Inspection on 06/02/06 for Olive House

This inspection was carried out on 6th February 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Olive House 03/10/07

Olive House 06/02/07

Olive House 05/09/05

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 6th February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Olive House DS0000036431.V273094.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.V273094.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 44 Category(ies) of Dementia (9), Dementia - over 65 years of age registration, with number (9), Old age, not falling within any other of places category (29), Physical disability (6), Physical disability over 65 years of age (6) Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The home is registered for a maximum of 44 service users to include: Up to 29 service users in the category of OP (over 65 years of age, not falling into any other category) requiring personal care Up to 9 service users in the category of DE(E) (Dementia over 65 years of age, not falling into any other category) requiring personal care. Up to 9 service users in the category of DE ( Dementia, under 65 years of age, not falling into any other category) requiring personal care Up to 6 service users in the category of PD(E) (physical Disability, over 65 years of age) requiring personal care Up to 6 service users in the category of PD (Physical Disability, under 65 years of age) requiring personal care Date of last inspection 5th September 2005 Brief Description of the Service: Olive House is registered with the Commission for Social Care to provide personal care and accommodation for up to 42 older people. Within the overall total there are 20 service users aged 65 years or over, 16 service users aged 65 years or over with dementia and 6 service users aged 65 years or over who have a physical disability. All require personal care. The service operates a rehabilitation unit for 6 service users. This unit is separately staffed and service users were making use of this facility. 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 previous 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.V273094.R01.S.doc Version 5.0 Page 5 The building refurbishment is now complete and the home provides personal care and accommodation for up to 44 older people in 5 separate units. There is a new building extension called the Kensington Unit. This provides a spacious lounge, conservatory, and modern garden decking overlooking the local bowling green. All bedrooms on this unit are en suite. There are also a number of assisted bathrooms, shower rooms and toilets for the service users throughout the home. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second in the inspection year and took place over one day. The service was inspected against the National Minimum Standards for Older People. Case tracking of service users also took place along with the rooms they occupy in the home. Observations were made of the care provided and the service users were invited to have a discussion with the inspector to discuss their experiences of life in the home. The inspection spoke to 4 service users, 3 care staff, 1 domestic and the registered manager. Breaches in regulations and standards that pose an immediate risk to service users have been highlighted for urgent action. What the service does well: What has improved since the last inspection? A tour of the building confirmed the home had undergone an extensive refurbishment and building programme. All furniture including beds was new. The new building extension provided service users with a large dining room with patio doors that opened out onto a wooden decked patio. Views overlooking the local Bowling Green and gardens were impressive. There was also a large lounge with plasma screen T.V and attached to this was a conservatory. Service users hen asked commented positively on the facilities. One service user said, “This is lovely isn’t it, and we’ve even got a conservatory”. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 7 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.V273094.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 1, 2, 3, 6 Written information about the home was comprehensive. Service users had a written contract. New Service users were always assessed prior to moving into the home. Rehabilitation facilities enabled service users to return home. EVIDENCE: Case tracking of service user case files confirmed that service users had been provided with a service user guide and statement of purpose and written contract. A thorough needs assessment had been carried out before service users moved into the home. Service users placed for intermediate care were admitted for up to 6 weeks before a planned discharge home. Rehabilitation facilities were sited in a dedicated space and included equipment, therapies, staff and treatment to promote activities for daily living and mobility. Olive House DS0000036431.V273094.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, 9, 10 Service user health care needs were identified and met through care plans. The records and control of medicines were poorly managed. Health and personal care arrangements were respected. EVIDENCE: Case tracking of service user case files showed that care plans had been drawn up from the initial service user assessment. Each care plan addressed areas of care and detailed the care to be given. Choices in day-to-day living, assistance, dietary needs, intellectual cultural needs, interests hobbies, background, life history, and lifestyle choices enabled staff to meet service users needs better. Care plans also contained a service user personal profile and reason for admission to the home that included a medical history, known allergies and last wishes. Care plans also highlighted individual use of specialist equipment to ensure service user safety and comfort in the home. A falls risk assessments were included in each care plan. Most care plans had been reviewed and care plan review sheets had been completed and signed by staff. