Inspection on 16/11/06 for Oliver House - City of York Council

This inspection was carried out on 16th November 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 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

Oliver House - City of York... 20/10/08

Oliver House - City of York... 19/11/07

Oliver House - City of York... 02/02/06

Oliver House - City of York... 10/08/05

Oliver House - City of York... 30/11/04

Oliver House - City of York... 06/07/04

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

CARE HOMES FOR OLDER PEOPLE Oliver House - City of York Council Oliver House 20 Bishophill Junior York North Yorkshire YO1 6ES Lead Inspector Jo Bell Key Unannounced Inspection 16th November 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oliver House - City of York Council DS0000034910.V313847.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 - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oliver House - City of York Council Address Oliver House 20 Bishophill Junior York North Yorkshire YO1 6ES 01904 653301 01904 634853 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) www.york.gov.uk 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 Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2nd February 2006 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. The weekly charge currently is £426.92. 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. There are limited parking spaces. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of the service took place on Thursday 16th November 2006. Prior to the site visit a pre-inspection questionnaire was returned. The visit took one inspector six hours to complete. During this time nine service users’, four relatives and five staff were spoken with. Three service users were case tracked in detail and documentation relating to health and personal care were examined. Discussions took place with the home manager regarding quality assurance, health and safety and staffing issues. Overall, the home provides adequate outcomes for service users. There were aspects of healthcare that were not being met or documented, a lack of an effective quality assurance system, and issues with health and safety which need addressing. What the service does well: What has improved since the last inspection? The home have introduced a computer system where service users can gain access to the internet. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oliver House - City of York Council DS0000034910.V313847.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 - City of York Council DS0000034910.V313847.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): 3 (Standard 6 is not applicable) Quality in this outcome area is good. Detailed assessments before admission mean that service users can be confident their needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three assessments were examined, these had been completed by a care manager prior to admission. The format included health and personal care, social history and details of how needs could be met. In discussions with these service users it was evident that these assessments had taken place with input from both the service user and family members. The manager of the home also carried out her own assessment to ensure individual needs can be met once the person has entered the home. Oliver House - City of York Council DS0000034910.V313847.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 & 10 Quality in this outcome area is adequate. Poor care planning documentation and auditing means that some service users needs are not consistently met. This judgement has been based on available evidence including a visit to this service. EVIDENCE: Nine service users were spoken with, of these eight said the care was either good or excellent. Four relatives were involved with these discussions and two stated how good the home was. Service users were observed being treated with respect and staff approached them in a professional and friendly manner. Observations in the lounge area showed service users looking clean and well cared for. Three service users were case tracked, and whilst an initial assessment had been undertaken (within six weeks of admission) the care plans and risk assessments produced from this information were poor. One service user who had a poor appetite had little information documented relating to his likes and dislikes at mealtimes, there was no record of him being weighed and no specific care plan or assessment regarding nutrition. This had not been picked Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 10 up by the care leader or manager, partly because no care plan audits take place. Along with this, the service user had been identified as ‘high risk’ for developing a pressure sore. This had not been reviewed since June 2004, and weekly reviews or evaluations had not taken place. This is a poor outcome for the service user as he could become undernourished, and there is a potential that his skin could break down and a pressure sore develop. The two other service users who were case tracked showed a similar pattern where risk assessments are not completed, nutrition is not checked, review and evaluations of how needs are being met are not taking place and no action is being taken to resolve these issues. Two relatives were spoken with who raised concerns regarding the care of their relative. They stated ‘she often wears other people’s clothes’. ‘Items have gone missing from her room (the door is not locked) and staff do not inform them if there are any changes’. They also felt their relative had lost some weight and staff are giving her food that she doesn’t like. The service user has a key worker though the family said she has never discussed care issues with them. The service user had hearing difficulties and was quietly spoken and was not able to confirm the level of care received. This information was discussed with the manager. It was suggested that a meeting takes place between the manager and family to address these issues. Service users did confirm they have access to a GP, chiropodist and district nurse when needed. This was observed during the visit. The manager was aware of how to contact the community psychiatric nurse, continence advisor and infection control nurse, this was evident in the contact sheets of the care plans. Service users were observed being given their medication at lunchtime, the care leader clearly knew the service users well. Medication charts were checked for three service users and this confirmed medication had been administered and recorded correctly. It was evident that the date and day printed on the chart did not correspond with the actual day. Currently no medication audits take place and stock balances had not been recorded during the past month. The home need to have a clear audit trail to make sure service users are receiving the medication they are prescribed and this can be accounted for. The controlled drugs were checked and these corresponded with the records, staff confirmed they have received medication training and medication were being disposed of appropriately. Oliver House - City of York Council DS0000034910.V313847.