. These were all appropriately referred to the relevant agencies and appropriate action was taken with regard to investigating these matters. Conversation with staff members showed that they were aware of the procedure to follow in cases of allegations of abuse. Indeed at least one of the allegations occurred over a weekend and there was evidence that appropriate action was taken at the time. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 19 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): 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained and there is a programme of redecoration and refurbishment to promote a comfortable and suitable environment where service users can be appropriately cared for. EVIDENCE: The grounds in the front of the home and the parking areas looked maintained. The inspector observed that the front of the home has been made more colourful with the use of flowers. The external aspect of the building looked maintained. The home has a redecoration plan which was available for inspection. The manager stated that there has been some delay with meeting some of the actions points within the timescales as identified in the plan. This was related to issues regarding fitting the redecoration plan within the budget for the home. Now that the home has a new budget, actions were being taken to address the redecoration Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 20 programme. The inspector noted that the corridors, the lounges and the dining areas on all the units have been repainted. The manager stated that she was in the process of receiving quotes to change the carpet in some of the communal areas and bedrooms. The bedrooms of service users continue to be personalised to a good standard and staff continue to take an active part in encouraging relatives of service users to bring the personal effects of service users to personalise the bedrooms. The home was on the whole clean with practically no odours. The carpet in some areas was looking stained. However as mentioned above the home is due to replace some of the carpet. The inspector noted that the home did not have appropriate facilities to clean spillages despite the policy being clear on the need for certain chemicals to be present in the home for these purposes. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 21 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): 27-30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing in the home is flexible and is provided in adequate numbers to meet the needs of service users. Training is provided to ensure that members of staff are able to understand and to meet the needs of the service users. EVIDENCE: During the inspection there were one trained nurse and two carers on the Dahlia unit during the day. There was an extra carer from 12:00 –18:00 on that unit. On the Ivy unit there were one trained nurse and two carers. The Daffodil unit with thirty beds was staffed with two trained nurses during the day and five carers in the morning and four carers in the afternoon. There was an extra carer on the Daffodil unit for a service user requiring one-to-one care. At night there were one trained nurse and carer on Dahlia and Ivy and one trained nurse and two carers on Daffodil unit. Further more there were an activities coordinator for each unit and support staff to address cleaning, laundry, maintenance and catering. The inspector was informed that the home uses practically no agency staff and has its own staff. As a result of the above the inspector concluded that appropriate numbers of staff are provided to meet the needs of service users. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 22 The home has about 46 carers. 23 are trained to NVQ level 2 or above. The manager stated that currently the home had 50 of its care staff trained to at least NVQ level 2 at the time of the inspection. There were 6 members of staff enrolled on the programme and the manager said that more members of staff might be enrolled before the end of the year. Four personnel files were inspected. It was noted that the files contained all records as required by legislation including appropriate references, completed application forms, CRB checks, proof of eligibility to work in the UK and proof of identity. A few members of the care staff had PoVA checks carried out while waiting for a full CRB disclosure to be carried out. In these cases records were available to show that these members of staff had mentors with whom they worked most of the time. There was evidence that the home uses the common induction standards from Skills For Care for new members of staff. The training grid and the training plan for the home were inspected. These were kindly supplied by the manager and the administrator. Examination of these documents showed that most staff in the home have had statutory training and that more training has been arranged for staff who have not had the training. There was also training in areas where the home needed to develop. On the day of the inspection the manager had arranged training on teamwork. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 23 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is able to fully discharge of her responsibilities. The home has an effective quality management system to ensure continuous improvement in the home. The management of personal monies in the home is of a good standard. Health and safety issues in the home are addressed appropriately to ensure the safety of service users, staff and visitors to the home. EVIDENCE: The manager is now registered and has enrolled on a Registered Manager’s Award course. Comments from staff and service users showed that they could approach the manager to discuss issues and that she takes issues that are brought to her attention seriously and ensures that these are dealt with in an Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 24 appropriate manner. Staff also commented that they have the opportunity to discuss issues in a range of meetings with the manager. The manager through the conversation with the inspector and with the way she dealt with issues, demonstrated that she had a good knowledge of the home, of service users accommodated in the home and about issues in the home. The inspector noted that that on one occasion she was encouraging visitors to attend a residents/relatives meeting that she was in the process of arranging. The management of the personal monies of service users was inspected. This task is the responsibility of the administrator. The home has a bank account and service users who have relatively large amounts of money with the home are allocated a sub-account. Access to the sub-accounts is limited to head office staff and request for money from the home has to go through a process where this is approved by the manager and the responsible individual prior to the money being sent to the home. The inspector looked at a sample of service users’ records. Statements for each sub-account were available for inspection. Separate records for in house expenditures were available and this showed that the personal money of service users was managed appropriately. It was noted that a receipt was kept and that an entry was made for each expenditure. This is good practice. It was also