Inspection on 15/10/08 for Olive Lodge

This inspection was carried out on 15th October 2008.

CSCI found this care home to be providing an Good service.

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 Lodge 17/10/06

Olive Lodge 04/10/05

Olive Lodge 14/04/05

Olive Lodge 04/11/04

Olive Lodge 11/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Olive Lodge Bedford Court Broadgate Lane Horsforth Leeds West Yorkshire LS18 4EJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Paling     Date: 1 5 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Olive Lodge Broadgate Lane Bedford Court Horsforth Leeds West Yorkshire LS18 4EJ 01132593800 01132819885 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Anne Rhodes Type of registration: Number of places registered: Joseph Rowntree Housing Trust care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Increase of one for apartment 36 only Date of last inspection Brief description of the care home Olive Lodge, close to Horsforth Town Street is a 34 bedded care home which has been purpose built to a high specification for the Joseph Rowntree Trust. There is sheltered housing and apartments on the same site and these are not registered. The home is close to shops, library, a health centre and other amenities. All the rooms are spacious and for single occupancy with en suite facilities. All have French windows leading onto small balconies. The dining room and sitting area on the first floor is reached by stairs and a passenger lift. Information is provided in the form of a detailed brochure. The current charges range from three hundred and ninety eight pounds and thirty two 0 Over 65 35 Care Homes for Older People Page 4 of 27 Brief description of the care home pence to four hundred and fifty six pounds and fifty six pence per week. The home should be contacted directly for up to date information about charges. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced visit by one inspector for one day. We were at the home from 09:35 until 17:00 on the 15th October 2008. The last key inspection for this service was 17th October 2006. The purpose of our inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and in accordance with requirements. Before the inspection we looked at accumulated evidence about the home. This included looking at any reported incidents, accidents and complaints. We Care Homes for Older People Page 6 of 27 used this information to plan the visit. We looked at a number of documents during the visit and visited all areas of the home used by the people who live there. We spent a good proportion of time talking with the people at the home as well as with the manager and the staff. We asked the home to provide some information before the visit by completing an Annual Quality Assurance Assessment (AQAA). We sent survey forms to the home providing the opportunity for people to comment on the service, if they wish. Information provided in this way may be shared with the provider but the source will not be identified. The majority of the surveys were returned and some of the comments are included in the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with enough information to enable them to make an informed choice about the home. The admission process includes pre-admission assessments and trial visits are offered to make sure that peoples care needs can be met at the home. Evidence: Everyone planning to move into the home has their needs assessed by a senior member of staff before they move in. This is to make sure that their specific needs can be met at the home. Following admission the assessment tool is reviewed and completed every 30 days. This means that any changes are quickly identified and appropriate action taken. The assessment tool helps to identify those areas of care where support is needed from care staff and a care plan is written with information about the support needed. Information is also taken from other sources such as other health care professionals who have been involved in the persons care before Care Homes for Older People Page 10 of 27 Evidence: admission to the home People are encouraged to visit the home themselves to help them decide whether they want to move into the home. One person who had only been at the home a short time told us that they had chosen the home with help from an independent organisation. They had visited the home for a meal, then for a day and had moved in initially on a trial basis. This person knew who her key worker was and said that she was being looked after by kind carers. She told us that she had been helped by kind carers to settle into the home. She knew what activities were going on and, as a vegetarian, had been given some good food. This person had brought some of her own furniture into the home to help make her room more homely. Everyone moving into the home is given information and surveys indicated that people felt that they were given enough information to help them decide about the home. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans contain enough information so that staff can look after people properly. Staff respect the privacy and dignity of people living at the home. People are protected by safe medication practices. Evidence: We looked in detail at a small sample of individual care records and saw that everyone has their own file with information about their care. Although staff know the people living at the home very well the detail within the care records does not always reflect this. The ongoing assessment tool does provide very good information in the form of a medical history and detail of dependency changes and it is a comprehensive document. However, information for staff in care plans about peoples needs and the support they need was not detailed enough. For example, one persons eating and drinking care plan did not include the fact that the risk assessment says this person was at risk with a reduced appetite or that she is vegetarian. Information in risk assessments and care plans needs to link together so that staff have the full picture about the support someone needs. We saw basic personal care plans, for example, Care Homes for Older People Page 12 of 27 Evidence: needs assistance with no detail of what and how and requires assistance to dress bottom half with no detail of how or when. Daily records have little detail and are not always informative. In some cases the written information we saw could be misinterpreted, for example, no problems this pm until 9.30pm. We saw the ongoing assessment of one person with dementia and there was good information about the changes in this persons mental state and the input needed from other healthcare professionals. Records showed