Inspection on 07/08/07 for Ogilvy Court

This inspection was carried out on 7th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 15/11/06

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 7th August 2007 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.V342932.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.V342932.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 (1), Dementia - over 65 years of age registration, with number (45), Learning disability (12), Learning disability of places over 65 years of age (12), Mental Disorder, excluding learning disability or dementia - over 65 years of age (45) Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide nursing care and accommodation to service users whose primary care needs on admission to the home are within the following categories:Service users of both sexes with dementia who are over 65 years of age (Category DE(E)) (no more than 30 persons) Male service users with dementia who are over 65 years of age (Category DE(E)) (no more than 15 persons) Service users of both sexes with dementia (Category DE) (no more than 1 person) Service users of both sexes with a mental disorder, excluding learning disability or dementia, who are over 65 years of age (Category MD(E)) (no more than 30 persons) Male service users with a mental disorder, excluding learning disability or dementia, who are over 65 years of age (Category MD(E)) (no more than 15 persons) Service users of both sexes with a learning disability who are over 45 years of age (Category LD) (no more than 12 persons) Service users of both sexes with a learning disability who are over 65 years of age (Category LD(E)) (no more than 12 persons) The maximum number of service users who can be accommodated is 57 15th November 2006 2. 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 and 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 has a large car park in the front, which can easily accommodate about fifteen cars. Ogilvy Court is a care home specialising in providing nursing care for elderly Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 5 residents over the age of 65 years with mental health needs or with dementia care needs and for residents with a learning disability from 45 years of age. It is purpose built and provides accommodation in mostly single rooms with ensuite facilities. It has three double bedrooms also with en-suite facilities. There are three units in the home. Ivy and Dahlia are on the ground floor and Bluebell is on the first floor. Ivy accommodates twelve residents with a learning disability, Dahlia accommodates fifteen male elderly residents with mental health/dementia care needs and Bluebell accommodates thirty mostly female elderly residents also with mental health/dementia care needs. The management structure in the home consists of the manager and three unit managers. The manager is closely supported by an operations manager. 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 residents are charged about £728 a week for a placement. At the time of the inspection, there were fifty-two residents in the home. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection took place on Tuesday 7th August from 10:00-18:00 and on Wednesday 8th August from 12:45 to 16:45. This is the first inspection for the period 2007-2008. During the inspection I was able to observe care practices, talk to residents, visitors to the home and the manager and some of her staff. I was also able to tour some of the premises, look at a sample of records and check for compliance with previous requirements. I am grateful to all residents and visitors, who spoke to me, and to the manager and all her staff for their support and assistance during the course of the inspection. What the service does well: The needs of prospective residents are appropriately assessed before they are offered a place in the home. The residents/representatives are encouraged to visit the home and are provided with the appropriate information to decide if the residents want to move into the home. Residents/representatives receive a contract/statement of the terms and conditions of the placement for them to be fully aware of their rights and obligations. The needs of residents, including the personal care needs of residents, are on the whole met to a good standard. The home provides a range of services including competent staff to ensure that the identified needs of residents are met as required. Pressure area care is of a good standard and residents benefit from a range of equipment to provide pressure relief according to the level of risk of developing pressure ulcers. Residents and their representatives are involved in drawing up and reviewing care records and risk assessments. The home maintains good contact with relatives and visitors of residents. Residents are referred to healthcare professionals as and when required. The home provides resources to ensure that residents benefit from organised activities inside the home and outside the home. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 7 The home continues to provide a pleasant, maintained and homely environment for residents to benefit from. Bedrooms of residents are personalised to a good standard. Residents are cared for by sufficiently competent staff that are provided in adequate numbers. The staffing levels are also flexible to reflect residents’ needs. The home has in excess of 50 of its care staff trained to NVQ level 2 or above. The recruitment of staff is carried out thoughtfully and according to good practice. All records as required by legislation are in place for employees. The manager runs the home in an inclusive and open manner. The management team including the units’ leaders ensure that the home is run in a smooth manner. The home benefits from a comprehensive quality assurance system that is effectively applied to ensure continuous improvement of the service. The health and safety aspects of the service are taken seriously and are attended to as required to ensure the safety of residents, visitors and staff. What has improved since the last inspection? The service users’ guide has been updated to include the range of fees charged by the home and information about the current registered manager. Care records have been improved to make these more comprehensive. These are maintained to a good standard and reviewed monthly or more often when required. Evaluation of care records is on the whole good and looks at how effective the care plans are in meeting the needs of the residents. The records with regards to pressure area care are good and demonstrate that residents in the home benefit from a good standard of care in this area. Residents are referred to the relevant healthcare professionals when there is evidence that their health might be compromised such as when they loose weight. The home now has a policy for the administration of flu vaccine, which was lacking during the last inspection. This if followed, will ensure that vaccine will be administered according to safe practices. The end of life care of residents and the wishes and instructions of residents/representatives and the arrangements in place to manage death and funeral are on the whole addressed in care records to make sure that staff will know how to deal with these issues should it be needed. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 8 There has been some improvement with regards to the laundering, ironing and storage of the clothes of residents, but this is an area where more progress could have been made. The homely remedy list has been reviewed and agreed with the GP to ensure safe practices with regards the medicines, which as used as ‘homely remedies’. The social and recreational needs of residents are appropriately assessed and recorded. Care plans are then put in place as required to make sure that residents’ needs in this area will be met. Activities coordinators have had training in this area and have liaise with other colleagues to share ideas and to promote activities for older people with dementia and mental health needs. The home takes complaints seriously and ensures that these if made are dealt with appropriately. Staff are trained to recognise abuse and to ensure the protection of residents. There is evidence of ongoing maintenance. The carpet has been changed in the first floor corridors and in some rooms and curtains have been changed in communal lounges. What they could do better: Care records could have been simpler by having a clear section for the assessment of needs, including an assessment about the mental health and dementia care needs of residents. Care plans must be clear about the action to take to manage the challenging behaviour of residents. In cases where residents are having one to one, care records must be clear about the support the residents are receiving and whether restraints are used and the type of restraints that are agreed. The clothes of residents must be ironed to a good standard and must be appropriately stored in the wardrobes and drawers of residents to ensure that residents’ appearances are always as good as possible. The instructions on creams and lotions about the application of these could be made clearer. Appropriate risk assessments must be put in place when residents are being offered their medicines in food, as the food my damage the protective coating which is found on some medicines. The menu has been reviewed but there must be compliance with the planned menu to ensure that residents receive nutritious and varied meals at all times. If compliance is not possible then changes made to the menu, must be equally nutritious and communicated to care staff. Staff must be clear about the menus that are in place to ensure that residents are offered the appropriate selection to make choices from. The front of the home could be made more inviting with more flowers and a higher standard of maintenance. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 9 Although residents’ money is generally managed to a good standard, more comprehensive records could have been kept in the residents’ records about the details of payments, which are made by head office for residents’ expenses. Items of equipment which are used for first aid must be prepared so that they are ready to use in an emergency 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.V342932.R01.S.doc Version 5.2 Page 10 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.V342932.R01.S.doc Version 5.2 Page 11 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 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents and/or their representative receive the necessary information to decide if they want to move into the home. Residents’ needs are assessed prior to them being admitted, to ensure that the home would be able to meet their needs. EVIDENCE: The manager had forwarded a copy of the updated service users’ guide to the commission. It was noted that this has been reviewed and that it now contains information about the range of fees charged by the home. Copies of the service users’ guide were available in the foyer of the home and in all residents’ bedrooms. Other documents were also available in the foyer of the home such as past inspection reports, the statement of purpose and a document about residents’ involvement in the home. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 12 I looked at the records of three residents to see if they were offered a contract/statement of terms and conditions of the service. Two of the residents have signed copies of the contract/statement of terms and conditions in their files and the third had a contract/statement of terms and conditions, which has been sent to his representative to agree to. I therefore concluded that residents receive a contract/statement of terms and conditions as required when they move into the home to make sure that they are aware of their rights and obligations. The care plans of residents, which were inspected, contained a pre-admission assessment of their needs and the needs assessment of the placing authorities. The format was not conducive to assessment of the mental health or dementia care needs of residents, but the manager and the nurses who carried out the assessments were skilled enough to ask questions about the mental health or dementia care needs, which they then recorded. It would have been helpful to have a format where prompts would have been available for the comprehensive assessment of the needs of people who are referred to the home, including the mental health and dementia care needs. The home has a relatively stable group of staff who have worked in the home for a number of years and who are familiar with the needs of the residents. From looking at records, including training records, observing the residents and the interaction of staff with residents, and checking the staffing level and skills of staff, I was able to conclude that the home is able to meet the needs of the residents that are accommodated in the home while taking into consideration the cultural and religious aspects of their care. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 13 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 Residents who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care records contain most of the information about the needs of residents and about how these needs are to be met, but these were not always that clear with regards to managing challenging behaviour. The healthcare needs of residents are met and their privacy and dignity are upheld. A few issues were noted with the management of medicines which may compromise the safety of residents. Staff are sufficiently competent and there is sufficient information in care records to make sure that residents’ end of life care would be managed sensitively and appropriately, should that be required. EVIDENCE: I looked at 5 care plans. Most of the care records were computerised, but a part was in a hard format. Copies of the plans of care were also copied in a hard format for residents or for relatives to look at and agree to. Looking at both sets of records I concluded that overall there was information about the needs of residents, but that the information was not always easily accessible. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 14 The needs assessments did not contain a format for the assessment of the mental health needs of residents. There was some information about how the mental health needs of the residents were affecting their ability to perform their activities of daily living but there was no separate assessment for the mental health needs except for the mini mental scoring to assess the level of cognition of residents. Information about the behaviour, level of depression if any, hallucinations or delusions if any, was not always addressed as part of an assessment, but some of the information was available in the actual plans of care of the residents. The plan of care of one resident addressing challenging behaviour, contained a lot of information including how this manifested itself, and was written in an essay format. From that the action to take to meet the identified needs was not immediately accessible. The care plans could have been more accessible if the assessment of needs were separate and if the plan of care contained only information about the action to take to meet the identified needs of the residents. Another resident had a care plan also about challenging behaviour where the plan provided information about the needs of the residents but did not say how the needs of the residents would be met. Care plans contained a number of risk assessments, which were kept under review, such as when there are limitations to the freedom of residents such as when bed rails were used. It was noted that the home accommodates residents who require one-to-one supervision because of their mental health needs and for their own safety. At times the residents needed to be guided and led to places of safety, as it was clear that the residents or other residents would be at great risk if this did not happen. The care records however did not always contain information about how this was going to be managed and how the residents would be supported. The home may have a policy of not restraining residents, but some form of restraints was observed and was found to be necessary for the safety of the residents, but this needed to be agreed and documented. Most residents presented as clean and appropriately dressed. Male residents were shaved appropriately and female residents did not have facial hairs as were identified during the last inspection. It was noted that the clothes of a few residents were still not being ironed appropriately and inspection of the cupboards and drawers of residents could have been in a tidier condition. Care plans addressed the pressure area care of residents who were at high risk of developing pressure ulcers. The plans of care were comprehensive and included a detailed description of the pressure relief equipment in use in the home to enable any person reading the record determine if appropriate pressure area care was being provided. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 15 I was informed that 3 residents in the home had pressure ulcers. Inspections of the care records of these residents showed that care plans were in place addressing the management of the pressure ulcers and there was evidence that other healthcare professionals were involved where necessary. Photos of the pressure ulcers and regular wound assessment were in place to give information about the condition of the ulcers. Turning charts, when in use, were also completed appropriately. There was some evidence that the care plans and risk assessments were agreed with the residents or their relatives. Although the care plans were computerised, hard copies were available for residents/representatives to see and agree to. The manager stated that the residents/representatives would be consulted when the care plans are reviewed monthly or more often. In some cases consultation of residents was difficult because of their ability to take part in this process and some did not have close relatives or their relatives did not visit often. Medicines management was noted to be of an adequate standard. All medicines were recorded when received. Appropriate records were also maintained when medicines were administered or not administered. The home has two clinical rooms one on each floor. Both were noted to be clean and tidy. They were both air-conditioned and the temperature of the room as well as the medicines fridges was regularly monitored. One of clinical rooms had some boxes and equipment on the floor, and it is recommended that these are not stored on the floor to prevent cross-infection. The opening date was missing on a few eye drops and topical medicines. The instructions about where to apply creams and ointments were also not very clearly identified on the medicines charts to ensure that the medicines were being applied at the right location. The medicines, which were not on the list of homely remedies and which were administered to residents as homely remedies, have been reviewed by the GP to be included in the list of homely remedies. I also noted that there were a few residents who were on pureed meals because of swallowing difficulties. They were on medicines in tablet forms. I was informed that at times staff gave the tablets with food. While it was clear that staff were not disguising the tablets with food, there was a possibility that the coating, which is found on a lot of medicines, being damaged by hot food. As a result the medicines of residents who are on pureed meals must be reviewed and liquid medicines should be suggested or the advice of the GP or the chemist should be sought with regards to administering the medicines with food. A few residents were on variable doses of medicines. It was not always clear what does of medicine was administered. For example when a resident was on a medicine to be given one or two tablets as required, it was not clear whether one tablet or two tablets were administered to the resident. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 16 Most care records contained information about the wishes and arrangements that have been made about the end of life care and death of residents. In the remaining few cases when the information was not available about arrangement for managing the death and funeral of residents there were records that relatives wanted to be contacted to make all the necessary arrangements, but the care records did contain information about the end of life care of residents. Training records showed that some members of staff have been trained and that others were being trained in providing end of life care and in understanding symptoms control and management. Notification to the commission about the deaths of residents showed that deaths in the home are managed appropriately. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 17 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 Residents who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have the opportunity to engage in social and recreational activities, which are suitable for their needs. The provision of meals to residents did not always offer them suitable choices. EVIDENCE: The social and recreational needs of residents are appropriately assessed at the point of admission. The care records contain a ‘life history’ of residents, which provides information about the background of residents, which may help in understanding particular aspects of the behaviour of residents. Care plans are put in place when the social and recreational needs of residents are identified. During the course of the inspection I observed that residents were asked and were offered suggestions and encouragements to make decisions about what they wanted to do to spend the time. The home has 4 activities coordinator. There is 1 full time activities coordinator for each unit and the Ivy unit has in addition a part time activities coordinator. I was informed that the activities coordinators have had training on activities suitable for residents with mental health and dementia care needs and that Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 18 they have visited other Care UK services to share ideas and to learn more about their area of work. On the day of the inspection, some recreational activities were being carried out with residents. A few of the activities were group activities and a few were on a one-to-one basis. Members of staff were also observed interacting with residents, while they were seated in the lounges. A few residents were engaged doing the things that they wanted to do such as watching TV or reading. A few of the residents went out for a short trip. I was told that residents regularly go out to various places of interests, particularly those who are accommodated on the Ivy unit. Over the weekend, a minibus is sometimes rented and is driven by a member of staff to take residents out. Some residents also attend day centres on a regular basis. A few residents were observed in the garden areas on either sides of the home. They came from all the units to enjoy the pleasant weather outside. Adequate number of staff was observed supervising residents when they were outside. I was informed that residents who want to go to church have the opportunity to go church with their relatives and friends and that the home would support residents where required. There are also representatives from the local churches who also visit the home to support residents. On the first day of the inspection according to the menu, lunch consisted of tuna and pasta bake, broccoli and leek mornay, potatoes, carrots, peas and banana and cream mousse. The actual lunch served was pasta, tuna and tomato sauce, broccoli, peas, potatoes and apple tart and custard for desert. The tuna and pasta bake was not prepared and instead tuna and pasta sauce were served separately and the mornay was not prepared. There was therefore no real second choice and the meals were found lacking particularly for residents who were vegetarians as the meals seemed to be low with regards to a source of protein, which would have been available had the mornay been prepared. The home has a four weeks menu cycle. It was noted that staff on two of the units were not clear of the week menu, which applied for that week. The daily choices of residents which are normally recorded a day before after residents are asked about the meals, were also not in place on the units when staff were serving the meals. There was also a change to the menu for the supper meals but members of staff were not aware of the changes until the food trolley was on the floor and therefore residents could not have been consulted about their choices prior to the supper being served. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 19 I was informed that the freezer was broken which lead to the changes being made to the menu, but staff on the units could have been notified of the changes, which happened on the second day of the inspection. There were also little reasons not to comply with the menu for lunch on the first day as the ingredients, which were missing from the meals were cheese and milk. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 20 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 Residents who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service offers the guarantee that complaints and allegations or suspicions of abuse are taken seriously and are dealt with as appropriate to ensure the safety of residents. EVIDENCE: The complaints procedure is included in the service users’ guide and is also available in the foyer of the home. The manager was observed on all the units. She knew all residents and visitors to the home well. Her office is on the ground floor and is available to people who want to speak to her. Staff spoken to during the course of the inspection, were aware of the need to report the concerns and the complaints of residents/representatives to the manager. There has been one complaint since the last inspection. The complaint was about concerns by a relative about the standard of care. The complaint was appropriately investigated and an opportunity was provided with the complainant to talk to a senior manager within the organisation. The investigation showed that the complaint was not upheld. Records about the complaint, investigation and outcome of the investigation were appropriately kept. Good practice was therefore noted with regards to how the service deals with complaints. An introduction on abuse is provided to all new members of staff as part of their induction. They then have further training and all members of staff have yearly updates. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 21 In the past all allegations of abuse have been appropriately reported and dealt with. There has not been any allegation of abuse since the last inspection. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 22 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): Residents who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service The home provides a maintained and appropriately decorated environment which residents can benefit from. EVIDENCE: The grounds in front of the home could have been maintained to a higher standard. While the lawn was being cut on the day of the inspection, the bushes and shrubs in the grounds were not trimmed and there were weeds in the grounds around them. The lawn was not that well maintained as there were weeds in them too. This made the home looked less inviting and might detract a little from all the good work that goes on in the home. Use of more colours and well-maintained front gardens would provide a more favourable impression. The parking areas were maintained and the exterior of the building was in an acceptable state. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 23 There was evidence of ongoing refurbishment and redecoration in the home. The carpet along the main corridor and in the lounges on the first floor has been replaced. A few bedrooms were also seen with new carpets and which have been redecorated. There are plans to replace the carpet in the corridors of the Ivy and the Dahlia units, and the flooring in the reception area. The curtains in all communal areas have been replaced and I was informed that there were plans to now replace the curtains in the bedrooms of residents. All communal areas were appropriately maintained and furnished to a good standard. These were used extensively by most residents. The dining rooms are located at some distance from the lounges and most residents were encouraged to mobilise to the dining areas and to have their meals there. This is good practice. Bedrooms of residents continue to be personalised to a good standard and where possible residents/representatives were encouraged to bring personal items in the home. Some residents were observed staying in their rooms, as they did not want to be in the communal areas. Their wishes were respected. There were no odours in the home and it was on the whole clean. A few stains noted on the carpet of the Ivy unit were clean as soon as these were pointed out. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 24 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 Residents who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care of residents is met and maintained by good staffing levels and by appropriately trained members of staff. EVIDENCE: There are 1 trained nurse and 3 carers during the day on the Ivy unit. At night there are 1 trained nurse and 1 carer. On the Dahlia unit there are 1 trained nurse and 2 carers during the day with an additional carer from 1200-1800. At night there are 1 trained nurse and 1 carer. The Bluebell unit is staffed by 2 trained nurses and 5 carers during the day and at night by 1 trained nurse and 2 carers. In addition to that, there was 1 resident who was receiving one-toone supervision to maintain her safety. There are also ample numbers of cleaners, handymen, and other ancillary staff to support the delivery of care. I looked at the personnel records of 4 members of staff. These were all maintained and all records as required by legislation were in place. There was also evidence of CRB checks and PoVA first checks. Induction records were in place to show that staff were receiving induction as per the Common Standards of Skills for Care, the national training organisation for social care. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 25 The home has about 46 carers in total. Out of this number 23 are already NVQ trained and 14 are in the process of studying for this qualification. As a result the home does have 50 of its care workers trained to NVQ level 2 in care. A plan of supervision was in place. Although records seen, suggest a sluggish period with regards to supervision prior to July, there was a marked improvement with regards to the number of staff having supervision in July. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 26 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): 30,33,35 and 38 Residents who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager runs the service in an open and inclusive manner. The home has an effective quality assurance system, which is appropriately followed to monitor the quality of the service. The personal money of residents is on the whole managed appropriately. The home takes health and safety issues seriously to ensure the safety of residents, visitors and staff. EVIDENCE: The manager has now been running the home for about 1½ years. She has been registered with the commission. She is a trained nurse and is in the process of completing the Registered Manager’s Award. Feedback about the manager from staff and visitors to the home is positive. Inspection of the home demonstrates that any issues that are identified are taken seriously and are Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 27 addressed in a timely manner. The manager also demonstrates a good grasp of the national minimum standards and of legislation in relation to care homes. The home has a quality management system as per the quality assurance procedure of Care UK. Satisfaction surveys are completed yearly. Results from the satisfaction survey, which was conducted last year, was available for viewing. The manager showed the inspector questionnaires that were being returned as part of the satisfaction survey for this year. An action plan was available following the satisfaction survey, which was carried out last year, addressing areas where the home did not score so well. Audits are also carried out regularly. The manager carries out audits in various areas, which are identified according to a schedule. These areas include catering, environment, medicines, care records and health and safety. Inspection of past audits showed that these were carried at regular intervals. There were actions plans when non-compliances were identified. There is then a yearly audit, which is carried out by