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 & 15 Quality in this outcome area is good. Service users have a range of activities to enjoy, they are encouraged to be autonomous and have a good standard of food and drink provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were observed enjoying chair exercises and bingo during the site visit. Care staff take it in turns to facilitate activities, these range from having entertainers in the home, trips out and dominoes and bingo. The activities each day are displayed on a notice board. Currently it is the responsibility of the home to raise funds for activities, and there is no extra time allocated for carers to be involved with these. The home are in the process of introducing a computer system where access to the internet can be gained. Training will be available for service users and interested people have already come forward. Service users in the lounge confirmed they can get up and go to bed when they want, staff ask them their preferences. Visitors were observed in the home and links with the community are forged through church groups and the local school. One service user said her relative had taken her out to a local café in the morning which she had thoroughly enjoyed. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 12 Some service users were observed walking in the grounds and they confirmed they can get exercise whenever they want. Staff spoken with stated that independence is encouraged and choice is always offered regarding individual routines. Breakfast and the lunchtime meal was observed and the kitchen was examined. The meals come from the hospital on five out of seven lunchtimes, then home cooked food is offered at teatime, breakfast and for the other lunchtimes. Staff were observed asking service users what they would like to eat. There were three dining areas, which were clean and tidy with pleasant décor. Eight service users were observed having lunch, they all said they enjoyed the food, the portion sizes were good and though some of the vegetables were frozen very little food was left on the plate. The pudding was fruit sponge and custard which two ladies thought was wonderful. Oliver House - City of York Council DS0000034910.V313847.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 & 18 Quality in this outcome area is good. Service users feel that staff listen to their concerns, though this view was not consistently shared by the relatives. Service users felt safe in their environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users confirmed if they had any concerns they would speak to the person in charge. Residents meetings do take place which gives them this opportunity. A complaints procedure is in place, and whilst the manager is not dealing with any complaints at present it was evident during the visit that one set of relatives had some concerns regarding care practices, and they did not feel able to discuss with the key worker or manager until prompted to do so. The home does not have a ‘complaints’ book/file. This makes it difficult to assess whether issues have been dealt with and what the action taken was. This is recorded on individual files though this information is not audited to identify if there are any themes to the concerns or whether it is particular service users that have issues. From a quality assurance point of view this information needs to be gathered in an effective manner. One issue was identified regarding staff which should have been addressed. Whilst this did not directly relate to a service user it may have an impact on the way service users are treated. The manager needs to address this. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 14 One adult protection issue is ongoing which relates to poor care practices. The outcome has not been determined yet, and whilst the home has vulnerable adults procedures in place it is evident that the manager needs to understand this procedure in greater depth. Staff are aware of the different types of abuse and have an understanding of the whistle blowing and ‘no-secrets’ document. Service users spoken with all said they felt safe and that staff were gentle and kind when moving and handling them. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. Service users enjoy living in this environment which is clean and well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users confirmed they liked their environment, there were plenty of communal areas to socialise in, with three dining rooms to choose from. Maintenance is carried out by a City of York Council Contractor, and the manager makes requests for any work which needs to be undertaken. Décor was pleasant and areas of the home were clean and pleasant smelling. Staff confirmed they had undertaken infection control training, this was recorded in their files. The laundry and sluice area was checked, there were sufficient washing machines and tumble driers for the number of service users in the home. Clothes looked clean and well ironed and service users generally said the system for washing and returning clothes works well. Different skips Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 16 and bags are used for soiled linen and staff are aware of how to deal with this. There is no designated laundry person, however this did not effect the service users. Domestic staff are employed in sufficient numbers to make sure the home’s standard of hygiene is maintained. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. Service users are cared for by a sufficient number of staff who have gone through an effective recruitment procedure and have received a range of training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a sufficient number of staff to meet the service users needs. Some staff have completed NVQ Level 2 and 3. The manager is supernumerary and there is always a care leader working on the ‘floor’. During the morning there are up to four care staff, supported by general assistants. This decreases in the afternoon/evening and overnight. There were twenty six service users residing at the home during the site visit. The home uses a small amount of agency staff though these tend to be the same people who visit each time. This was confirmed by the care staff. Staff receive induction training, though this is being reviewed and a new format is currently being introduced. This will cover all aspects of mandatory training within specific time scales. This should ensure that service users receive care from appropriately trained staff. The induction training is equivalent to ‘Skills for care’ guidance. During the visit, call bells were answered promptly and service users were dealt with in a prompt and efficient manner. The manager is aware of the different categories of registration, and knows that only service users age sixty Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 18 five and over with personal care needs, can be admitted to the home. One person has mental health needs as this is being reviewed with input from the community mental health team. Service users are cared for by staff who have been through a good recruitment procedure. Two references are obtained and a police check and protection of vulnerable adults check are carried out prior to employment. Staff files were checked and this was evident. The manager discussed the recruitment procedure and was clear about the procedure to follow. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is adequate. Improvements to the quality assurance system and some aspects of health and safety are needed to ensure the home is well managed, which will be positive for service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users generally felt the home was well managed. The manager has not applied to become registered with the CSCI though she has been working in this role for approximately twelve months. This needs to be addressed. The manager has worked at previous care homes for older people and has completed her NVQ Level 4 in Management. Concerns were identified regarding the lack of an effective quality assurance system. Service users can have their views raised at a residents meeting, Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 20 though no annual development plan covering all aspects of quality assurance is in place. The manager needs to complete audits relating to care plans and medication, this would make sure that outstanding areas are identified and addressed. The home is aware of how to report incidents under Regulation 37 notifications, only a small number of these have been received. The manager needs to be confident that relatives are happy to discuss any concerns with her or the key workers/care leaders. Service users spoken with confirmed that they can have a ‘pocket money’ account. This is generally used for toiletries, hairdressing, or chiropody. This is documented, and is a system used throughout the City of York Council’s care homes. The pre-inspection questionnaire gave details of power of attorney and the use of giro-cheques. No issues were raised regarding service users finances. The assessment carried out by the care manager when a service user enters the home does discuss the fees and how payment is arranged. Health and safety was discussed and information of certificates was provided in the pre-inspection questionnaire. Contracts are in place for lifts and hoists and fire alarm testing takes place weekly. Staff receive fire safety, first aid and moving and handling training as mandatory, this was confirmed by staff and when checking these records. The manager is hoping to develop a training matrix will give an overview of all the training, when it has taken place and when it is due. The sluice rooms and laundry did not lock, service users are put at risk of harm because the laundry contained a plastic tub with table salt in, and the sluice rooms had very hot water and detergents on display. The manager must consider the risk to service users. Hot water temperatures are tested on a monthly basis by the care leader. However, in two bathrooms, temperatures had not been taken prior to a service user having a bath. A thermometer and sheet were in the bathroom but on one occasion this was completely blank and on another only one entry had been made. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 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 2 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 1 x 3 x x 1 Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP7 OP7 Regulation 13 15 Requirement Service users must have risk assessments in place which are current and reviewed regularly. Service users must have their care needs documented, reviewed and evaluated on a regular basis. Pressure sore assessments must be checked monthly, especially when a service user is identified as being ‘high risk’. Staff must be aware of service users likes and dislikes regarding food. Staff must have a system for identifying if service users are underweight or weight, and take action to rectify this. Information regarding nutrition must be properly documented and reviewed. The medication trolley must not be left unattended in the corridor, and must be secured to the wall when in the office. The medication charts must have the correct day and date on to ensure service users receive the correct medication. DS0000034910.V313847.R01.S.doc Timescale for action 23/11/06 23/11/06 3. OP8 13 23/11/06 4. OP8 17 23/11/06 5. OP9 13 23/11/06 Oliver House - City of York Council Version 5.2 Page 23 6. 7. OP31 OP33 9 24 8. OP38 13 9. OP38 13 The manager must become registered with the CSCI Service users must have their views and opinions sought through an effective quality assurance system. Medication and care plan audits need to take place as part of this process. Service users must not have access to large quantities of table salt or detergents in the sluices or laundry room. These areas must be kept locked when not in use. Staff must test the temperature of the water prior to service users getting into a full immersion bath. 16/03/07 16/12/06 23/11/06 23/11/06 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 OP16 OP18 Good Practice Recommendations The home should consider having a ‘concerns/complaints’ book to record issues raised by service users. The manager should have a greater understanding of the home’s adult protection procedures. Oliver House - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office 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 © 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 - City of York Council DS0000034910.V313847.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!