that the home had been proactive in making sure the description of this person was put on the police data base as they used to go out of the home frequently. We also saw some good evidence to show staff understanding of this persons condition. For example, why they are hard to weigh as they doesnt understand the sit-on weigh scales and to help them co-ordinate clothing as they are much more settled when dressed well. Care plans are not person centred. The lack of detail in care plans makes monthly review and evaluation hard and we did not see any evaluation of care plans. The lack of evaluation means that progress and changes in peoples care needs are not clear. The fact that daily records are also not detailed makes it hard to get a sense of peoples health and well being. Staff do know people very well and people are being looked after properly but there is little written evidence of this. Person centred care plans need to be developed to reflect the good care being provided. We saw evidence of in-house monitoring of records with a handwritten note about what needed updating in these particular records. Peoples religions are recorded but there was not enough detail of how people are supported to pursue their beliefs. For example, believes in God but no information about church attendance, in another case attends Quaker meetings, very active then not as active but with no information of what happens now and in another case attends church now and again but no information for staff of when, how or which church. There were good records of visits from other healthcare professionals and their input and any changes in treatment. End of life plans are being discussed with people and one relative said that they were particularly pleased by this and found it reassuring to have discussed difficult issues. On the day of our visit there had been an expected death which was very well managed and the home was calm. Relatives of the person asked to speak to us and spoke highly of the care their mother had received and the support given to them as well. They said: Couldnt have been more supportive to us and mum and Care Homes for Older People Page 13 of 27 Evidence: maintained her dignity at all times. They were kept fully aware of what was happening and their wishes were followed. The manager told all the staff about the death including those due on the late shift. Other people living at the home were also told in a sensitive way. People are given the opportunity to self-medicate following a risk assessment. Copies of the completed risk assessments should be sent to the GP for his agreement and information. Each room has a secure and lockable cabinet where the individuals medication is kept. Each member of staff has to complete a set of competencies before they can administer medication. In addition, the deputy manager, who is a nurse, assesses everyone 3 times a year. The home has a good service from the doctors surgery and from the community matron. She visits twice a week to see people and to give staff advice. The home recently changed their supplying pharmacist and get very good service from them. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in maintaining contact with their family and friends. People say that they have enough to occupy their time and are able to spend their time how they wish. People have a varied and nutritious diet Evidence: Everyone we spoke with told us that they spent their time in the way they wanted. One person had just had a bath but said that she sometimes preferred it in the evening and it was her choice. People are supported to keep in contact with their family and friends. Those who are able come and go as they wish. There is a monthly activities programme and everyone is given their own copy every month. The programme is also displayed on the noticeboard. The type of activities arranged is led by the people living at the home. There is an active residents committee and a Newsletter is produced regularly. The potential for some people to become isolated in their rooms has been recognised and an activities organiser has been appointed. The manager and people living at the home feel that she has enhanced the activity provision. She is able to do more one to one work with people and small group work. There is also a reliance on volunteers in activity provision, for Care Homes for Older People Page 15 of 27 Evidence: example the volunteer driver also calls bingo. There is an active painting group and some of the work completed by people living at the home is displayed in the conservatory area. One recently admitted person was aware of what activities were available and said that there was something going on all the time. The lunchtime meal is the main meal of the day. Most people come to the dining room for their meals. The cook has been at the home since it opened and knows peoples likes and dislikes. Surveys included some mixed views about the food but overall people said that they felt the food was good. The lunchtime meal looked good and smelt appetising. People said: the cooks treat you very personally and if you dont like the two alternatives do what they can to make sure you have a good meal the home could do better quality food, more interesting I think they need more kitchen staff at tea time so we can always have a proper cooked meal I think the home should check that we do not have to wait a long time for personal care and then find out why when we do I am very happy with the service This is not home to me but the next best thing They care for me in all ways Retains residents dignity and values them as individuals Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an effective complaints procedure and people feel that their concerns will be taken seriously. People feel safe at the home. Evidence: There is a comprehensive complaints procedure, which is displayed on the wall in the entrance area. Everyone living at the home gets their own copy and people said that they feel able to speak up. The complaints log shows that people have access to complaints forms and use them. The records show that the manager deals with any complaints properly giving clear responses to complainants. The organisation has appointed a Quality and Compliance Officer. This person reviews complaints and the initial investigation carried out in-house. The manager is then given guidance about any further action needed. The complaints log gave us clear evidence that any complaints are dealt with appropriately. We recommended that the manager should keep a running log to provide a quick reference of the source of the complaint, whether it concerns the care home, the sheltered flats or the bungalows, and the outcome, that is, if it has been upheld or not. All staff have training about safeguarding vulnerable adults. The training is provided by the manager and someone from the training unit of the organisation. The sessions are Care Homes for Older People Page 17 of 27 Evidence: planned on an ongoing basis and the next sessions are planned for November. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable and well maintained environment. Evidence: The entrance area is spacious and welcoming with suitable piped music playing. Normally the administrators office is manned so there is someone to help with enquiries, although this was not the case on the day of this visit. There are automatic doors to the entrance of the home and we talked to the manager about general security as we had walked in and around part of the home before being challenged by staff. All the areas we visited were clean and fresh smelling. Peoples rooms are spacious and people have lots of their own belongings with them. The en suites have fully assisted showers. The communal bathrooms are also large with fully assisted baths so that people have a choice. There is a passenger lift and stair lift to the first floor and some people use the main staircase. There are comfortable chairs positioned around the home so that people have somewhere to rest as they take exercise around the building.The home is built around a central garden area that is accessible to people. Many of the rooms have Care Homes for Older People Page 19 of 27 Evidence: small balconies on which people grow flowers providing a very attractive outlook. The large communal dining/lounge area is on the first floor and there is a conservatory on the ground floor. The conservatory is used for craft work and painting and is used to display peoples artwork. There is also computer access in this area. The laundry is small but well equipped and very well organised. There are good infection control practices in place. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well trained and competent staff team look after people. People are protected by robust recruitment practices. Evidence: There were enough staff on duty on the day of the visit. There is also a team of ancillary staff to support the care staff over the seven day period. The duty rotas showed that staffing levels are kept at this level. Any shortfalls in staffing numbers are filled by care staff from the homes staff bank. The addition of an activities organiser has enhanced the staff input into the provision of occupation and activities. The organisation provides a whole range of training opportunities for staff to make sure that they have the knowledge to look after people properly. On the day of the visit the deputy manager and a senior carer were on a training course connected with Care Home End of life Supportive Services (CHESS). The number of care staff who have achieved a National Vocational Qualification (NVQ) in care at level 2, 3 and 4 is around 87 . There is a clear commitment to training care staff to a high level. The organisation has an annual staff training plan in place and the manager identifies individual staff training needs through the established supervision and appraisal programme. Care Homes for Older People Page 21 of 27 Evidence: Staff training certificates are displayed in the home along one of the corridors and include NVQ certificates, dementia courses and the safe handling of medication. Catering staff also complete NVQ in cooking. We looked at the recruitment files of two recently employed bank carers. Original documents at held by the organisations personnel department. Copies of documents were available for inspection and we saw that all the required checks are completed before people start work at the home. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is well organised and practices promote and safeguard the health, safety and well being of people living at the home. Evidence: The provider needs to make application to remove the nursing category from the registration certificate. Personal care only is provided at the home and any nursing support is given by the community nursing service. We met with the provider in December 2007 and following this it was agreed that they would apply to have the nursing category removed. The home is managed by an experienced manager who has been at the home for several years. She holds the Registered Managers Award (RMA) and an NVQ in care at level 4. She provides continuity at the home and clear leadership to staff. The home continues with the flexible staffing project. This is a study looking at the changing Care Homes for Older People Page 23 of 27 Evidence: needs of people living at the home, making sure, through training and work with the community healthcare teams, that peoples needs can be met at the home. This has meant that on occasions people with quite complex needs have been looked after at the home with the cooperation of other healthcare professionals who have provided training and support. In addition to this, the manager has also been reviewing night staff numbers following some research produced by the Joseph Rowntree Foundation into Support for Older People at night. Regular meetings are held with the staff and the most recent one was on 10th September 2008. Notes of the meeting were displayed on the staff notice board. Staff said: 100 backing from management, resident and family and our work colleagues Staff said that they feel very well supported by the manager and their colleagues and they work well as a team in doing their best for people living at the home. There is also an established system of staff supervision and appraisals. The home does not act as appointees for anyone but do manage small amounts of money for people. They keep clear records with two signatures for any money put in or taken out. There is an active Residents committee and they hold regular meetings and are made to feel involved in the running of the home. The quality assurance systems are currently under review by new Quality and Compliance Officer. The manager is trained to provide fire training to staff and is due to complete a refresher course with West Yorkshire Fire Service. The deputy manager is also to be trained as a fire trainer. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care plans should be person centred and provide enough detail so that people can be sure that they will be looked after in the way they want. A running log of complaints should be kept to clearly identify the area of complaint and the outcome of the investigation, whether the complaint has been upheld or not. 2 16 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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