This inspection was carried out on 10th August 2005.
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 made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
CARE HOMES FOR OLDER PEOPLE
City of York Council Oliver House 20 Bishophill Junior York North Yorkshire YO1 6ES Lead Inspector
David Martin Unannounced 10 August 2005 10:00 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 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. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service City of York Council Oliver House 20 Bishophill Junior York North Yorkshire YO1 6ES 01904 653301 01904 634853 Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) City of York Council Post vacant Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 30/11/04 Brief Description of the Service: Oliver House is a care home run by City of York Council and registered to provide a service for 30 older people of either gender aged over 65 years who do not have any specialist requirements. Oliver House was purpose-built approximately 40 years ago and is located within a short walk of local facilities in Micklegate. The centre of York is within 1 mile. The accommodation is provided in single rooms on three floors. The upper floors are accessible via passenger lift. There is an enclosed rear garden. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out on 10 August 2005. It was unannounced and took 6 hours to complete. The majority of time was spent within with the service users in the home at the time of the inspection and with the staff on duty. There were opportunities to have discussions and observe staff interaction with the service users. The lunchtime meal was observed. A sample of service user files was examined and a check was made as to whether the home had complied with recommendations from the last inspection. Verbal and written feedback was given at the end of the inspection to the registered manager. What the service does well: What has improved since the last inspection? What they could do better:
The manager is new in post and is concentrating on managing change which have unsettled the staff group. She has yet to identify areas for improvement. The vetting of staff prior to commencing employment needs to be tightened up to ensure that service users are, as far as possible, protected from abuse. An Immediate Requirement Notice was issued regarding this matter. To confirm that the systems in place for the administration of medicines are safe the supplying pharmacist should be invited to inspect. To prevent errors occurring, out-of-date medicines should be disposed of promptly. To make sure that the building is safe and healthy for service users, fire doors should only be held open by authorised means and the installation of air extraction equipment in the smokers’ lounge should be considered. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 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. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 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 standard(s) 3 & 6 Prospective service users have sufficient information about the home to make a positive choice about moving in. EVIDENCE: Many of the service users confirmed that they had visited the home prior to admission and had made a positive choice in moving to Oliver House. The case file of the service user most recently admitted to the home was inspected. This provided evidence that an assessment and personal information about the service user had been provided to the home by the care manager. One of the home’s management team will visit a prospective service user in his/her own home or hospital. All prospective service users are encouraged to spend a day in the home prior to admission as part of the assessment process. Intermediate care is not provided. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 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 standard(s) 7 -10 The health and social care needs are met. EVIDENCE: A sample of service user plans was inspected. They provided background information and a description of the day-to-day task that service users can accomplish and those where some assistance is required. The relative of one service user was very satisfied with the care provided and said her ‘auntie is being very well looked after’. All service users are registered with a GP of their choice and are able to see other health care professionals as the need arises. This was confirmed by service users and evidence was also available in case files. The systems for the administration of medication were inspected and, on the whole, were found to be satisfactory. The manager was advised to invite the supplying pharmacist to inspect. Out-of-date medication should be disposed of promptly. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 10 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 standard(s) 12-15 Service users are able to follow a lifestyle that suits their individual needs and they are able to maintain social contacts. EVIDENCE: Service users said they were pleased with the services offered at Oliver House and that the standard of care met their expectations. They said that they are able to see their relatives and friends and can choose whether or not to be involved in any organised activities. The service users said that the food was good. Observation of the lunchtime meal provided evidence that all service users were able to manage without assistance. Staff were observed to be encouraging service users who were reluctant to dine. The meal was wellpresented and seemed to be enjoyed by service users. Religious services are held in the home. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 11 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 standard(s) 16 & 18 Service users are protected from abuse and their right to complain is upheld. EVIDENCE: Service users have been provided with the home’s complaints leaflet. In discussion, service users said they had no complaints to make about the quality of service in the home. They were clear about raising their concerns if they needed to. The home has a copy of the latest version of the multi-agency procedures for the protection of vulnerable adults. Staff have received training in safeguarding older people as part of NVQ courses. The agency staff employed in the home at the time of inspection confirmed that they had completed adult protection training. They understood the need to report any concerns and were clear about who to report to. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 12 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 standard(s) 19 & 26 Service users live in a home which is well-maintained but there were some safety issues which need to be addressed. EVIDENCE: Service users’ bedrooms are comfortably furnished and have been decorated with personal items such as photographs and ornaments. There are numerous sitting rooms and dining rooms which are maintained in good order. Some health and safety matters were identified: the sluice door (a fire door) was wedged open, in addition to the breach of fire safety this allowed access to hazardous substances. Both matters were rectified prior to the end of the inspection. To minimise the risk of passive smoking for non-smoking service users, the smokers’ lounge should be provided with adequate air extraction equipment. To minimise institutional practice, the written risk assessments stuck on certain items of furniture should be removed. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 - 30 Service Users’ needs are met by adequate numbers of staff, but new staff are not vetted properly EVIDENCE: There are adequate numbers of staff on duty. Agency staff are employed to cover sickness and vacancies. Those who spoke with the inspector were wellqualified and expressed a commitment to providing service users with a good standard of care. This was borne out through observation. Some permanent staff said there is some resentment of agency staff but there was no evidence to indicate that this impacts on the quality of care and support received by service users. Two new starters had not been cleared through the Criminal Records Bureau or POVA. An Immediate Requirement Notice was issued to the effect that no staff should commence employment without such checks being carried out. City of York have since confirmed in writing that the situation regarding the two members of staff has been rectified. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 Service users live in a home which serves their best interests. EVIDENCE: The home has recently undergone a change in management. The new manager is not registered and no application has been yet been received by CSCI. It is too early to comment on the effects of this change. A sample of the monies held on behalf of service users’ was checked against the records and was found to tally. A sample of records relating to the ongoing safety of the premises was checked and found to be up-to-date. City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 16 No 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. 2. Standard 9 29 Regulation 13 18 Requirement Out-of-date medicines should be disposed of promptly. New staff should not commence employment prior to Criminal Records Bureau or POVA clearance Fire doors should not be held open by unauthorised means. Timescale for action 30/09/05 Immediate Requirement issued 30/09/05 3. 19 23 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. 3. Refer to Standard 9 19 19 Good Practice Recommendations The supplying pharmacist should be invited to inspect the systems for the storage and administration of medicines. Written risk assessments should not be stuck on furniture. The smokers’ lounge should be provided with adequate air extraction equipment City of York Council Oliver House J53_J04_S34910_Oliver House_V236953_190705_stage4.doc Version 1.40 Page 17 Commission for Social Care Inspection Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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