Inspection on 14/06/06 for Oliver House

This inspection was carried out on 14th June 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

Oliver House 05/11/08

Oliver House 12/05/08

Oliver House 21/05/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Oliver House Oliver Road Ilkeston Derby Derbyshire DE7 4JY Lead Inspector Janet Morrow Key Unannounced Inspection 9:45 14 and 19th June 2006 th 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 Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 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. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oliver House Address Oliver Road Ilkeston Derby Derbyshire DE7 4JY 0115 9440484 0115 9440417 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) Sajid Mahmood Kim Ferguson Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Variation to admit one named service user under the age of 65 years in the category PD, as named in the notice of proposal letter. 25th October 2005 Date of last inspection Brief Description of the Service: Oliver House is situated in a quiet, accessible area within the village of Kirk Hallam, close to the town of Ilkeston. The home is registered for the care of 26 elderly residents and admits residents with nursing needs. There are separate sitting and dining areas within the home. There is a garden to the rear of the building, which has been designed to be easily accessible to residents. There is passenger lift and staircase access to the first floor facilities. The home provides 24 single bedrooms (8 with en-suite facilities) and 1 double bedroom (without en-suite facility). There are sufficient additional toilet and hygiene facilities provided throughout the home. Residents are encouraged to personalise their rooms if they wish. All rooms are equipped with a link to the call system. Support services are in place with a choice of General Practitioners, and chiropody, dental, optician and other services arranged as appropriate. A visiting hairdressing service is provided. The home has open visiting arrangements. The scale of fees is from £417.90 - £467.90 per week. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and took place over two days for a total of 7.75 hours. Care records and staff records were examined. A partial tour of the building was made. Four members of staff, seven of twenty residents and four sets of relatives were spoken with. Written information supplied by the home prior to the inspection visit informed the inspection process. A new proprietor was in the process of taking over the business and was not yet familiar with all the details of running the business in the best interests of residents. What the service does well: What has improved since the last inspection? What they could do better: Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 6 A quicker response to some outstanding requirements and to repairs would improve the service, for example in relation to care needs. Concerns had also been raised about the length of time taken to resolve a problem with the hot water. Some aspects of medication administration procedures need improving to minimise the risk of errors occurring. There should be some method of showing that a resident’s care needs have been discussed with them, such as a signature, and that they have agreed to their care plan. More specific detail on care plans would minimise the risk of care needs not being addressed and more regular reviewing of risk assessments, such as those related to moving and handling, would enhance the care provided and ensure the safety of both residents and staff. There should always be a care plan where a risk has been identified, such as in relation to nutrition, and it should be clear from the records exactly what care has been provided. This was raised as an issue at the previous inspection in October 2005 and needs to be addressed in a consistent manner. Record keeping in residents’ care files and staff files needs to be updated to ensure that all the information listed in Schedules 1-4 of the Care Homes Regulations 2001 is available. The provision of a sluicing disinfector would improve infection control procedures. Identified odours should be eliminated. A review of bathrooms’ usage should be completed and consideration be given to how to improve the bathrooms in order that residents are able to use them and have the choice of a shower if they wish. The views of visitng professionals should be sought to assist quality assurance processes and the action taken in response to questionniares and verbal feedback should be made clear and be recorded. 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 House DS0000067423.V300079.R01.S.doc Version 5.2 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 Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 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): 2, 3, and 4 There was sufficient admission information available to establish that the home was able to meet residents’ needs. Quality outcome in this area is good. This assessment is based on the information available including a visit to the service. EVIDENCE: Two residents’ records were examined and showed that assessment information was received from external professionals and the home also conducted their own assessment and background information prior to admission. This established that the home was able to meet individual needs. Terms and conditions of residence were not examined but information received since the last inspection in October 2005 showed that there was a breakdown of costs to include the cost of nursing care. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 More specific detail in care planning would enhance the care provided and ensure that all needs were met. Residents were treated with respect, which ensured their privacy and dignity was upheld. Medication record omissions had the potential for errors to occur. Quality outcome in this area is adequate. This assessment is based on the information available including a visit to the service. EVIDENCE: Two residents’ care files were examined and both had a care plan in place that contained detailed information on how to address needs. However, there were some inconsistencies in the recording of information. For example, a nutritional risk assessment on one file showed a high risk but there was no detail on how to address the risk; a pressure sore had been identified on one file but it was unclear from the care plan what had occurred after a specific date, although staff stated it was healed and this was confirmed by the resident concerned; one file did not have a continence assessment completed although this was an area of need. Risk assessments were not being reviewed consistently. For example, on one file examined, a moving and handling assessment and a general risk assessment of the