CARE HOMES FOR OLDER PEOPLE
Olive House Olive Avenue Newton Flotman Norwich Norfolk NR15 1PF Lead Inspector
Kim Patience Unannounced Inspection 12th January 2006 10:40 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 Olive House DS0000027517.V272217.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. Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Olive House Address Olive Avenue Newton Flotman Norwich Norfolk NR15 1PF 01508 471718 01508 471719 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) Mr Richard Gray Mrs Elizabeth Gray Mrs Elizabeth Gray Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: Olive House was erected in 1996 and is a purpose built residential home designed to provide accommodation to 35 older people. Accommodation is on the ground floor and all rooms are single with en suite facilities. The home is situated in the south Norfolk village of Newton Flotman in a quiet residential street and stands in its own grounds with a landscaped garden to the rear and a large car park to the front. Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took approximately 4.5 hours to complete. The manager/proprietor was available for consultation throughout the inspection and helpful in facilitating the process. During the inspection, some communal areas of the home were entered, along with a number of service users rooms. Records relating to the service users, staff and running of the home were inspected. Three service users, a relative and two care assistants were interviewed in private. Comment cards were sent to stakeholders, however, at the time of writing this report only those sent to professionals had been returned. The manager stated that service users were provided with the opportunity to complete comment cards and this would be offered once again. What the service does well: What has improved since the last inspection?
The last inspection did not raise any requirements or recommendations and as with this inspection the outcome was positive. Therefore, it is difficult to measure the improvements made. However, the home is committed to
Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 6 continuous improvement on a day-to-day basis and this is demonstrable by the level of consultation with service users and staff. As mentioned earlier, the level of training provided is an example of continuous improvement, by way of enhancing the workforce knowledge and skills to improve the services offered. 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. Olive House DS0000027517.V272217.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 Olive House DS0000027517.V272217.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): 6 The home does not provide intermediate care services. EVIDENCE: The home does not provide intermediate care services. Olive House DS0000027517.V272217.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): 0 Standards not assessed on this occasion. EVIDENCE: Standards not assessed on this occasion. Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 The home provides a wide range of activities to meet people’s expectations, preferences and interests. The home promotes contact between residents and those with whom they have significant relationships. EVIDENCE: The home employs an activities coordinator whose role is to assess people’s interests, hobbies and preferences on admission, to plan an programme of activities generated from peoples interests, consult with residents on a ongoing basis, promote and encourage participation and liaise with staff about the implementation of the programme of activities. This is good practice and the management demonstrate commitment to ensuring that people are provided with meaningful stimulation. The assessment of activities for each individual is limited, however, the coordinator visits residents regularly to discuss their interests. The home needs to develop a more detailed social care plan that can be reviewed during the visits and would more clearly evidence the fact that people’s needs are being assessed and reviewed. See recommendations. The programme of activities is displayed in the entrance lobby and shows that in the course of a week the home provides activities such as, exercise
Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 11 sessions, board and quiz games, craft-work, knitting and reminiscence. In addition, entertainment and events are arranged in and out of the home such as, a fashion show, a singer/entertainer and seasonal events. At Christmas, some of the resident went to the pier hotel for dinner and found it an enjoyable experience. Residents spoken with confirmed that the home was very lively and there was always something to do if they wanted to participate. They knew the activities coordinator and talked of her visits, during which they discussed their interests. One resident spoke of a particular interest she has in needlework and how the home promoted this interest by giving her items of clothing and bedding to repair. She found this extremely satisfying and felt that in this way she was contributing to the running of the home. There was also an opportunity to talk with a visiting relative who expressed how pleased she was that, although her mother has dementia, the home encouraged her to participate in activity that would meet her individual needs. She was encouraged to participate in group activities and supported to engage, however small the contribution. Comment cards were sent to visiting professionals and one community nurse stated that ‘ the atmosphere is homely and warm with a good deal of stimulating activities provided’ The activities coordinator maintains some records of residents who take part in the activities and daily records show some attendance, however, the records do not include all residents and all activities. Therefore, it is recommended that the coordinator establish a system whereby the activities and the names of those who attend are listed. See recommendations. It was evident when walking around the home that people enjoyed being in the communal areas, mixing with other residents and bringing people together with similar interests has created a very sociable environment. The management and staff are very welcoming to visitors, during the inspection many visitors were seen coming and going. Residents were seen going out with relatives and one resident had recently returned following a four-week holiday abroad. One visiting relative said that she was always welcome at the home and found the staff very accommodating. She was offered drinks during her visit and could stay for a meal if she wished. The homes approach encourages interaction between visitors and residents making people feel comfortable and welcome during the time of their visit. A complimentary letter from a relative to the manager and staff was read, which stated ‘ you manage to maintain a fantastic attitude of friendliness and welcome, patience and good humour at all times’. Service users records show that the home considers the need for social contacts and each file inspected contained details of the next of kin and other Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 12 significant relationships. Records also show that the home maintains good contact with relatives keeping them informed of any change. Olive House DS0000027517.V272217.