noted during the last inspection that the money for one service user was used to purchase one item of equipment. The service user did not have a representative and therefore it was not clear how consent was received for the purchase of that piece of equipment. Since then the home has reviewed its procedures. In cases where a service user has money which can be used to benefit his/her care, and when the equipment to be purchased is not routinely provided by a service, equipment could then be purchased only after the funding authority has agreed to it. The home has a separate clinical governance department which looks at quality issues in the home. A quality assurance policy is available in the home and a quality management system is also in place. An audit format covering key aspect of the service was seen. The audit is carried out yearly by the clinical governance manager and a report is produced. A quality rating is also allocated to the home depending on the findings of the audit. A recent audit has been carried out this year and the home has moved to a green level (the organisation uses the traffic light system to rate the quality of the service) from a red level which was the rating allocated to the home last year. A customer satisfaction survey has also been carried out. A report has been prepared following an analysis of the satisfaction questionnaires, which were returned and an action plan has been formulated to address areas where improvement was needed. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 25 The inspector looked at the management of health and safety in the home by touring a sample of the premises and by looking at a sample of health and safety records. It was noted that maintenance contracts were in place to demonstrate that equipment in the home were maintained satisfactorily. Safety certificates were in place for the electrical wiring system, portable electrical appliances, equipment using gas, and for the treatment of the water system in the home to prevent Legionella. LOLER certificates were in place for the hoist and for the lift. There were records of weekly fire detector tests and of the emergency lights system. A fire risk assessment and an emergency fire plan were in place. A health and safety risk assessment was also up to date. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 26 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 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 2 STAFFING Standard No Score 27 3 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 X 3 Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 27 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 OP1 Regulation 5(1)(b) Requirement The registered person must ensure that the service users’ guide contains information about the range of fees charged by the home. The service user’s plan must be sufficiently detailed to ensure that all aspects of the health, personal and social care needs of the service user are met. The manual handling risk assessment and the care plan on manual handling must accurately describe the action to take and the equipment to use to address all the manual handling manoeuvres of service users. The registered person must involve service users or/and their representatives not only in drawing up care plans but also in the review of care plans. Efforts made to arrange for the above must be documented as evidence that this opportunity is being offered to residents (Previous requirement-timescale 30/06/06 partly met). The registered person must DS0000059961.V319947.R01.S.doc Timescale for action 31/12/06 2 OP7 15(1,2) 31/01/07 3 OP7 13(5) 31/12/06 4 OP7 15(2) 31/01/07 5 OP8 23(2)(n) 31/12/06 Page 28 Ogilvy Court Version 5.2 6 OP8 12(1) 7 OP8 13(1)(b) 8 9 OP9 OP9 13(2) 12(1)(a) 10 OP10 12(4)(a) ensure that the appropriate pressure relief equipment is provided to service users according to their individual risk assessment. The registered person must ensure by training of staff or otherwise that the pressure relief equipment in use is described in the care records as evidence that appropriate pressure area care is being provided for residents. (Previous requirement, timescale of 15/9/05, 30/06/06 not fully met). The registered person must also ensure that photographs or wound mapping are used to monitor the condition of the pressure ulcers. Service users who at risk of malnutrition must be referred to the relevant healthcare professional as soon as possible. All medicines used as homely remedies must be approved for use by the GP. The home must have a policy on the administration of Flu vaccines. The registered person must ensure that staff who administer flu vaccines have training on immunisation as recommended by the Nurses and Midwifery Council and that the relevant emergency medicines which should be on the premises in cases of anaphylactic shock are in place in the home when the vaccines are being administered. The registered person must ensure that the clothes of residents are always ironed appropriately and that these are put away tidily in the wardrobes and drawers of residents. (Previous requirement, timescale of 15/9/05, 30/06/06 not fully DS0000059961.V319947.R01.S.doc 31/12/06 31/12/06 31/12/06 31/12/06 31/01/07 Ogilvy Court Version 5.2 Page 29 11 OP10 12(1,4) 12 OP12 16(2) (m,n) 16(2)(i) 13 OP15 14 OP26 13(3) met) The registered person must ensure that female service users do not have facial hair unless it is the choice of the service user to have these. The social and recreational needs and the life story of service users must be completed comprehensively. The registered person must review the provision of meals in the home to ensure that the individual needs of service users, including the cultural and ethnic needs, are being met. The registered person must ensure that staff are familiar with the procedure in place for the cleaning of spillages and must also ensure that the equipment needed for this purpose is also in place. 31/12/06 31/01/07 31/12/06 31/12/06 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 OP4 Good Practice Recommendations To ensure that the home is able to meet the needs of all service users admitted to the home it is recommended that the cultural and religious aspects of the care of service users are incorporated in the care plan to ensure that the needs are being addressed in a holistic manner. It is recommended that the manager explore the use of ‘person-centred care approach’ in care planning. The inspector recommends that the home explore activities suitable for the needs of residents with dementia and apply these in the home where possible and that all care staff are also involved in this process as part of the provision of holistic care. Training should be provided to DS0000059961.V319947.R01.S.doc Version 5.2 Page 30 2 3. OP7 OP12 Ogilvy Court 4 OP15 activities coordinators in the provision of activities for service users with dementia and mental health needs. The home should consider whether the use of low fat products is suitable for elderly service users who may be nutritionally compromised. Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Ogilvy Court DS0000059961.V319947.R01.S.doc Version 5.2 Page 32 - 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. 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