Inspection on 05/09/05 for Olive House

This inspection was carried out on 5th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Olive House 03/10/07

Olive House 06/02/07

Olive House 06/02/06

Olive House 06/12/04

Olive House 12/08/04

Olive House 15/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Olive House New Line Bacup Lancashire OL13 OBT Lead Inspector Mrs Christine Mulcahy Unannounced Inspection 5th September 2005 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 Olive House DS0000036431.V251671.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 DS0000036431.V251671.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Olive House Address New Line Bacup Lancashire OL13 OBT 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) 01706 873322 Lancashire County Care Services Mrs Doric Hilda Davis Care Home 32 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (12), of places Physical disability (5), Physical disability over 65 years of age (5) Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Within the overall total of 32, a maximum of 12 service users requiring personal care who fall into the category of OP Within the overall total of 32, a maximum of 15 service users requiring personal care who fall into the category of DE(E) Within the overall total of 32, a maximum of 5 service users requiring personal care who fall into the category of PD or PD(E) who reside in the intermediate care unit. The service should at all times, employ a suitably qualified and experienced manager who is registered by the National Care Standards Commission 6th December 2004 4. Date of last inspection Brief Description of the Service: Olive House is registered with the Commission for Social Care to provide personal care and accommodation to thirty two older people. Within the overall total there are 12 service users aged 65 years or over, 15 service users aged 65 years or over with dementia and 5 service users aged 65 years or over who have a physical disability. All require personal care. The home is located on the main New Line Road close to local shops, a library and other amenities in the town centre of Bacup. The home is situated on a main bus route that offers transport to all towns in the Rosendale area. There is also a well-attended day service sited in the building. At the time of the inspection building work and refurbishment of the home was in progress. Plans seen and discussions with the Area Manager confirmed that the work in progress was extensive and nearing completion. Because of the building work there had been no service user admissions for eighteen months, however 7 service users from a nearby local authority home were admitted two weeks prior to this inspection. The service operates a rehabilitation unit for 6 service users. This unit is separately staffed and service users were making use of this facility. Bedrooms were located on the ground floor and first floor of the building. On completion of the refurbishment it is intended that the home will provide personal care and accommodation for up to 44 older people in 3 separate units. It is also intended for the home to have a number of assissted bathrooms, shower rooms and communal toilets for the service users. Additional services like day care and respite care will continue to be provided at Olive House. Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first unannounced inspection in 2005. The inspection took place over two days. The service was inspected against the National Minimum Standards for Older People and involved examination of records and discussion with a number of service users. There are references to the case tracking process. This is a method where the inspector focuses on a small representative group of service users. All records pertaining to these people are inspected along with the rooms they occupy in the home. Observations are made of the care provided and the service users are invited to have a discussion with the inspector to discuss their experiences of life in the home. This is not to the exclusion of the other service users, with a number of other service users being involved in the inspection process in various other ways. Breaches in regulations and standards that pose an immediate risk to service users have been highlighted for urgent action. The inspection was carried out with the co-operation of the duty residential care officers. Over the course of the inspection the inspector spoke to 6 service users, 7 staff members, and the responsible individual. A tour of the premises took place including all bedrooms and the new building work, which is nearing completion. Documents were read and care observed. What the service does well: The staff and management at Olive House try to make sure that all service users receive a high standard of care within a comfortable environment. A number of service users commented on the cleanliness of the home and were impressed with the refurbished units including their bedrooms new furniture and communal spaces. Service users had positive comments about the home and it was apparent they were very satisfied with the care they received. When asked service users made positive comments about the décor and furnishings of the home. One service user said, “I’m over the moon, I’m really happy here”. Staff confirmed that training was ongoing and had undertaken training in first aid, moving and handling, basic food hygiene and health and safety. A robust and thorough recruitment and selection process was in place based on equal opportunities. The procedure ensured service users were protected from harm and were in safe hands at all times. Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 6 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. Olive House DS0000036431.V251671.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 DS0000036431.V251671.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): OP 1, 2, 3 Although written information about the home and the facilities was comprehensive a number of service users had not been provided with an up to date service user guide. This information needed reviewing to reflect the services provided at the home following the refurbishments. Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 9 EVIDENCE: Service users recently transferred from another LCCS home were being helped by staff to settle into their new home. A service user when asked confirmed that he was unsure about the terms and conditions of his contract and had not received written confirmation to advise him that details within the contract would remain unchanged. Case files of recently admitted service users were examined contained information about their previous home. It was apparent that they had not been provided with an existing copy of the Service User Guide or Statement of Purpose for Olive House. Service users who were new to Olive House had recently been assessed to ensure their needs could be met at Olive House. Copies of the assessment were included in the service user case file and examined by the inspector. Discussions with the registered manager also confirmed this. The registered manager was required to ensure that all service users admitted to the home are provided with up to date information that reflects the current service and facilities at Olive House. The home does not provide intermediate care. Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 10 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): OP 7, 8 The health care needs of service users were identified and met in an ad hoc fashion. Care plans were basic and badly organised and held out of date information. Risk assessments did not clearly identify the risk potential to service users. EVIDENCE: Case tracking of two-service user case files showed that care plans had initially been drawn up from the initial service user assessment. However, both care plans examined held information that was out of date. One care plan examined used a format that identified the service user needs and the steps to take to meet the needs. The care plan was not comprehensive and gave only brief details of the care to be given. Another care plan of a service user with multiple complex health needs was examined. The care plan was last completed in 2002 and highlighted the reason for the service user admission. The plan had been reviewed regularly but did not highlight the changing needs of the service user. Sections of the care plan relating to the service user relationship with family, hopes for the future, medical history and last wishes were also included and were last completed on 05.02.2002. Although daily diary sheets relating to this service Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 11 user had been written on a daily basis there were no clear instructions to detail how the care should be given. There were instructions from the registered manager at the front of the care plan which made clear that the service user meals should be liquidised or mashed at all times. However under the heading “Dietary Needs” written information contradicted these instructions stating that the service user had no dietary needs. A hospital care plan written on 04.11.2002 included strategies and recommendations on how to manage this particular complex health need. There was also a written risk assessment completed on the 02.03.2005 that accompanied the hospital plan. The risk assessment was basic and risks were highlighted by a tick list. There were no instructions to explain how and when the care should be given, who should administer the care, and what equipment should be used to help the staff meet the service user needs better. Due to the service user being at risk of falling out of bed a mattress was used as a crash mat to prevent the service user from risk of harm, however there was no falls risk assessment available to demonstrate the level of risk to the service user. When asked the registered manager and care staff stated that the service user GP and District Nurse had agreed to this procedure and had advised accordingly. However there was no evidence to confirm this. Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 12 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 not assessed on this occasion EVIDENCE: Olive House DS0000036431.V251671.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): Standard not assessed on this occasion EVIDENCE: Olive House DS0000036431.V251671.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): OP 19, 26 There were sufficient toilet and washing facilities in the home. All areas in the home were safe and well maintained. The home was clean, pleasant, and hygienic. EVIDENCE: Bedrooms and communal living areas had recently been redecorated and furnished to a good standard. Bedrooms and bathrooms were located on the ground floor and first floor of the building. When asked service users made positive comments about the décor and furnishings of the home. One service user said, “I’m over the moon, I’m really happy here”. A tour of the home showed a good standard of cleanliness and hygiene. At the time of the inspection building work and refurbishment of the home was in progress. Plans seen and discussions with the Area Manager confirmed that the work in progress was extensive and nearing completion. Olive House DS0000036431.V251671.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): OP 27, 29, 30 Staff numbers were not adequate to meet the service user need. Staff training had taken place and was ongoing. Staff files held information required to ensure service users are safe from harm or abuse. EVIDENCE: Discussions with staff highlighted that the skill mix was appropriate to service user assessed needs. The inspector spoke to 7 staff who when asked were aware of the homes policies and procedures and knew where they could be located. A member of staff described her employment route that followed the homes recruitment policy. There was a robust and thorough recruitment and selection process in place based on equal opportunities. Examination of two staff files confirmed that appropriate Criminal Record Bureau and POVA checks were carried out prior to them starting work for the organisation. Staff confirmed there training opportunities at the home were available. When asked staff confirmed they had undertaken training in first aid, moving and handling, basic food hygiene, drug abuse, safety/ falls in the elderly, fire awareness and safe handling of medicines. Staff files examined confirmed that information required was held on each file. Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 16 One service user commented positively on the staff team and said that he felt safe and well looked after. When asked about the numbers of staff on duty a service user relative said, “I feel that there aren’t enough staff”. When asked staff highlighted the shortfalls in the staff rota and expressed their concerns about this. One staff commented that due to the layout of the building and small living units it had become increasingly difficult to ensure the safety of the high dependency service users. She said, “I’m worried because we’re not always able to keep an eye on the residents whilst we are around the unit doing other things”. Another care assistant said, “There are about 10 residents who have high dependency needs, they all need help with personal needs like dressing and we can’t see them because sometimes we’re in another part of the home.” The inspector raised this issue with the area manager and the registered manager. They advised that staffing levels may be reviewed once the new unit was in operation. The staff rota was examined and complied with the minimum staffing levels required by the previous registering authority. Olive House DS0000036431.V251671.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 not assessed on this occasion EVIDENCE: Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 19 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 OP1OP2 Regulation Reg 4&5 Requirement Timescale for action 19/11/05 2 OP7 Reg 15 (1) 15(2) 3 OP8 Reg 13(4)(b) (c) The registered manager must ensure that all service users admitted to the home are provided with an up to date copy of the homes Statement of Purpose and service user guide The registered manager must 05/01/06 ensure that all service users are provided with a plan of care that sets out in detail the action to be taken by care staff so that all aspects of the health and social care needs are met. The care plan must be kept under review. Immediate start and complete By The registered person shall 05/01/06 ensure that any activity that service users participate in is so far as reasonably practicable free from avoidable risks by ensuring that risk assessments are included in all service user care plans where necessary. Immediate start and complete by Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Olive House DS0000036431.V251671.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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