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 11 One service user commented positively on the care received and said, “The staff are wonderful, they do some shopping for me and bring me things I need.” There was a medication policy and procedure at the home. Written guidance was available for staff to follow when administering medication. Policies and procedures examined ensured service user safety. All medicines were stored securely ensuring service users were kept safe from harm. Medication Record Sheets were completed accurately. The Controlled Drugs Register was examined and the inspector noted that another designated member of staff had not witnessed the administration of some controlled drugs. Also the receipt and disposal of Controlled Drugs were not recorded accurately in the CD register. The registered manager was required to ensure that medicines in the custody of the home are handled according to the requirements of the Medicines Act 1968 and other relevant guidelines from the Royal Pharmaceutical Society. Arrangements to ensure service users privacy and dignity is respected were in place. Staff induction instructed them how to treat service users with respect at all times. Staff were heard using service users preferred term of address. One service user said, “If I need to see a doctor, I would always use my room, they always look after me.” Olive House DS0000036431.V273094.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): OP 12, 13, 14, 15 Daily routines were flexible and varied. Visiting times were flexible. Service user autonomy and choice were maximised. Meals were varied and nutritious. EVIDENCE: Case tracking and discussions with service users confirmed that routines and daily living were mostly based on service user wishes. This information was highlighted in care plans. Past interests, hobbies, present needs and wishes were also included in care plans. “We can get up more or less when we want.” said one service user. Another service user said, “I have a lot of contact with my sister, she comes every day and people of the same religion visit now and again, it’s always nice to see them.” Another service user said, “I’m very satisfied with my accommodation but I’d like more outings to places of interest. Where I lived before I could get to the market and buy books”. A keen reader, he went on to say, “I haven’t been out of here since I moved in and I do miss going out”. He went on to explain that the book exchange service visited once every 4 weeks but he still liked to get out and about with the support of the homes transport and staff. The registered manager was required to ensure that details about service users current interests was included on the service users care plan. The care plan should include actions on how to meet the service user social needs. The registered manager said that she would look into booking transport provided to enable service user outside hobbies and interests were met. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 13 When asked service users confirmed relatives dealt with their financial affairs. The registered manager confirmed this was the case for most of the service users. One service user when asked confirmed that his solicitor dealt with his personal affairs. Three full meals were served daily two of these were hot. The meal served on the day of the inspection was Hotpot. Service users were given ample sized portions of the meal that looked appealing and appetising. Menus were changed regularly and there was always a choice of meals served. Service users were asked individually which meal they would prefer. Staff were available to offer assistance in eating although service users seen were able to eat independently. A service user when asked that they had enjoyed the chosen meal and a number of people commented on how good the food was at the home. One service user said, “The food is very good”, another said, “The food is lovely here”. Another service user stated, “I don’t like some of the food served here because I like spicy food. The cook makes special meals for me like chillis and the manager will bring in stuff like curries and sweet and sour. They really look after me”. Meals were served in dining rooms attached to each unit. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 14 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): OP 16, 18 The homes clear and effective complaints procedure included the stages and timescales for the process. Service users knew who to complain to. Procedures to protect service users from abuse were in place. EVIDENCE: There was a simple clear and accessible complaints procedure. A copy of this had been given to all service users at Olive house. When asked service users said that they knew whom to complain to. One service user said, “If I had a complaint I ‘d go to see the manager and talk to her. You can talk to the staff about anything.” When asked the registered manager and staff confirmed they always listened to and acted on the views and concerns of service users and others. The registered manager stated that service users were always listened to and issues were sorted out before they became problems. The inspector examined the homes record of complaints and noted that no complaints had been made since the last inspection. There was a robust procedure for responding to suspicions or evidence of abuse or neglect (including whistle-blowing) that ensured the safety and protection of service users. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 15 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, 21, 22, 24, 26 All areas of the home were safe and well maintained. Specialist equipment, furnishings, toilet and washing facilities met service user needs. The home was clean, pleasant and hygienic. EVIDENCE: The location and layout of the home was suitable for it’s stated purpose. It was accessible safe and well maintained meeting service users individual and collective needs. Building and refurbishment work had been completed to a good standard and had been designed to meet relevant guidelines. There were ample accessible toilets for service users close to lounge and dining areas. Assisted baths were available in each area of the home. Where rooms weren’t en suite toilets were within close proximity of service users bedrooms. En suite facilities accommodated service users own wheelchairs and other aids. Call systems with an accessible alarm facility were provided in every room. Grab rails were provided in bathrooms, toilets and corridors. Aids, hoists and Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 16 assisted toilets and baths were installed and capable of meeting the assessed service user needs. Doors to service user bedrooms were fitted with locks and service users were provided with a key as requested. Bedrooms seen had been furnished by the home with good quality furniture. Some bedrooms had been personalised by service users who had brought their own possessions with them. Laundry and sluicing facilities were sited appropriately in the home following relevant guidance. The premises were kept clean and free from offensive odour. The registered manager was required to ensure that service user smoking areas are provided with suitable extractor fans. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 17 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 files held information required to ensure service users are safe from harm or abuse. Staff training had taken place and was ongoing. EVIDENCE: Discussion with staff and service users highlighted that the skill mix was appropriate to meet service user assessed needs. The inspector spoke to 3 staff who when asked were aware of the homes policies and procedures and knew where they could be located. Staff confirmed they were happy at Olive House and were comfortable with their employers. 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. A member of staff described her employment route that followed the homes recruitment policy. Staff files examined confirmed that information required was held on each file and training opportunities at the home were available. A number of staff had undertaken training in first aid, moving and handling, basic food hygiene, NVQ in care, health and safety and safe handling of medicines. When asked a number of service users commented positively on the staff team and said that they felt safe and well looked after. Service user and visitor comment cards had not been returned to the Commission for inclusion in this report. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 18 When asked one service users commented that there were not always enough staff on duty. He said, “The staff work really hard and look after me the best they can. Two staff have to help me when I want to go to the toilet or get out of bed but if they’re busy in other areas I have to wait, but I can’t wait”. He then went on to explain, “It’s embarrassing and I don’t want to have an accident while I’m waiting for staff to help me”. The registered manager stated that the ratios of staff are currently 1 staff to 8 service users and one staff works between each unit in the home if necessary. Some tasks are prolonged due to complex service user needs. This person can be called to help with one service user and other service users have to wait to be toileted. There is no allowance made for staff when escorting service users to hospital, or to cover staff breaks. A number of staff confirmed this when asked. The staff rota was examined and complied with the minimum staffing levels required by the previous registering authority. The registered manager was required to ensure that staff ratios are determined according to the assessed needs of service users. The registered manager was also required to ensure that where service users might be at risk of harm, this must be highlighted in a risk assessment and preventative action must be taken. Additional staff must be on duty at peak times of activity during the day to reflect service user need and the layout of the home. Domestic and kitchen staff were employed in sufficient numbers to ensure standards relating to food, meals and hygiene were met. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 19 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): OP 31, 33, 35, 38 The attitude of the staff and management is to ensure the home is friendly, comfortable and flexible for the service users. Written procedures ensure the health and safety of staff and service users are safe guarded. Service users interests are protected. EVIDENCE: It was apparent that service users lived in a home that was run to suit the needs and choices of the service users. All the records required for the efficient running of the home were available and stored securely to be accessed by designated senior staff. Service users or their representatives had access to their records on request. Policies and procedures were available to all members of staff. A copy of the complaints procedure was included in the service user guide. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 20 The registered manager has many years experience of working with older people and has numerous work related qualifications. The health safety and wellbeing of staff and service users were promoted through the homes policies and procedures. Records of staff employed at Olive House were kept securely. Service users controlled their own money where possible. Written records of all transactions were made for those whose money was handled for them. Staff had received training in moving and handling, fire safety, first aid, food hygiene, and the safe handling of medicines. Requirements relating to staffing levels, service user risk assessments, Controlled Drugs, smoking and ventilation have been made. The inspector was satisfied the registered manager had tried to ensure compliance with other relevant health and safety legislation through robust policies, procedures and practices in other areas. Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 21 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 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 X 3 2 3 STAFFING Standard No Score 27 2 28 X 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 2 Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 22 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 Reg 15 (1)15(2) Requirement The registered manager must 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 To be completed by the date shown. The registered manager must ensure that all medicines including Controlled Drugs in the custody of the home are handled according to the requirements of the Medicines Act 1968 and other relevant guidelines from the Royal Pharmaceutical Society. Timescale for action 05/05/06 2 OP9 Reg 13(2) 06/02/06 3 OP12 Reg 16(m)(n) 4 OP25 Reg 23(2)(p) The registered manager must 05/05/06 ensure that details about service users current interests are included on the service user care plan. The registered manager must ensure that service user smoking 05/05/06 areas are provided with ventilation suitable to meet service users needs. DS0000036431.V273094.R01.S.doc Version 5.0 Page 23 Olive House 5 OP27 Reg 18(1) 6 OP27 Reg 13(4)(c) The registered manager must ensure that staff ratios are determined according to the assessed needs of service users. Additional staff must be on duty at peak times of activity during the day to reflect service user need and the layout of the home. The registered manager must ensure that where service users might be at risk of harm, this must be highlighted in a risk assessment and preventative action must be taken. 06/02/06 06/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI Olive House DS0000036431.V273094.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!