bedroom had not been reviewed since the date of admission Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 10 in 2001. Access to health professionals such as opticians and dentists was recorded in the files examined. General observation during the inspection showed that staff and residents enjoyed warm relationships and privacy and dignity was upheld. Residents and relatives spoken with confirmed this. However, there was mixed feedback about the care provided from relatives during the inspection. This ranged from being positive and stating that they were ‘very pleased’ with the care to less positive comments about a slow response to needs such as being taken to the toilet. Two residents’ medication administration record (MAR) charts were examined. These corresponded with the dispensing system but there were omissions on one day for the teatime administration. Handwritten MAR charts had not been signed and dated by two people. This was raised as an issue at the previous inspection in October 2005. There were no controlled drugs on the premises, although Temazepam was stored under controlled conditions and there was a controlled drug register available for the recording of their administration. An appropriate company undertook the disposal of medicines. A copy of the Royal Pharmaceutical Society Guidelines was available. The medication refrigerator temperatures were recorded on a daily basis and were within safe limits. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Meals and activities were well organised which enhanced residents’ daily life. Personal choice was facilitated but improving access to personal records would further improve the control residents had in their lives. Quality outcome in this area is good. This assessment is based on the information available including a visit to the service. EVIDENCE: The routines of the home were flexible and residents’ interviewed stated that they had the choice of staying in their own rooms, going out or participating in activities. Entertainment was advertised on a notice in the home and one relative spoken with praised a specific entertainment company that had proved popular with residents and visitors. Written information supplied by the home stated that entertainment occurred on a monthly basis and that games, such as in-house bowling and bingo, occurred. All relatives spoken with stated that they were made to feel welcome at any time, including meal times. The serving of the lunchtime meal was observed and all residents spoken with stated that they enjoyed the food. Staff spoken with were able to demonstrate a general awareness of dietary needs, although there were no specific diets required at the time other than a need to liquidise one resident’s food. The dining area was bright and cheerful but most residents chose to eat in their armchairs at an adjustable table. Sample menus were supplied as part of the Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 12 written information provided by the home and showed that a choice was available and that food was nutritious. The manager was aware of how to contact advocacy services when required. There was no evidence available to show that residents had access to their personal information. Neither of the files examined had a signature to show that care had been discussed with residents. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints were handled objectively, which ensured that residents concerns were listened to. Policies and procedures and staff training were in place to protect residents from abuse. Quality outcome in this area is good. This assessment is based on the information available including a visit to the service. EVIDENCE: The home had a clear complaints procedure that stated complaints would be investigated within seven days. The written information supplied by the home stated that no complaints had been received since the last inspection in October 2005 and there had been no complaints received at the office of the Commission for Social Care Inspection, although one relative had raised a concern about a problem with the hot water that was resolved prior to the inspection visit. The previous inspection in October 2005 identified that an adult protection policy and procedure was in place and that the home had a copy of the Derby and Derbyshire Local Authority Social Services procedures. The home’s training record stated that adult protection training had occurred and staff interviewed confirmed this. The written information provided by the home stated that there had been no allegations of abuse in the last twelve months. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 The home was generally well maintained, but additional improvements would further enhance residents’ accommodation. Quality outcome in this area is adequate. This assessment is based on the information available including a visit to the service. EVIDENCE: The home was clean, tidy and odour free. Repairs were attended to and staff interviewed stated that equipment was in good working order. Relatives spoken with also stated that they found the home clean and tidy. The major concern raised by relatives was the length of time taken to resolve a recent problem with the hot water system that had led to one part of the home being without hot water for three weeks until a new boiler was installed. This was now resolved satisfactorily. Water temperatures at randomly selected outlets were found to be safe during the visit. Radiators were guarded. Written information provided by the home had evidence that hot and cold water services had been sterilised in November 2005. The laundry was neat and tidy. Washing machines had sluice facilities. Staff had undertaken infection control training. The communal areas were odour Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 15 free but a tour of the building identified one bedroom and corridor that had an unpleasant odour. The written information supplied by the home stated that new carpets had been fitted in the main lounge, entrance hall and in three bedrooms. The same areas had also been painted and new curtains had been fitted in the lounge and bedrooms. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 There were sufficient well trained staff which ensured that residents’ needs were met. Recruitment procedures were robust, which ensured residents’ safety. Quality outcome in this area is good. This assessment is based on the information available including a visit to the service. EVIDENCE: The written information provided by the home stated that there were 364 care staff hours deployed to meet residents needs and that these had been calculated on the information given in the Residential Care Forum staffing tool. This showed that there were sufficient staff to meet current residents’ needs. The information provided by the home also stated that six of twelve care staff had achieved a National Vocational Qualification to Level 2, which meant that the home had achieved the target of 50 of care staff having an NVQ2. Training in mandatory health and safety areas was undertaken although staff interviewed felt that more could be done in this area. Staff also confirmed that they had received adult protection and dementia training since the last inspection in October 2005. Three staff files were examined and generally found to be in good order. However, one file had only one reference available although the checklist on the file indicated that two had been requested. Criminal record bureau checks, identity information and evidence of qualification by PIN number from the Nursing and Midwifery Council was available. A completed application form was also in place but more vigilance is needed to ensure gaps in employment are fully explained. Although older application forms did not ask for health information, new forms had been amended to provide this. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 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): 31, 33, 35, 37 and 38 The home was well managed but more attention to quality assurance and record keeping would ensure that the home was run in the best interests of residents. Quality outcome in this area is adequate. This assessment is based on the information available including a visit to the service. EVIDENCE: The manager had completed the Registered Managers award and was a first level nurse, having worked in the care of older people since 1988. The new proprietor was partially involved in the inspection but was not yet fully conversant with quality assurance procedures or the home’s management systems. Written information provided by the home showed an analysis of a survey of residents’ and relatives undertaken in March 2006. Feedback was generally positive and praised the care provided with comments such as ‘the nurses are Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 18 very good here’ and ‘ my mother is kept clean and her clothes are beautifully ironed’ being recorded. Action required was detailed on the analysis but it was not clear whether or not this had been implemented. Verbal feedback received on the day from staff, residents and relatives was mixed; some was very positive with residents and relatives stating that staff were helpful whilst less positive feedback stated that staff were sometimes slow to respond to requests for assistance and that there was a lack of attention to detail in the care provided. Staff spoken with felt that greater input was needed for induction on general care issues. The home had not yet received any feedback from visiting professionals. The manager stated that the home did not deal with anyone’s finances but that relatives or the local authority administered them. This was confirmed on the written information provided by the home. Records were maintained and securely stored. Some of the information required by Schedules 1 –4 of the Care Homes Regulations 2001 was missing such as gaps in residents’ files and staff files as identified earlier in the report. A valid insurance certificate was on display in the home. Health and safety issues were addressed. Written information supplied by the home included copies of up to date maintenance certificates for the hoists, emergency lighting, lift, electrical wiring, water sterilisation and gas safety. Environmental Health had visited since the last inspection In October 2005 and Derbyshire Fire and Rescue Service had visited in November 2005. The manager stated that any issues raised in their reports had been addressed. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 3 Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 20 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 15 (1) Requirement Timescale for action 01/08/06 2. OP8 12 (1) (b) 3. OP9 13 (2) Each residents file must be drawn up with the resident, recorded in a style accessible to the resident and agreed and signed by the resident or their representative. If it is assessed as inappropriate that the resident or their representative are consulted or option is declined, this must be recorded. Previous timecales of March 2005, September 2005 and December 2005 not met. Timescale extended. The care home must be 01/09/06 conducted so as to make proper provision for the care, and where appropriate, treatment of residents. Previous timescale of December 2005 not met. Timescale extended. There must be arrangements for 01/09/06 the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Previous timescale of January 2006 not met. Timescale extended. DS0000067423.V300079.R01.S.doc Version 5.2 Oliver House Page 21 4. OP37 17(1)(a) Schedule 3 There must be records maintained in respect of each resident, which includes the information specified in Schedule 3 of the Care Homes Regulations 2001. Previous timescale of January 2006 not met. Timescale extended. 01/08/06 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 OP26 OP21 Good Practice Recommendations A sluicing disinfector should be provided. This is a previous recommnedation and has not yet been addressed. It is recommended that a review of bathrooms usage should be completed and consideration be given to how to improve the bathrooms in order that residents are able to use them have the choice of a shower if they wish. This is a previous recommnedation and has not yet been addressed. Bedroom furniture as listed in Standard 24 should be provided. Reasons not to do so should be recorded in all files. This is a previous recommendation and has not yet been addressed. The residents’ guide to the home should include residents’ views of the home and make reference to the most recent inspection report. This is a previous recommendation and was not assessed on this occasion. All identified risks should have a care plan in place to address the risk. This is a previous recommendation and has not yet been addressed. Handwritten medication administration record (MAR) charts should be signed and dated by two people. This is a previous recommnedation and has not yet been addressed. DS0000067423.V300079.R01.S.doc Version 5.2 Page 22 3. OP24 4. OP1 5. OP7 6. OP9 Oliver House 7. 8 OP26 OP33 9. 10. OP8 OP33 The identified areas in the home should be odour free. The views of visiting professionals should be sought for quality assurance purposes. This is a previous recommendation and has not yet been addressed. Risk assessments, particularly moving and handling assessments, should be reviewed on a regular basis, at least annually. The action taken in response to quality assurance questionnaires should be recorded. Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Oliver House DS0000067423.V300079.R01.S.doc Version 5.2 Page 24 - 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!