CARE HOMES FOR OLDER PEOPLE
Oriel Care Home Ltd 87 Hagley Road Old Swinford Stourbridge West Midlands DY8 1QY Lead Inspector
Christine Lancashire Unannounced Inspection 21st January 2006 14:00 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 Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 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. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Oriel Care Home Ltd Address 87 Hagley Road Old Swinford Stourbridge West Midlands DY8 1QY 01384 375867 01384 443597 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) Oriel Care Home Ltd Elizabeth Jane Linford Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th September 2005 Brief Description of the Service: Oriel House is situated on the main Stourbridge to Oldswinford Road, a short distance from Stourbridge town centre, where there is a range of local facilities. The home comprises two properties, which are linked by an enclosed walkway. The larger of the properties was constructed as a private dwelling in the mid 19th century and conversion works have been carried out in a sensitive way, with care being taken to retain many of the original features. All areas are decorated and maintained to high standards, with a rolling programme of maintenance being evident. There are twenty-five single rooms, twenty-one having en-suite facilities. Two conservatories, in addition to the living room and two dining rooms, ensure that residents have a choice of seating areas and association. There is an attractive garden, which provides a pleasant view from the conservatory and a safe area in which residents may exercise. The owners are involved in all aspects of the management and day-to-day activity of the home, ensuring that high standards are maintained. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a short, unannounced inspection which took place on a Saturday afternoon. The aim of the inspection was to assess those key standards which had not been covered at the last visit and to check that the requirements of the previous report had been met. The inspector met three members of staff on duty. The home was quiet, with most of the residents relaxing after lunch. The manager was available to supply the necessary documents and evidence. What the service does well: What has improved since the last inspection? What they could do better:
All previous requirements have been met and those new standards inspected were also met. Although staff have received some training in adult protection, the inspector recommends that all staff undertake a training course in elder abuse. The manager will continue to monitor standards at the home and to look for areas where the home can improve its performance. Feedback from residents is an integral part of this process. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 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 Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 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): These standards were not assessed at this visit. Standard 3 was met at the last visit and standard 6 does not apply at this home. EVIDENCE: Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 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): 9 Residents are protected by the home’s policies, procedures and practice in relation to the storage, handling and recording of medication. EVIDENCE: There are appropriate arrangements for the storage and administration of medication. Residents who wish to hold their own medication are enabled to do so, following an assessment of capability. This applies mainly to creams and lotions. There is a policy and procedure in relation to medication and this is available for staff reference. All staff who administer medication are suitable trained. The majority of staff have recently undertaken accredited training and the remainder are enrolled on a course starting the week after this inspection. The inspector checked the medication administration sheets and found that they were appropriately completed, with use being made of the codes when doses had been missed. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this visit. All were met at the previous inspection. EVIDENCE: Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Residents are protected from abuse at this home. EVIDENCE: Staff have received some training in adult protection and this issue has been discussed at staff meetings. Twelve members of staff have completed and elder abuse course and this includes all shift supervisors. In the opinion of the inspector, all staff would benefit from this training and this was discussed with the manager. The home has a policy in relation to adult protection. The procedures are multi-agency and make reference to the ‘No Secrets’ guidance. A short summary of this is kept on display on the notice board. The contact numbers for the relevant agencies and the police are readily available. There is a whistle blowing procedure for staff. Residents at this home are able to raise any issues or complaints with the manager or with representatives or relatives in the community and there is no indication that the arrangements for protection are inadequate. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Residents live in a safe and well-maintained environment. EVIDENCE: This home is decorated to high standards with good quality furniture and furnishings. An ongoing programme of maintenance ensures these high standards at all times. At the previous inspection, the inspector identified the need to replace one carpet and to ensure that the door to the lounge met with the requirements of the fire service. These areas have now been addressed. In addition, a ramp has been installed to facilitate access to the home by people with limited mobility and wheelchair users. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,29 Residents’ have their needs met by the numbers and skill mix of staff. Residents are protected by the home’s policies and practices in relation to recruitment. EVIDENCE: There are sufficient numbers of staff to meet the needs of the residents. However, at the last inspection, the inspector raised the issue of care staff undertaking cleaning and cooking duties as well as general care work. This was considered to be inappropriate due to possible infection control difficulties. This issue has now been addressed. When care staff undertake domestic duties, they do so for one full shift each week. This means that they are free to care for residents for their other shifts and the risk of cross infection is minimised. In addition, there is now a cook on duty to prepare lunch and the evening meal during the week. At the weekends, care staff who come on duty for an evening shift prepare the tea before commencing any care duties. This system seems to be working well. The recruitment and selection procedure and practice has been reviewed and all references are authenticated. Gaps in employment history are explored with the applicant. A new interviewing process has been developed and this includes an updated questionnaire, with set questions. Records of all interviews will be kept and held on files. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 35,37 Residents’ financial interests are safeguarded by the home’s practices in relation to the handling of money. Residents’ best interests are safeguarded by the home’s record keeping, policies and procedures. EVIDENCE: It is made clear at the time of admission that the home does not handle finances on behalf of residents. Where residents are not able to handle their own finances, they are assisted by a relative or other representative. The amount of any personal shopping or additional services, such as hairdressing, is added to each resident’s monthly account. No cash usually changes hands within the home. The manager informed that inspector that, if ever it was necessary to make a small cash advance to a resident, then this would be supplied and signed for by the resident and the member of staff.
Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 15 At the last inspection, the standard of record keeping was found to be good. However, the inspector raised the issue of the apparent lack of a signing-in process for visitors. This has now been addressed. There is now a signing in book at each entrance and the inspector was asked to sign this and to produce evidence of her identity on entering the building. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 16 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 X X X x HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X x STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X 3 X Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 17 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 Refer to Standard OP18 Good Practice Recommendations The inspector recommends that all staff attend elder abuse training. Oriel Care Home Ltd DS0000063620.V279794.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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