CARE HOME ADULTS 18-65
Omnia 50 Sale Road Norwich Norfolk NR7 9TP Lead Inspector
Hilary Shephard Unannounced Inspection 28th November 2005 09.50 Omnia DS0000027301.V259928.R01.S.doc Version 5.0 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 Omnia DS0000027301.V259928.R01.S.doc Version 5.0 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 Adults 18-65. 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. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Omnia Address 50 Sale Road Norwich Norfolk NR7 9TP 01603 435621 01603 435621 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) Norwich MIND Sandra Flanagan Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Twelve (12) people with a mental disorder, excluding learning disability or dementia, may be accommodated. 6th July 2005 Date of last inspection Brief Description of the Service: Omnia became operational in July 2002 and was registered in December 2002. Omnia has been developed to provide a service assisting and enabling people with mental health problems to lead a more independent and fulfilling life style. Omnia is split into two houses (wings) each accommodating six clients. There is also a range of other facilities, which ensure that the planned skills and personal development programmes can be undertaken in pleasant and wellmaintained surroundings. The third wing of the building accommodates the main offices and outreach team for Norwich MIND. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place over 5 ¾ hours during which time the inspector spoke with 1 client and 3 staff. A total of 6 comment cards were received from clients and 7 from relatives/visitors. The views of residents and staff, where appropriate, are reflected in the findings in the report. A tour was made of the building and the inspector also looked at samples of care plans, staff files and safety records. At the end of the inspection feedback was given to the Manager. Two recommendations were made as a result of this inspection. What the service does well: What has improved since the last inspection?
The home has improved the signage outside making it easier to find. The life skills programmes have been altered and updated to include group work in specific areas such as self-esteem building. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 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. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Clients’ needs are assessed before admission and they are confident that the home is capable of meeting their needs. EVIDENCE: Care plans contained good and comprehensive assessments completed before the clients were admitted. The assessments include a section about what clients hope to achieve by being in the home. The home uses the care programme approach and uses all information gathered before and after admission in conjunction with the clients to formulate a plan of care. The home has a robust philosophy about the type of service they offer and is careful to admit people who have the capabilities needed for them to be able to move on to community living. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 9 Each client has risk management strategies in place focusing on their mental health problems providing good guidelines for staff to follow. EVIDENCE: Risks are clearly identified and good guidelines are in place enabling staff to work with the clients to overcome or manage these. Staff also complete risk assessments twice a day, briefly assessing each person to see how they are coping and if they need help. Staff demonstrated a very good understanding of the clients’ needs and feedback obtained from relatives and visitors indicate that clients are very well supported and are enabled to develop skills needed for independent living. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards not assessed at this inspection. EVIDENCE: Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Clients choose how they receive personal support; all aspects of their health needs are well managed and safe medication practices are in place. EVIDENCE: Care plans indicated that clients health needs are identified and staff advised they provide input and support as required but that this is very much led by the clients themselves. Clients work with staff putting guidelines together to enable their emotional and physical needs to be identified and to put strategies in place enabling these to be addressed. One client said he thought living in the home had really benefited him and he was ready to move back home. Clients generally administer their own medication unless their risk strategy has identified a problem. Staff work with clients as part of their care programme to guide and support them in the administration of their medication. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards not assessed at this inspection. EVIDENCE: Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Clients benefit from living in a comfortable and well-maintained home, although some parts of the home were not very clean. EVIDENCE: The home is well maintained, nicely decorated and comfortably furnished. Clients are responsible as part of their care programme for keeping the home clean and doing their own cooking with staff support. Generally the home was clean, but one of the kitchens was very dirty. At the time of the inspection, a plate of food had been left uncovered in a very dirty microwave, there were bits of food all over the floor, surfaces were dirty and the kettle and tea/coffee tray was badly stained. Cleaning instructions and rosters have been developed to give the clients an understanding of their responsibilities. The kitchen was cleaned later by one of the clients. See recommendations. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 Clients benefit from being cared for by well qualified and knowledgeable staff and are protected by the homes recruitment practices. EVIDENCE: Seven out of the eight permanent staff employed at Omnia have completed NVQ level 3. The home also employs a bank of staff, which includes two student social workers and a student mental health nurse. Training records indicate that staff attend a variety of training courses, many focussing on aspects of mental health care. Staff confirmed that they are provided with lots of training opportunities relevant to their work and that the training received definitely benefits the clients. Feedback received from visitors indicates that clients are well supported by staff who are knowledgeable about the individual clients needs and mental health problems and very capable of providing appropriate care. An example was given of how staff recently managed a client in crisis in the absence of the manager. Staff were said to have worked well as a team and provided good support to the client. The home benefits from a low staff turnover, which makes Standard 34 difficult to assess. However, the manager regularly audits the staff files to make sure they contain all the required information as at present Norwich MIND manage Omnia’s recruitment.
Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 15 Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 Clients and staff are well supported by an experienced and competent manager. Clients are involved in the running of the home and benefit from living in a safe environment. EVIDENCE: The manager has completed NVQ level 4 in care practice and has almost completed the Registered Managers Award. Staff and clients clearly respect the manager and very positive feedback was given about her competency and skills. The home runs well, staff are motivated, competent and work very well as a cohesive team. Clients benefit from the stability and continuity that a low staff turnover provides. The home undertakes regular quality monitoring involving everyone who comes into contact with the service. Regular staff and client meetings are held, care plans are reviewed and clients are very much involved in the outcomes they want to see from the life skills programmes. A new programme has been developed since the previous inspection and although this has only been running five weeks, one client expressed the benefits gained from this programme.
Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 17 Fire safety records were checked and were in good order. Accident records are kept separate from the home and the inspector did not check these, however the manager checks them on a regular basis. It would be good practice to file these on individual staff and client files to enable better monitoring of accident type and frequency. See recommendations. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 4 X 3 4 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Omnia Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000027301.V259928.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA30 YA42 Good Practice Recommendations The Registered person should ensure all parts of the home are kept clean. The Registered person is recommended to keep accident records on individual staff and clients files. Omnia DS0000027301.V259928.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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