Inspection on 19/11/07 for Oliver House - City of York Council

This inspection was carried out on 19th November 2007.

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

Oliver House - City of York... 16/11/06

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 19th November 2007 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.V333764.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.V333764.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 vacant post 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.V333764.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 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. Details provided in October 2007 state that the weekly fees are £432. Additional charges are made for hairdressing, chiropody services and individual items like toiletries. The service provides an information booklet about the home to prospective residents. The Statement of Purpose and service user guide, which gives information about the home is available, with a copy of the latest inspection report, for people to read. Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for, before the inspection. This is called an Annual Quality Assurance Assessment (AQAA) Information from surveys, which were sent to people who live at Oliver House, their relatives, and other professional people who visit the home. 10 were sent to people at the home and 8 were returned. 3 were sent to peoples’ relatives and 1 was returned. 3 were sent to GP’s, 3 to Care Managers and 4 to visiting healthcare professionals, 2 in total were completed and returned A visit to the home by one inspector, which lasted six hours. This visit included talking to people who live there and their visitors, and to staff and the manager about their work and training they had completed. It also included checking some of the records, policies and procedures that the home has to keep. • Information about what was found during the inspection was given to the home manager at the end of the visit. What the service does well: What has improved since the last inspection? People have completed risk assessments in place which help to promote a person’s well being and give staff a clear understanding of how to meet individual needs. A more robust induction programme has been implemented which includes mandatory training. Oliver House - City of York Council DS0000034910.V333764.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. The summary of this inspection report can be made available in other formats on request. Oliver House - City of York Council DS0000034910.V333764.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.V333764.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People who use this service experience adequate quality outcomes in this area. People have their needs fully assessed prior to admission though this does not mean that individual needs are being met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: All people are assessed before they agree to move to the home. A care manager carries out this comprehensive assessment as well as either the manager of the home, or one of the care leaders. This assessment looks at the physical, emotional and social needs of the individual, to ensure that the home can provide the level of support that they require. Three assessments were inspected, whilst these were effectively completed with relevant information it was evident that some people needed to be reassessed to ensure the home could still meet their needs. The manager was aware of the homes registration categories though some people were confused, and staff felt that Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 9 needs could not always be met. The home have three high dependency beds though observations during the day and information from surveys suggested a review of the current client group is needed. It is extremely important to ensure that a new person is placed appropriately and consideration is given to the current client group and the skills and competency of the staff. Both the staff and the manager confirmed that training in dementia care has been offered. Staff feel this needs to be an indepth course though they are not being supported financially to complete this. It was discussed with the manager that staff feel they need to complete this because of the increased needs of the people using the service, even though the home does not have a dementia category as part of their registration. Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use this service experience adequate quality outcomes in this area. Generally health and personal care needs are met though more detailed systems are needed to underpin the care that is given. This will prevent people being put at risk. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People looked well cared for, nails, teeth, hair and skin looked clean and people were dressed in their own clothes. Three care plans were inspected and some improvements had been made to the risk assessments, specifically relating to nutrition and moving and handling. All three plans had care plans in place and some of these had been reviewed and evaluated. However, more detail is needed which reflects people’s changes to their condition i.e if a person is getting more confused or the routine regarding getting up and going to bed, along with people’s religious needs. Daily contact sheets were completed and a key worker system is in operation. It would be beneficial if the care plans were regularly audited to ensure the care needed is the care Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 11 that is given. Visits from doctors, district nurses and the chiropodist are evident and advice is sought from the continence advisor and infection control nurse when needed. The manager is aware of how to notify the CSCI of any accidents or incidents which affect people using the service, though an audit of the number of accidents over a month or three monthly period would help identify if the risk assessments were appropriate or if any other measures need to be considered to reduce the risk to people. During the visit staff were observed dealing with people in a pleasant and dignified manner. Staff knock on doors prior to entering and people are able to bring personal belongings into the home to help them settle into their new environment. The medication system was inspected, generally this had improved since the last visit twelve months ago. A blister pack system is in operation which staff feel is user friendly. Three medication charts were checked, people had received the correct medication though routine stock balances are not taken, a clear audit trail is needed to reduce any error occurring. Daily fridge temperatures are recorded and some staff have completed medication training. Staff were observed administering medication and this was carried out in an appropriate manner. Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service experience adequate quality outcomes in this area. People have access to some activities and there is some autonomy and choice offered. People enjoy the home cooked food and drink provided. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People are able to participate in some activities, though this is dependant on the staffing levels and the availability of staff, as there is no designated person to undertake activities. People spoken to said the home have bingo, quizzes and the occasional trips out. The television, music, newspapers and magazines are available and staff interact on a one to one basis with people when they can. Visitors are encouraged and they were observed in the home throughout the day, the visitor’s book also confirmed that people visit at different times. People do have a choice regarding their daily routine, though issues were raised regarding the day and night staffs expectations. For example staff coming on duty on a morning may expect that some people will be up and dressed and ready for breakfast whilst others will be left in bed (individual choice). Though on an evening some staff felt that there is an expectation to get everyone into bed before the night staff arrive. This needs to be a balance, care plans do not specify when a person normally goes to be or gets up and Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 13 this would be helpful. This is a management issue which needs to be sorted out. It is therefore unclear if autonomy and choice is always offered. People do have their religious needs generally met, though better recording of this information is needed. The home are currently undergoing a three month trial regarding the use of home-made food versus hospital food. The lunchtime meal was observed. People enjoyed the whole dining experience and the home-made food seemed very popular, with good portion sizes and plenty of choice. The dining room was suitable and people choose whether to eat in one of the communal areas or in their own room. The cook was aware of those people who were underweight and how the food needed to be fortified. Assistance was given where necessary and this was carried out in a dignified manner. Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience adequate quality outcomes in this area. People feel safe in their environment, though more staff training in abuse awareness is needed to minimise any risk of harm. Complaints are dealt with effectively. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home have a complaints procedure which is standard throughout the City of York Council, surveys completed showed that some people know how to complain whilst a minority were unsure. People spoken to on the day said they would speak to a Care Leader or the manager if they had any concerns. No formal complaints have been made to the CSCI regarding Oliver House. Some staff have completed abuse awareness training, and the manager is aware of the action to take if an allegation is made. A copy of the multi-agency procedure for vulnerable adults is available and staff are aware of the different types of abuse. Care staff were spoken to who confirmed this. People looked happy and comfortable in the home and no concerns were raised regarding staff’s attitude or manner. All staff complete a police check and protection of vulnerable adults check prior to starting work in the home. It would be beneficial if abuse awareness training was mandatory for all staff on a yearly basis. Oliver House - City of York Council DS0000034910.V333764.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service experience good quality outcomes in this area. People enjoy living in the home which is clean and well maintained. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Oliver House is located centrally for local amenities in York, the home is purpose built and is easily accessible. People said they liked living in the home and all areas inspected smelt clean and fresh. The home can arrange a contractor to visit when maintenance is needed or redecoration. Some staff have completed infection control training and throughout the day staff were observed washing their hands and wearing protective clothing. The laundry area was suitable and clothes looked clean and well ironed. Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 16 The home have had an outbreak of diarrhoea and vomiting recently, though this was managed effectively. The infection control nurse was involved and the correct procedures were followed which minimised the amount of time the home had to be closed to visitors. Only a few people using the service were affected and staff spoken to were aware of the action to take to minimise cross contamination. Oliver House - City of York Council DS0000034910.V333764.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service experience adequate quality outcomes in this area. People do not consistently have their care needs met, due to a range of staffing issues. Though staff are safely recruited and inducted. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People are generally well cared for with staff being competent and skilled in delivering care. The manager is supernumerary and at times there are two care staff on duty with a care leader. Agency staff are used though staff spoken to felt it is often more difficult with new agency staff who do not know the residents very well. People using the service made a range of comments including “the staff are lovely and help me as much as they can”, one person said “I feel sorry for the staff because they do not have time to do everything”. The staffing levels need to be reviewed partly because staff feel people are getting more and more confused and therefore they need more time spent with them. Some people need two carers to look after them and on other occasions staff are expected to complete washing and ironing and provide activities for people. More effective communication between the staff and manager is needed to help resolve some of the staffing issues. Some staff have completed an NVQ level 2 and 3 in care which the home is keen to promote. Induction training now includes a twelve week programme Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 18 where mandatory training is incorporated. The induction is equivalent to Skills for Care which covers a range of care practices and information needed to complete the role of carer. The home are aware of the City of York’s recruitment procedure, this is dealt with centrally by Human Resources. Two written references are obtained, along with a police check and protection of vulnerable adults check. Staff files inspected confirmed this to be the case. Staff also spoke about the checks they had undergone prior to starting work at Oliver House. Oliver House - City of York Council DS0000034910.V333764.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use this service experience adequate quality outcomes in this area. The home could be run more effectively. There is a lack of quality assurance where people can share their views and concerns regarding the service, and care practice systems are not fully audited. Though the health and safety of people is maintained. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The manager of the home is an experienced senior carer who has been in post for two years. An NVQ Level 4 in management has been completed though an application to be registered with the CSCI has not been submitted. This was a requirement twelve months ago and is still outstanding. The manager feels she is open, approachable and fosters a culture where staff can come and discuss Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 20 any issues or concerns. A range of staff were spoken with during the day and surveys were completed regarding staffing issues. Some staff felt the manager was ineffective at dealing with issues including training, supervision, issues with uniforms and care practices relating to differences between day and night staff. These were discussed with the manager as outcomes for people using the services may be affected. The manager needs to implement a quality assurance system which includes seeking views and opinions of people using the service, this will identify if people are happy with the care they receive. Audits of the care plans and medication system are needed and regular residents and relatives meetings would be beneficial. The manager needs to be more proactive in developing these systems. The annual quality assurance assessment was completed prior to the visit, however there was very little evidence available to confirm what the service does well and how it has improved in the past twelve months. Finances were discussed, people are able to keep ‘pocket money’ in the home, and three people were spoken with who confirmed they can use this to pay for the hairdresser, toiletries or newspapers. The City of York Council use the same system in each home. Health and safety was discussed and a selection of safety certificates were checked. Water temperatures are taken regularly and some staff confirmed they have attended fire training, moving and handling training and infection control. However the records were not clear and therefore this could not be consistently confirmed. One person had not received induction training, though due to experience they were able to fulfil their role. The home has completed a fire risk assessment and tests regarding emergency lighting, fire alarm testing and general safety are in place. People said they felt safe in the home and no other concerns were raised. Oliver House - City of York Council DS0000034910.V333764.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 3 Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 22 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 OP3 Regulation 14 Requirement People must only be admitted if their needs can be met. People who are in the home outside the current registration category must be reassessed. Stock balance of medication must take place on a regular basis. Staff must check the actual amount of tablets they receive from the pharmacist and ensure these are correct. The manager must become registered with the CSCI (previous requirement not met-timescale 16/03/07) 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. (Previous requirement not mettimescale 16/12/06) The manager must address staffing issues effectively. This will help staff morale. Timescale for action 19/12/07 2. OP9 13 26/11/07 3. OP31 9 19/02/08 4. OP33 24 19/02/08 5. OP31 18 19/12/07 Oliver House - City of York Council DS0000034910.V333764.R01.S.doc Version 5.2 Page 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. Refer to Standard OP7 Good Practice Recommendations A regular audit of the care plans needs to take place, more detailed information is needed to ensure changing needs are reflected in the care plans. A review of the staffing levels needs to take place to ensure people’s needs can be met by the current staff group. OP27 Oliver House - City of York Council DS0000034910.V333764.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: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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.V333764.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. 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