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): 16 The home has systems in place to ensure that people are able to make a complaint or raise concerns that will be dealt with in an appropriate timely manner. EVIDENCE: The home has a clear and accessible complaints procedure that is contained within the service users guide and issued to all service users at the time of admission. In addition, a comments book is situated in the reception area to encourage service users or visitors to make comments about the service if they wish. The home has not received any complaints since the last inspection and no complaints have been received by the Commission. Olive House DS0000027517.V272217.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): 19, 26 Service users can be assured that the home provides a safe, well-maintained environment with systems in place to ensure that it is kept clean, pleasant and hygienic. EVIDENCE: During the inspection, various parts of the home were visited, including a number of service users rooms. The home is nicely decorated and furnished throughout, making it appear bright and airy. There is a large communal lounge, a conservatory, quiet lounge and a dining room, which provides choice of places to sit. Service users rooms are comfortable, with lots of personal effects such as photos and ornaments. All areas were clean and tidy, the home employs a team of domestics to ensure that a high standard is maintained. Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The management is able to demonstrate that sufficient numbers of staff are employed at the home and have the necessary skills and knowledge to deliver a care service to meet the needs of people living in the home. There are systems in place to ensure that any person wishing to work at the home is considered safe and has the necessary skills and qualities to provide a service consistent with the values and principles of the home. EVIDENCE: The home has experience very few changes in staffing and has a consistent team of care staff. Staff spoken with said they were very happy working at the home and well supported by the management team. Morale appeared to be very high which demonstrates that staff have job satisfaction and clearly feel involved in the running of the home. Staffing levels are determined by peoples assessed needs and there are a greater number of relatively self-caring, independent residents. There are 5 care assistants on duty in the morning, 3 in the afternoon up until 10pm and 2 waking night staff, supported by an on call manager. There is a manager or person in charge on each shift. The home has had very little recruitment activity in the past year due to the stability of the team. However, they have robust recruitment procedures in place that ensure the protection of residents. All prospective employees are required to complete an application form and attend a face-to-face interview. If
Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 16 offered a position, a criminal records check is completed and two references are requested. Staff files inspected showed that they were maintained in accordance with the requirements, containing evidence of identification and the necessary pre-employment checks. The home has a comprehensive training programme that includes induction, foundation and NVQ. Of the 22 care staff employed at the home 15 are trained to NVQ2 or above and in the next 12 months a further 6 members of staff will commence an NVQ. The manager is a NVQ assessor, which is an asset to the home. In the past 12 months staff have been trained in subjects such as, moving and handling, abuse awareness, diabetes, Parkinson and stroke management. In addition, mandatory training such as health and safety, moving and handling and fire safety. Training needs analyses are completed during annual appraisals and any training needs identified, are sourced where possible. The management’s commitment to training is admirable and demonstrates an understanding of the importance of a well-trained team in order to deliver quality services. Olive House DS0000027517.V272217.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): 33,35,38 The home has mechanisms in place to monitor quality, however, does not have a recognisable quality assurance system. The home has systems in place to safeguard service users finances, however they cannot demonstrate this on an individual basis. The home has systems in place that protect the health safety and welfare of service users and staff. EVIDENCE: The home has quality-monitoring processes in place such as, stakeholder surveys, residents meetings and internal audits. However there is a need to develop a recognisable quality assurance system whereby they can analyse and produce the results of quality monitoring in a report that can be given to the service user and the Commission. See requirements.
Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 18 The way in which the home supports service users with their finances was assessed. A small amount of money is kept, in a safe, for a number of service users at their request. Individual financial transaction records are maintained and show monies paid in and out. Two people, one of who is the service user where possible, sign each transaction. The records are subject to an internal audit every two months when the records are checked against the monies held to ensure that the amounts tally. The record keeping was good, however, the money held for each service user is pooled and therefore it was not possible to check that the records were accurate for each individual. The home must ensure that the money for each service user is held separately. See requirements. Health and safety records, policies and procedures were inspected. An environmental health inspection was completed in August 2005 with no issues arising and a fire safety inspection was completed in December 2005 again with no issues arising. The Commission was provided with reports from the two agencies to this effect. The home has procedures in place that ensure risk assessments are carried out for the environment, COSSH, fire safety and other aspects relating to health and safety. Fire safety procedures were inspected, alarm tests are completed on a weekly basis and equipment is tested by external contractors on an annual basis. Other equipment such as, small electrical, the assisted baths and hygiene units are serviced under contract and hoists are examined every six months. All staff working at the home are trained in health and safety when joining the home and provided with annual refresher training. Olive House DS0000027517.V272217.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 X X X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 X 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 X X 3 Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP33 Regulation 24 Requirement The registered person must establish and maintain a system for monitoring and improving the quality of the care provided and provide service users and the Commission with a report in respect of quality assurance on an annual basis. The registered person must ensure that service users personal allowances are not pooled. Timescale for action 30/04/06 2 OP35 16(2)(l) 03/02/06 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 OP12 Good Practice Recommendations It is recommended that the registered person develops a more detailed social care plan for each resident and maintains a record of participation in activities held. Olive House DS0000027517.V272217.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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