Inspection on 27/02/06 for Oliver Court

This inspection was carried out on 27th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oliver Court 05/02/08

Oliver Court 14/02/07

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

CARE HOME ADULTS 18-65 Oliver Court Bath Hill Terrace Great Yarmouth Norfolk NR30 2LF Lead Inspector Hilary Shephard Announced Inspection 27th February 2006 09.30 Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 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 Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 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 Adults 18-65. 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. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oliver Court Address Bath Hill Terrace Great Yarmouth Norfolk NR30 2LF 01493 332552 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jane Allison Matheron Mr John Edward Matheron Mr Roger Laurence Beevis Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (11) of places Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. In the absence of the manager, a senior member of staff must be on duty during the waking day (between the hours of 8am and 10 pm) 7 days per week. The registered numbers will be increased to 11 allowing one of the flats to be used by a co-habiting couple. Not applicable. Date of last inspection Brief Description of the Service: Oliver Court opened in October 2005 and is situated adjacent to the owners other care home, Appleton Lodge. Oliver Court is a three-storey building comprising of 10 flats situated near to the centre of Great Yarmouth. Oliver Court provides care and accommodation for up to 11 people aged between 18 and 65 who have mental health problems. The home provides residents with individual flats, which include a small kitchen with washing machine, fridge, freezer and cooker. The flats also have their own bathroom, separate bedroom and living room. Two flats are situated on the ground floor; the others are on the first and second floors. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection since it became registered in October 2005. This inspection was announced and was carried out over 9 ¾ hours. During the inspection, four out of eleven residents and two members of staff were spoken with. A tour was made of the building and the inspector looked at care plans, safety records, medication and staff files. Eleven comment cards were received from residents, and seven from relatives/visitors. The views of residents and staff where appropriate are reflected in the findings of this report. What the service does well: What has improved since the last inspection? What they could do better: Medication needs to be recorded and managed in a safer way to reduce the risk of errors. Pre-employment checks on new staff need to be improved to ensure that residents are protected from harm. Fire safety is being compromised by residents propping open the kitchen doors within their flats. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 6 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. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Residents’ needs are properly and thoroughly assessed before they are admitted. EVIDENCE: Residents are given opportunities to visit the home prior to admission, and staff from the home will visit them to make their own assessment. One resident confirmed she had visited the home before admission and was given an information pack to help her make a decision. Residents’ care files contained information and assessments from social workers and Psychiatrists and the owners confirmed that they aim to obtain as much information about the residents as possible using a variety of sources. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Care plans include detailed information about residents emotional and psychological needs, risks have been assessed with strategies in place and residents are enabled to make decisions about their lifestyle. EVIDENCE: Residents said they were aware of their care plans and that their key worker worked on these with them. Care plans were comprehensive and contained good detail about risks associated with the residents’ individual mental health problems and clear guidelines for staff in how these risks are to be managed. As the home aims to encourage and promote residents independence, the care plans contain a section about how their recovery and future is to be planned and managed. The residents clearly lead their care and said that staff are there if they need help with anything. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11, 12, 13, 14, 15 and 17 Opportunities for personal development are good; residents are independent and are encouraged to maintain contact with their families and friends. Residents buy and prepare their own food. EVIDENCE: Residents are generally independent and are able to take themselves into town, to hospital appointments and visit their friends and families outside of the home. Appropriate relationships are supported by staff and recently the home varied their registration to allow a co-habiting couple to move into one of the flats. The home has a designated activities co-ordinator who arranges and encourages residents to take part in a variety of activities. If residents choose not to participate staff work with them on an individual basis. The residents said they enjoy playing bingo and attending the art and crafts classes held in the home. With staff assistance, some residents have secured voluntary employment in the local area. The home does not cook meals for the residents, it is expected they will shop for food and cook for themselves and they are provided with a weekly food allowance. Residents were pleased with the facilities provided in their flats and spoke of the food they like to cook and said that staff will help them if they need it. Residents are also able to visit Appleton Lodge (next door) for Sunday lunch if they wish. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 11 Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Residents’ emotional needs are well cared for and staff make every effort to manage their physical health needs. Medication needs to be managed better. EVIDENCE: Residents spoke of how they felt they had improved since being in the home. One comment card from a relative advised they were pleased with the progress of their relative. One resident was not happy with the way aspects of her physical health care was managed, however, it was clear from information recorded in the care plan that staff were making every effort to manage her particular health need. Care plans indicated that residents’ emotional and physical needs are identified and clear guidelines are in place showing staff how these needs are to be managed. Medication was inspected and the home uses a system of blister packs from Boots and non-blister packed medication (for special medication) from a separate pharmacy. It was noted that the home uses a system of providing some residents with compliance aids (medi-wallets) for administering their own medication and that these are not labelled with the medication administration details. The manager currently fills these compliance aids from medication already dispensed by the pharmacy and gives them to residents on a weekly basis. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 13 Photographs of the resident have been put on all of their non-blister packed medication, the MAR and the compliance aids which is seen as good practice. Medication administration records (MAR) indicated that some medication had not been booked in or carried forward from the previous month, which made it difficult to track the correct amount of tablets given. One MAR indicated staff had recorded the wrong administering code. One resident’s medication, when tracked, did not add up correctly. Requirements have been made regarding medication. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Residents are confident their concerns are listened to and acted upon and they feel safe, but poor recruitment practices place them at risk from harm. EVIDENCE: Residents said they would speak with the manager if they had any concerns and comment cards indicated that 10 out of the 11 residents felt safe in the home. Staff have had training in adult protection and were aware that the home had a policy and procedure regarding this. The manager and owners have a very good understanding of the correct reporting procedure for any adult protection issues. Recruitment is detailed under Standard 34. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 26, 27, 28 and 30 Residents’ benefit from living in a home that is clean and from accommodation that promotes an independent lifestyle. Because some residents insist on propping open their kitchen doors the environment is not always safely maintained. EVIDENCE: All residents have their own flats, which are well equipped enabling them to learn or maintain independent living skills. Residents are expected to keep their flats clean and tidy and to do their own washing and ironing. Some residents were very able to do this themselves and staff assisted those who needed help. The home has a large ground floor room, which is used for planned activities. Before moving into the home the residents were given the opportunity to choose the decoration in their flats and all flats reflected each residents individual style and tastes. Fire safety is detailed under Standard 42. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 34 and 35 Changes made to staffing allocation have improved the residents’ care and good training opportunities are provided. By not following proper recruitment practices the home places residents at risk from potential harm. EVIDENCE: Currently two staff have NVQ level 3, one has NVQ level 2 and the deputy manager is a recently qualified Social Worker. One member of staff is due to commence NVQ level three. The owners hold in-house training sessions for staff relevant to the care needs of the residents and have developed good induction and foundation training. Since opening the home in October, the owners have made some changes to the staff structure matching their skills to the needs of the residents and said this was working well. Staffing levels were seen to be matching the needs of the residents who said they thought the staff were good. One resident said the staff helped her feel better. Continuity of care is maintained by a good key worker system that ensures staff take responsibility for the care of two or three residents including their care plans. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 17 Three staff files were checked. One indicated the staff member had commenced without a criminal records bureau disclosure (CRB), two had supplied a CRB from a previous employer, none of them had any POVA (protection of vulnerable adults) checks prior to commencement and two indicated that staff had commenced before the home received two written references. One staff file had no record of their identification. However, the home has a good style of application form, which had been completed in full for all of these staff, and records are generally made of staffs interviews. A requirement has been made regarding recruitment checks. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38 and 42 The home is well managed by a competent manager and deputy manager but aspects of fire safety need to be improved. EVIDENCE: The manager currently manages two homes and is well supported in both by competent deputy managers. The owners are also very supportive and visit the home regularly. Residents said they thought the manager was good and kind. Generally health and safety is well managed, staff have completed first aid and fire safety training. However, some residents insist on propping open the kitchen doors within their flats and this needs to be addressed. A fire risk assessment has not yet been carried out and the home should ensure this is done as soon as possible. The owners advised that the hot water was not yet regulated to a safe temperature but they have arranged for a plumber to visit and address this. A requirement and recommendation has been made regarding fire safety. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 4 26 3 27 4 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 X X X 2 X Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 20 N/A Are there any outstanding requirements from the last inspection? 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 YA20 Regulation 13 (2) Requirement Timescale for action 31/03/06 2 YA34 19 The registered person must ensure that medicines are managed, administered and recorded safely, in particular: • Compliance aids must be properly dispensed by a suitably qualified person ensuring they include the medication administration instructions and medicine details. • The correct administration codes must be used on the MAR’s. • Medication must be booked in and carried forward correctly on all MAR’s to provide an audit trail. The registered person must 31/03/06 ensure that two written references and a POVA first check is received PRIOR to staffs commencement. Staff must also be supervised by a designated person until a satisfactory enhanced CRB is received. Oliver Court DS0000065549.V284500.R01.S.doc Version 5.1 Page 21 3 YA42 23 (4) The registered person must ensure safe closing devices linked to the fire alarm system are fitted to fire doors that are regularly wedged or propped open. 31/03/06 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 2 Refer to Standard YA20 YA42 Good Practice Recommendations The registered person is recommended to complete regular audits of the MAR charts to reduce omissions and minimise risk of errors. The registered person is recommended to complete a full fire risk assessment of the building. 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