the Clinical Governance Department of the organisation. A copy of last year’s audits was available for inspection. The audits are quite comprehensive and are carried out independently from the home. It looks at aspects of the service that is provided by the home. A summary of the findings is then produced with an action plan to address areas where the home did not perform so well. The home manages the personal monies of a few residents. The administrator has the responsibility of maintaining the records and managing this aspect of the service. She is the appointee for a number of residents. It was not very clear of other efforts that have been made with regards to finding an appropriate appointee for the residents. Regulation 20(3) of the Care Homes Regulations 2001 states that ‘the registered person shall ensure so far as practicable that persons working for the home do not act as the agent of a service user’. The money of residents is kept in a main corporate account managed by the organisation, in which residents have sub-accounts. Some residents have a small amount of money, which is kept in the home for day to day expenses and which is topped up by the residents’ representatives as required. On the whole, records were kept of expenses that were being made on behalf of residents and receipts were kept as evidence of these expenses. The head office at times made payments from residents’ accounts. While records were available at the head office about the details of these expenses, there were no records in the home to give information about these expenses. It is recommended that information is available in the residents’ records about all expenses that are made from the residents’ accounts to account for all the withdrawals that are made from the accounts. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 28 Health and safety issues in the home were appropriately maintained. All checks with regards to equipment, fire testing, water temperature testing, wheelchair testing were being carried out regularly. Safety certificates for Portable Electrical Appliances, electrical wiring system, gas using equipment and for the water system in the home were in place and there was evidence of maintenance of equipment in the home. The gas safety certificate however mentioned that gas appliances in the kitchen were only visually checked and it was not clear if this fully covered the safety of the gas appliances in the kitchen. A health and safety risk assessment, fire risk assessment and a fire emergency plan were available for inspection and were up to date and comprehensive. The home has some items of equipment in place to use when providing first aid. These included suction machines, ambibags and a mouth pieces. While the suction machine on the ground floor was connected and ready to use in an emergency, the one on the second floor did not have a suction tube ready to be used if required. Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 29 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 3 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 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 3 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.V342932.R01.S.doc Version 5.2 Page 30 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(1,2) Requirement Timescale for action 31/10/07 2 OP9 13(2) 3 OP9 13(2) That care plans about managing challenging behaviour are clear about the action to take to manage the challenging behaviour to ensure the safety of residents and staff. That the plan of care for residents who are supervised on a one to one basis be clear about how they are being managed and whether restraints are used, the acceptable form of restraints that can be used and the length of time that these could be used. The practices with regards to 30/09/07 administering the medicines of residents who are on pureed meals in their meals must be reviewed and liquid medicines must be considered with advice from the GP or the chemist as required to make sure that medicines are administered in a safe manner to residents. To ensure that appropriate 30/09/07 records are kept, the actual amount of medicines administered when a variable dose of the medicines is prescribed must be recorded as DS0000059961.V342932.R01.S.doc Version 5.2 Ogilvy Court Page 31 4 OP9 13(2) 5 OP10 12(4)(a) required. The date of opening of eye drops and topical medicines must be recorded to ensure that the medicines are not administered after they have expired. The instructions about where to apply creams and ointments must be clearly identified on the medicines charts to ensure that the medicines are applied at the right location. 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 and 31/01/07 not fully met) The registered person must review the provision of meals in the home to ensure that the individual needs of residents, including the cultural and ethnic needs, are being met (Repeated requirementtimescale 31/12/06 not fully met). The registered person must ensure that nutritious and wholesome meals are provided to residents at all times and that the menus are complied with as required. Changes in the menus must be communicated to care staff, so that they are able to inform residents of the changes and record the choices of residents accordingly. That the choices of residents about the meals are sought and recorded as far as possible. That all items of equipment that are used to provide first aid are prepared and made ready to be DS0000059961.V342932.R01.S.doc 30/09/07 31/10/07 6 OP15 16(2)(i,j) 30/09/07 7 8 OP15 OP38 12(3) 13(4)(c) 30/09/07 30/09/07 Ogilvy Court Version 5.2 Page 32 used in an emergency if required. 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 2 3 Refer to Standard OP9 OP19 OP35 Good Practice Recommendations It is recommended that nothing is stored on the floor of the clinical room to prevent cross-infection. That the standard of the maintenance of the grounds in front of the home is reviewed to make the front of the home more welcoming and appealing. It is recommended that information is available in the residents’ records about all expenditures that are made from the residents’ accounts to account for all the withdrawals that are made from their accounts. The manager should make enquiries with regards to whether the gas safety certificate fully covers the gas appliances in the kitchen. 4 OP38 Ogilvy Court DS0000059961.V342932.R01.S.doc Version 5.2 Page 33 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.V342932.R01.S.doc Version 5.2 Page 34 - 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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