CARE HOMES FOR OLDER PEOPLE
Olivia Residential Care Home (2) 7 Beechcroft Avenue New Malden Surrey KT3 3EG Lead Inspector
James O`Hara Key Unannounced Inspection 16th October 2006 09:50 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 Olivia Residential Care Home (2) DS0000013427.V315626.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. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Olivia Residential Care Home (2) Address 7 Beechcroft Avenue New Malden Surrey KT3 3EG 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) 020 8949 1701 020 8949 1701 Mrs Lucja Bart Mrs Lucja Bart Care Home 6 Category(ies) of Dementia (6), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (6), Old age, not falling within any other category (6) Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th December 2005 Brief Description of the Service: The home is situated in a quiet residential area, yet close to both local amenities and town centre facilities. The home is much influenced by Polish language, food, religion, media and culture. This meets the needs of residents ideally, as some of the residents are Polish and it is clear that this influence is much valued by those who live here. It should be noted that the service is not exclusive to residents from Poland, but any prospective residents should be aware of the influence of Polish culture in the Home. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key unannounced site visit was carried out between 9.50 and 1.20 pm on a Monday morning/afternoon. Methods of inspection included a tour of the premises, observation of contact between staff and residents, discussion with two residents, a visiting district nurse and the registered manager Mrs Lucia (Maggie) Bart. Records examined included residents care plans, risk assessments, complaints, adult protection, staffing and training records, Criminal Records Bureau Checks, medication, and health and safety records. Requirements and recommendations from the previous inspection were also discussed with Mrs Bart. A large number of residents and relative’s questionnaires were also returned to the Commission as feedback. What the service does well:
Mrs Bart is Polish and the home is much influenced by Polish language, food, religion, media and culture. This meets the needs of residents ideally, as some are Polish. It should be noted that the service is not exclusive to residents from Poland, but any prospective residents should be aware of the influence of Polish culture in the home. Suitable arrangements are in place to ensure that the resident’s health care needs are identified and met. The home uses questionnaires to identify and record the views of residents, their relatives and friends. This information is used by the home as an effective quality monitoring system. One questionnaire returned from a General Practitioner said, “there is a very happy atmosphere the residents are looked after very well”. Another from a District Nurse said, “I visit Olivia residential home on numerous occasions, I have always observed the standards of care given to residents holistic and high quality, residents are well looked after and their needs are met”. The district confirmed her comments during the visit. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 6 Resident’s questionnaires also indicated that they were happy with services offered at the home. During the inspection one resident said, “The home is marvellous we get everything we want, within reason, I am very very happy living here”. A large number of Commission For Social Care Inspection questionnaires were returned to the Commission as feedback. Relatives indicated that they were very happy with the service provided. One relative said, “It is always very welcoming, spotlessly clean and serves excellent food, a high quality service all round” Another said “I am very happy with the home and care of my mother ins all respects” yet another relative who travels a long way to visit said “all members of staff made me feel welcome and after my long trip provide me with refreshments and even an overnight stay”. What has improved since the last inspection? What they could do better:
There were two requirements and four recommendations set at the last inspection. These have all been addressed. As a result of this inspection three new recommendations have been set. The overall impression when visiting the home is that it is well organised and well managed. It is evident that Mrs Bart is very committed to meeting the needs of the residents. However there are some areas for improvement. The home should keep a daily register of controlled medication. The home should complete a weekly staffing roster that indicates persons working at the care home, and a record of whether the roster was actually worked. The home should seek written advice from the fire officer regarding the wedging open of resident’s doors.
Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 7 The inspector would like to thank the residents, Mrs Bart and staff for their support on the day of the inspection. 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. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 8 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 Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The registered manager is Polish and the home is much influenced by Polish language, food, religion, media and culture. This meets the needs of residents ideally, as some are Polish. It should be noted that the service is not exclusive to residents from Poland, but any prospective residents should be aware of the influence of Polish culture in the Home. EVIDENCE: The home has a Statement of Purpose that would provide any prospective residents or their representatives with the information they need to make an informed decision about whether or not to use the service. Sadly one resident passed away since the last inspection. No new residents have moved into the home since that last inspection.
Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 10 The registered manager stated that a care manager would refer new residents. She said that she would obtain care managers needs assessments and other appropriate information prior to completing the homes own assessment to see if the home is suitable placement for the new resident. Residents and their family would be encouraged to visit the home to see if they liked it before they decide to move in. It is evident that significant time and effort is spent making admissions to the home. Mrs Bart considers carefully the needs assessment for each prospective resident before agreeing admission to the home. Prospective residents and their family, always have the opportunity to visit and spend time in the home prior to agreeing admission. Mrs Bart said that she would be prepared to visit the prospective resident and their family to get to know them. The home does not offer intermediate care. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 11 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place to ensure that the resident’s health care needs are identified and met. EVIDENCE: All residents are registered with a local General Practitioner. Medication is stored in a locked cabinet in the dining room and on the day of the inspection records accurately reflected administration details. Evidence was seen of medication reviews carried out by the General Practitioner. The home has a book for the receipts and returns of medication. Evidence was seen that a local pharmacist visits the home. The pharmacist left a note for the attention of the Commission For Social Care Inspection to say that he carries out regular visits to the home to offer advice on medication and reviews.
Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 12 It was noted that the home has some controlled medication. It is recommended that the registered manager develop a daily register of controlled medication. One resident’s file was examined at random. The resident had an individual plan of care that was generated on admission and developed throughout the residents stay. Mrs Bart stated that all of the residents care plans are reviewed on an annual basis. Reviews involve all relevant parties, including residents, family members or representatives, key-worker and care managers. There was evidence that a Chiropodist visits the home every three months and an Optician and a Dentist visit on an annual basis or sooner if need be. On the day of the inspection the District Nurse and the Dentist visited the home. The District Nurse said that the home is a lovely place and the manager communicates very well with the health care team. If the manager has any concerns about the residents she contacts them immediately and they are always happy to help. Mrs Barts daughter is a qualified occupational therapist. The home has its own questionnaires that it employs as part of a quality monitoring system. These had been completed and returned by a number of health care professionals. Comments included; General Practitioner “there is a very happy atmosphere the residents are looked after very well”. Physiotherapist “ this is a thoroughly well run care home with a happy atmosphere and much attention to the needs of the residents”. District Nurse “I visit Olivia residential home on numerous occasions, I have always observed the standards of care given to residents holistic and high quality, residents are well looked after and their needs are met”. Community Psychiatric Nurse “ residents appear well cared for in an environment which suit their needs and ethnic origins” Resident’s questionnaires also indicated that they were happy with services offered at the home. One resident spoken to on the day of the inspection said, “The home is marvellous we get everything we want, within reason, I am very very happy living here”. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 13 Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are being provided with a range of opportunities for recreational and social activity that is in accord with their social, cultural and religious needs. EVIDENCE: The home has sought the views of residents and considered their varied interests and abilities when planning the routines of daily living and arranging activities. Routines are very flexible and residents can make choices in major areas of their life. The routines, activities and plans are resident focussed, regularly reviewed, and can be quickly changed to meet individual residents needs. Residents are supported to maintain links with the local religious community, both through assistance with transport to and from church, where required, and through visits to the home from a Polish priest. Residents are able to maintain links with the wider Polish community through access to satellite television broadcasting in the Home. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 15 The home has developed residents questionnaires in order to identify and record the views of residents, their relatives and friends. This information is used by the home as an effective quality monitoring system. The home’s menu contains a number of Polish dishes, reflecting the preferences of some of the service users. On the day of the inspection lunch consisted of a polish meatballs, potatoes, mixed vegetables. This was sampled and was well presented and tasty. Residents said that they enjoyed food provided in the home. Mrs Bart said that residents are offered opportunities to go on car trips to Kingston and Richmond Park, shopping and walks. Activities in the home include group exercise (facilitated by Mrs Barts daughter, a qualified Occupational Therapist) drawing and knitting, reading newspapers and books and watching Polish television. Resident’s questionnaires returned to the Commission as feedback indicated that they liked living at the home, that they were well treated by staff, that they liked the food and they were provided with suitale activities. I was obvious during the inspection that residents were treated with great respect and dignity and they were able to do the things they wanted to do. A large number of relative’s questionnaires returned to the Commission as feedback. Relatives indicated that they were very happy with the service provided. One relative said, “It is always very welcoming, spotlessly clean and serves excellent food, a high quality service all round” Another said “I am very happy with the home and care of my mother ins all respects” yet another relative who travels a long way to visit said “all members of staff made me feel welcome and after my long trip provide me with refreshments and even an overnight stay”. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that any concerns they may have are listened to and acted upon. The home has suitable vulnerable adult protection and abuse prevention measures in place to ensure residents are so far as reasonable practicable protected from abuse, neglect and/or harm. EVIDENCE: The home has an appropriate Complaints procedure, a copy of which is included on the Statement of Purpose. Residents and others associated with the home state that they are extremely satisfied with the service provision, feel very safe and well supported by a highly aware manager. The home has adopted the Protection of Vulnerable Adults policy developed by the Royal Borough of Kingston, the host authority for the service. All staff has attended Adult Protection training. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 17 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, 20, 21, 23, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall impression when visiting this home is that it is well decorated, homely, comfortable, clean, and hygienic and meets the needs of the currents residents. EVIDENCE: The home is situated in a quiet residential area, yet close to both local amenities and town centre facilities. The home has a dining room with tables and chairs however the registered manager stated that given the choice residents generally like to eat in their rooms. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 18 The home offers access to toilet and shower facilities on the ground floor, whilst a bath is available on the first floor. Toilets and bathrooms in the home were found to be clean, functional and attractive on the day of inspection. The home appears to meet the current needs of residents well. There is evidence of regular consultation with appropriate health care professionals to ensure that the needs of the residents are met. Observation revealed that residents are afforded the opportunity to personalise their rooms to reflect their tastes and preferences. All bedrooms have been fitted with call bells. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is supported to run the home by her husband and her two daughters. One of her daughters is a fully qualified occupational therapist. The home also employs one full time member of staff. This continuity of care is undoubtedly one of the home’s strengths and contributes to the family atmosphere. EVIDENCE: Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 20 The home is run as a family business, Mrs Bart is supported by her daughter a fully qualified occupational therapist and a member of staff who lives in. Mrs Bart’s husband and another daughter also work at the home when required. This continuity of care is undoubtedly one of the home’s strengths and contributes to the family atmosphere. As previously recommended a training programme has been developed for staff at the home. This includes staff training on Food Hygiene, First Aid, Fire Safety, Moving and Handling, Medication, Health and Safety and Protection of Vulnerable Adults. Evidence was seen that staff has attended training fire safety, food hygiene, moving and handling, adult protection, medication and dates are planned for staff to attend health and safety and first aid. Three of the five residents are from Poland. The input of Polish staff members familiar with the language and customs of a Polish Home is of particular value. The ability of staff to converse with residents in their first language is clearly beneficial to meeting their individual and collective needs. Mrs Barts stated however that the home offers support to residents from any culture or religious persuasion. She stated that staff at the home is able to communicate in seven different languages. Sadly one of the residents passed away in July this year. At present there is a vacancy for a new resident. Mrs Bart stated that should any new residents needs be assessed as needing more staff support then the homes staffing levels would be reviewed. As recommended at the last inspection the registered manager sent a copy of the homes staffing roster to the Commission. The roster indicates that staff works the same shifts every week but is not completed on a weekly basis. It is recommended that Mrs Bart complete a weekly staffing roster that indicates persons working at the care home, and a record of whether the roster was actually worked. Criminal Records Bureau Checks were seen for all members of Mrs Bart’s family and the one member of staff. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 21 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is very well managed whilst maintaining an atmosphere of calm and conviviality. The management approach of the home creates an open, positive and inclusive atmosphere. Mrs Bart is highly competent in caring for older people. Other professionals see her as someone who consistently provides high quality services. EVIDENCE: Mrs Bart has completed the Registered Managers Award and NVQ level 4 in Care, she has a good deal of experience in the management of small care homes and brings her range of skills to bear in the day-to-day operation of the service.
Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 22 Mrs Bart is highly competent in caring for older people. Other professionals see the manager as someone who consistently provides high quality services. Mrs Bart stated that she does not have overall control over any of the resident’s finances. Three relatives hold power of attorney and two residents are under the court of protection. If Mrs Bart purchases items for the residents she will keep receipts and request reimbursement. As required at the last inspection Mrs Bart has completed a fire safety procedure for the home and ensured that all staff is aware of the procedure, ensured that regular quarterly fire drills occur and records of these are kept in the home. Mrs Bart provided evidence that a fire officer from the London Fire & Emergency Planning Authority provided training to staff and offered advice to the home. Mrs Bart stated that the fire officer also advised that resident’s bedroom doors and communal doors could be wedged open in the daytime but need to be closed in the nighttime. A requirement was set at the last inspection that the homes four smoke detectors are checked on a weekly basis. Mrs Bart provided evidence that the home smoke detectors are checked on a regular weekly basis. It is recommended that the registered manager seeks the advice of the fire officer regarding the wedging open of resident’s doors in writing and send a copy of this to the Commission. Certificates were seen for Portable Appliance testing 18/06/06, Legionella testing 19/09/06, Landlords Gas Safety 05/09/06, fire equipment checked May 2006 and Environmental Health visited the home on the 16/08/05. Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 23 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 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 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 4 X 4 X 4 X X 3 Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP9 OP27 Good Practice Recommendations It is recommended that the registered manager develop a daily register of controlled medication. It is recommended that the registered manager complete a weekly staffing roster that indicates persons working at the care home, and a record of whether the roster was actually worked. It is recommended that the registered manager seeks the advice of the fire officer regarding the wedging open of resident’s doors in writing and send a copy of this to the Commission. 3. OP38 Olivia Residential Care Home (2) DS0000013427.V315626.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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
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