CARE HOMES FOR OLDER PEOPLE
Olcote 142 High Lane Burslem Stoke-on-trent Staffordshire ST6 7BT Lead Inspector
Ms Wendy Jones Unannounced Inspection 26th September 2005 05:30 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 Olcote DS0000008322.V254932.R01.S.doc Version 5.0 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. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Olcote Address 142 High Lane Burslem Stoke-on-trent Staffordshire ST6 7BT 01782 766204 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) Mrs Dellah Anne Hodges Mr David Hodges Mrs Dellah Anne Hodges Care Home 1 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1) of places Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd March 2005 Brief Description of the Service: Olcote House is a small home, registered to accommodate one person within the Mental Disorder category, less than 65 years of age. The proprietors Mr and Mrs Hodges, have provided care and accommodation for one resident user for the past eighteen years The home provides a single bedroom on the first floor for the personal use of the resident with accessibility to all other areas of the home. The standard of physical environment is high throughout and its ambience is warm and welcoming. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on the evening of 26th September 2005. Mr and Mrs Hodges and the service user were in the home throughout the visit. Information for the inspection was gathered from discussion and conversation with the providers and the service user; from inspection of documentation and records pertinent to the inspection process; observation of the environment and of interactions. What the service does well:
The service provides a home like environment for the service user, in comfortable and very well maintained surroundings. The standard of care planning and documentation is high, with evidence of very regular reviews and of service user involvement. The rapport and relationship between the providers and service user was of a mutual respect and affection. The atmosphere was supportive and promoted the service users independence within a framework of sensible risk taking. The health care needs of the service users were well met, with evidence of regular health reviews, liaison and discussion with health professionals. The systems for the administration, recording and stock control of medication were satisfactory. The service user retains regular contact with his relatives, on records there was evidence of relative satisfaction with the care and service the service user received. The standard and variety of food was high, the service user commented very favourably about this issue, and was included in the day-to-day decision making about the meals provided. Policies and procedures were in place, risk assessments were explicit all had been reviewed regularly. The fire safety of the service user was assured by regular fire safety checks and fire drills. Mrs Hodges commitment to training should be applauded; Mrs Hodges has completed the NVQ 4 in care and management and has the Registered Care Managers Award. She is also planning to undertake some additional training in Mental Health. She has completed a certificated medication course and both
Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 6 providers have attended a first aid course. As the main cook in the home Mrs Hodges has a basic food hygiene certificate. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 1,3,4. The Statement of Purpose and Service User Guide were excellent providing potential service users with the necessary information regarding the home. EVIDENCE: A Statement of Purpose was provided that detailed the service philosophy, the facilities offered, the qualifications and experienced of the providers and their staff. All information provided, gave prospective service user all the information they may require to make an informed judgement about moving into the home. The Service User Guide was equally as explicit; the service user had his own copy. Both documents have been reviewed on at least an annual basis. The service user had lived with the providers for approximately 20 years. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 7,8,9,10. The standard of care plans was excellent, providing the reader with a comprehensive plan to follow to ensure that the service user needs were appropriately met. The service users health needs were satisfactorily met ensuring his well-being and safety. The medication at this home is well managed promoting good health. There was evidence from observations and from discussion that the service user was treated with respect and was offered every opportunity to live an independent life. EVIDENCE: Care records included a thorough assessment of need, the service uses the British Institute of Learning Disabilities assessment and reviews this monthly to ensure that any changes in the service user are recognised quickly and appropriate action taken.
Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 10 The 24 hour plan of care was explicit in it’s detail leaving no doubt of the preferred routines of the service users and clearly identifying possible triggers to behaviour and early signs of deteriorating health. The service user was clearly involved in all aspect of his care and recorded his views and account of his care and experience at the home, every 6 months. The records indicated that he was entirely satisfied with the quality of his care and the opportunities offered to him. In conversation during this visit the service user confirmed this opinion, and expressed satisfaction with all aspects of his life. Medication records were satisfactorily maintained, and the stock control records were up to date. Mrs Hodges had received training in the safe administration of medication. A certificate of attendance confirmed this. The service user did not self medicate and this matter was not discussed at this inspection. A review of medication was undertaken with the relevant health professionals every 6 months. The health care needs of the service user were being properly met. The records showed regular reviews of physical and mental health needs including hospital appointments for acute issues. An annual preventative health check was carried out and recorded and regular visits to community health services i.e. dental and ophthalmic services were recorded. Specialist health services were involved in the 6 monthly reviews of health and care. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard: 13,14 and 15. The standard and variety of food was excellent, providing the service user with a healthy, balanced and fulfilling diet. EVIDENCE: The service user was routinely involved in the routines of the home and was clearly seen as a member of the family, taking responsibilities for walking the dog on a daily basis, for assisting with shopping and other chore that he chose to participate in. The service user gave an account of his daily routines and the opportunities for social and recreational activities. He attended a variety of occupational and recreational activities throughout the working week including a gardening and poetry group, therapeutic activities, musical events, social events and group support sessions etc mainly at the “American club”. In his free time the service user reported that he attends the local football matches, and enjoys watching locally played sports such as cricket. He also has hobbies and interests that keep him busy and occupied with the home and have resulted in outings to special places on interest. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 12 Day trips are arranged as a family, and although there hasn’t been an annual holiday with Mr and Mrs Hodges this year, there have been a number of day trips and he has visited his family for a few days in the summer. Contact is maintained with the service users family. By very regular telephone contact and letters and occasional visits. The daily care records showed that the service user was offered a balanced, healthy and varied diet. When asked if he had a choice, the service user responded that there wasn’t anything he didn’t like and was entirely happy with his diet. It was clear that decisions regarding food were discussed routinely on a daily basis with a consensus reached by both providers and the service user. Records of fridge freezer temperatures were recorded daily and were within the temperature ranges recommended. Mrs Hodges had a current food hygiene certificate. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 16, The home has a satisfactory complaints system with evidence that the service user feels that his views are listened to and acted upon. EVIDENCE: Mrs Hodges had produced a complaints procedure that was explicit and available in the home, on display in the hallway and included in the service user guide. As with other documents it was subject to an annual review. No complaints have been received at the home, or by the Commission for Social Care Inspection. The records provided for inspection purposes included very complimentary comments about the service from relatives of the service user. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 19, 20, and 24,26. The standard of the environment within this home is good providing the service user with an attractive, clean and homely place to live. EVIDENCE: This inspection did not include a thorough inspection of the home. The home does provide comfortable, attractive and well-maintained facilities “a home from home”. Communal space is provided in a lounge to the front of the property, a sitting room/lounge and a compact galley kitchen/diner. There is a bathroom and wc on the first floor and a separate wc on the ground floor. The service users bedroom was spacious and comfortably furnished, he had clearly made it his own, with evidence of family photographs and items of interest on display. The home was clean throughout.
Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 15 Since the last announced inspection, an extension to the property on the ground floor has started. Building work has commenced but has hit a hiatus, as some difficulties with the building contractor have emerged. Essentially stopping work, the providers are now in dispute with the contractor and have sought legal advice and the assistance of the local government trading standards department to help in this matter. In the interim the extension is not usable or accessible, as the works have not been completed. The area had been made as safe as possible, a risk assessment was to be completed for access to the rear of the building. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 27,28 and 30. Staffing and training arrangements were satisfactory, ensuring that the service user receives a high standard of care. EVIDENCE: The service is a family run business. The providers are Mr and Mrs Hodges; Mrs Hodges is the care manager. Mr and Mrs Hodges provide the day-to-day care for the service user. Training records showed that mandatory training was up to date. Additional training had been accessed in mental health, certificates to evidence attendance were on display in the home. Mr Hodges should consider a basic food hygiene course. On an occasional basis the providers use other family members to provide care, the qualifications and experience of this staff group are recorded in the Statement of Purpose, CRB checks have been carried out. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard: 31,33,37,38. The health and safety of the service user is assured by the service by very good risk assessment, regular fire safety checks and fire drills. The care manager provides an effective and competent service, ensuring the service user was properly and well cared for. The standards of record keeping throughout are excellent, ensuring that the service user needs are appropriately met and that his rights are safeguarded. EVIDENCE: Mrs Hodges has achieved NVQ level 4 and the Registered Care Managers award. She has consistently demonstrated her commitment to the service by accessing additional training and is undertaking a community mental health course to further increase her knowledge base. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 18 Risk assessments were in place for the environment and for general activities, individual risk assessments were in place for the service user, all were explicit in their detail, had been discussed with the service user and had been reviewed regularly. Mrs Hodges provided evidence that on an annual basis she sought the views of the relatives and significant others about the quality of care delivered to the service user. The responses were seen during this visit. An annual review of the Statement of Purpose was carried out. Fire records and drills were appropriately maintained with monthly checks of the fire alarm and monthly fire drills. Servicing documentation was not inspected during this visit. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 4 3 X X X 3 X 4 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X X X 3 3 Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard 30 37 Good Practice Recommendations Mr Hodges should consider a basic food hygiene course. A risk assessment should be completed for the rear garden around the site of the extension. Olcote DS0000008322.V254932.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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