Inspection on 02/07/08 for Orione House

This inspection was carried out on 2nd July 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Orione House 18/12/07

Orione House 18/04/07

Orione House 29/08/06

Orione House 14/11/05

Orione House 08/06/05

Orione House 11/02/05

Orione House 23/08/04

Orione House 18/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Orione House 12-14 Station Road Hampton Wick Kingston-upon-Thames Surrey KT1 4HG Lead Inspector Sandy Patrick Key Unannounced Inspection 10:00 2nd July 2008 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 Orione House DS0000017385.V364500.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. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orione House Address 12-14 Station Road Hampton Wick Kingston-upon-Thames Surrey KT1 4HG 020 8977 0754 020 8977 0105 manager.orione@sonsofdivine.org 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) The Sons of Divine Providence Lydia Davis Care Home 34 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (34) Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th December 2007 Brief Description of the Service: Orione House is a purpose-built care home owned by the Sons of Divine Providence. They are a Catholic Missionary Order of Priests, Nuns and Brothers who welcome all faiths to their Homes. The home is for up to 35 people in single rooms. The home is situated in a residential area close to Hampton Wick Station and local shops. There is a large conservatory to the front of the home which leads to a garden and car park. At the rear of the house is an enclosed garden with flower beds, mature trees and a pond. A chapel is situated in the garden which is for use by anybody who wishes at Orione House. Fees range from £559 per week for a single room and £592 per week for a single room with ensuite facilities. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection included an unannounced visit to the home on 2nd July 2008. We met people who live at the home, staff on duty, the Manager and visitors. We looked at the environment and records. We asked the Manager to complete a quality self assessment about the service. We wrote to the people living at the home, their visitors and staff and asked them to complete surveys about their experiences of the service. 6 people who live at the home returned surveys to us. We looked at all the information we have received since the last key inspection. Most people told us that they were happy with the care they received at the home. Some of the things people told us about the home were: ‘Generally a well run home.’ ‘The staff are very kind.’ ‘I enjoy sitting in the lounge with the other people and chatting to them.’ ‘It is a wonderful home and the staff couldn’t get any better.’ What the service does well: People are happy living at the home. The staff are well supported and trained. The home is well managed. Records are organised and clear. The home provides support for people to follow their Catholic faith. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: People need to have support to meet their individual social needs. There needs to be some more improvements to the environment. There needs to be some improvements to medication records. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 7 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. Orione House DS0000017385.V364500.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 Orione House DS0000017385.V364500.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, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a range of information to help people make a decision about moving to the home and they are able to visit to see if they like it there. Their needs are assessed to make sure the home is suitable. EVIDENCE: People who are interested in moving to the home are given a Welcome Pack. This includes the Statement of Purpose, Service User Guide, complaints procedure, map of the area, schedule of fees, information about inspection reports, plans of rooms, plus an application form for the person and one to be filled in by the GP or hospital doctor. People told us that they had enough information to help them make a decision about moving to the home. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 10 People who are interested in moving to the home and their relatives are always invited to visit and stay for the day or the night (if they wish) so that they can sample life at Orione House. During this time the Manager or Deputy Manager assess their needs through talking to them and observations. They also speak to relatives, professionals and other people who can contribute to the assessment. Assessments are recorded and the care needs of each person are reviewed after they moved to the home to make sure these are being met. People are able to say whether they want to continue to live at the home after a few weeks staying there. We saw records of assessments, application forms and reviews of care plans. One person told us, ‘the home was recommended to me because of my faith, I came to visit and like it here, so I decided to stay.’ Everybody has a written contract/statement of terms.. We saw some copies of these which had been signed by the person or their relative and representatives of the organisation. People living at the home told us that they had their own copy. Orione House DS0000017385.V364500.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s individual needs are recorded so that the staff know what they need to do to help people meet their needs. The staff work with other professionals to help keep people healthy. EVIDENCE: The Manager and Deputy Manager have written new care plans for all the people living at the home. They are starting to write night care plans for everybody. We looked at a sample of care plans. We saw that these were clear and information was presented so that staff could easily understand how to meet people’s individual needs. We saw that the plans focused on people’s abilities and strengths as well as their needs. We saw that the care plans reflected the things which had been identified at assessments. Not all the care plans we saw had been signed by the person or their representative. We felt that care plans needed to give more details about Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 12 people’s individual social needs, interests and their life before they moved to Orione House. The staff should talk to people living at the home and their families to find out about these things. The Manager told us that she aims to create detailed life plans for each person. Some of the people living at the home are able to understand their care plans and should be given a copy of these to keep. The Manager should think of ways the information could be presented to those who may not understand the format they are written on. Consideration should be given to large print, verbal recordings and use of photographs and pictures to help people understand these care plans. We saw that there were assessments that recorded the risks people face and how these could be minimised. The senior staff are responsible for updating and reviewing care plans once a month. Care staff write daily notes. A hairdresser visits the home each week and people can make appointments with her. Everybody is registered with local GPs and other health care professionals as needed. We saw evidence that the staff worked with other professionals to monitor and meet health needs. One GP holds a weekly surgery at the home and we saw that there were good systems for the staff to communicate with them. Each person has been assessed for their mobility and the equipment they may need. The staff have regular training to make sure they can help people to move around safely. The Deputy Manager is qualified to provide training to staff and assess their capabilities. New equipment to help people move around safely has been purchased in the last year and is available on each floor. Health care professionals have assessed people for the use of bedrails. There are records of these assessments. We saw that accidents, falls and incidents we appropriately recorded and that action was taken to minimise the risks of people falling. People told us that they received the medical support they needed and that the staff helped them to stay healthy. One person said, ‘I see the doctor when I need to and they visit me at the home.’ Senior staff have been trained to administer medication. People are able to manage their own medication if they want to and it is considered safe. We saw that there are recorded risk assessments for these people. We saw that there are appropriate procedures regarding medication. The pharmacist who Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 13 supplies medication to the home visited and checked storage, administration and practice in April 2008. They were happy with the way in which the home managed medication. We looked at medication storage and records. We saw that record keeping was generally good and information on the amount of medication held, doses and administration were accurate. But we saw that the sheets medication was recorded on did not have information on people’s allergies. Records were appropriately signed. Medication was stored securely and the majority was appropriately labelled. Some homely remedies (non prescribed medicines) were not labelled. There was no recorded date of opening for some medicines which had an expiry date linked to the date of opening. The Manager told us that people are supported to have a bath or a shower whenever they want. One person told us that they did not have a bath as often as they wanted and they were not able to. This was discussed with the Manager who told us that she would inform people that they could have a dialy bath or shower if they wished. We saw one person leaving the bathroom after they had had a bath. They had their own supply of toiletries and said that the staff had supported them well. We saw staff treating people with respect and listening to them. The staff were polite and friendly to everybody. We heard the staff complementing people on their hair and outfits and asking them how they felt and if they enjoyed the things they had just done. People we spoke to said that the staff were kind and attentive. One person said, ‘they help me with everything I need’. Another person told us, ‘the staff are cheery and look after me wonderfully’. People are asked about their choices for their end of life care and we saw that this is recorded. Orione House DS0000017385.V364500.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There have been improvements to organised activities for groups of people. People need to have more support to pursue individual interests and activities. People are able to entertain visitors when they want. People are able to make choices about their daily lives. There is a choice of freshly prepared food. EVIDENCE: There is a part time activities coordinator. Over the last year she has been on a special course to learn more about providing good activities. Some of the relatives have volunteered to assist with outings and activities. Regular planned activities include bingo, exercise, board games, films, quizzes and singing. We met the activities coordinator and she was enthusiastic. She said that sometimes people did not want to join in the things which she had organised. The staff need to find out more about people’s individual interests and hobbies and support people to pursue these. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 15 On the day of our visit we saw staff chatting with people in communal rooms, playing music and discussing this, singing and people enjoying the Wimbledon tennis tournament on the television. The Manager said that following requests from people who live at the home there have been more special events organised. These include celebrating St Valentine’s Day, St George’s Day and Burns Night. The children from a local school have also visited the home to sing. There have been some outings to the theatre, pubs and places of interest. One person told us that the staff had supported them to go on a shopping trip to a local town centre. Some people told us that they had enjoyed certain activities. One person said, ‘I like making craft things.’ We saw that there were records of people’s participation in activities. Orione House is a Catholic home and offers religious support for people through daily services and use of the chapel. People of other faiths are also welcomed at the home and the Manager said that everybody at the home was accepting of different faiths and cultures. One person told us, ‘my relative always attends Mass and Holy Communion and they involve her as much as possible’. We saw people spending time in the lounges, garden and bedrooms. Visitors are welcome at any time and we saw people visiting the home throughout the day. Visitors told us that the staff made them welcome and the Manager said that she felt staff were very hospitable to visitors. Relatives are invited to join people for meals and activities if they wish to and the staff support this. People living at the home said that they felt able to include their visitors and family in their lives at the home. The Manager told us that people living at the home have started to feel more confident in speaking to her about their concerns and the ideas they have about the home. Meetings for them and their relatives are held four times a year. There is a notice board of information and photographs for people living at the home. This includes the latest CSCI inspection report, information on special events and activities, the complaints procedure and details of the hairdresser. People living at the home told us that they were able to choose where they spent their time, what they wore and what activities they participated in. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 16 The home employs two chefs. All food is freshly prepared and people have two main choices for each meal. The Manager said that the Chef had spoken to people about the menu and made changes that they had suggested. The Manager told us that people living at the home had requested a change to mealtimes and that this had been introduced. She told us that a wider range of snacks and fresh fruit is now provided following requests for these. There have been changes to the way in which meals are served and staff are expected to sit with people who need support for the whole of a meal. We saw that the atmosphere in the dining room at lunch time was friendly and people were relaxed and chatting over their meals. We heard the staff giving people choices about food and drinks. We saw that some people chose to eat in their rooms or other areas of the home and that their food was taken to them. During our visit we saw that the menu for the day was written on a large board only shortly before the main meal was served. We felt that it would have been better if this had been displayed earlier in the day. Some people told us that they liked the food and others said that they would like some changes to the food. Some of the things people said were: ‘The menu options are not discussed and the portion sizes are just standard not personalised.’ ‘I would like the menu to be more imaginative.’ ‘I like the food but we don’t have much choice.’ ‘I think the food is wonderfully good.’ ‘Top marks for the food.’ Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 17 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures to help people make complaints and designed to protect them from harm. EVIDENCE: The complaints procedure is given to everyone when they move to the home and a copy is displayed on a notice board in the main entrance hall. All formal complaints are recorded. We looked at the records of these. We saw evidence that the complaints had been appropriately investigated and that feedback had been given to the complainant. We saw that things had changed as a result of some complaints and that the staff had learnt from these to improve practice. It would be useful for the Manager to compile a log of all complaints in addition to individual records, to assist with auditing. One person told us, ‘the staff do not always follow up my complaint’. Other people told us that they knew who to make a complaint to and that they felt complaints were appropriately resolved. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 18 All staff, including kitchen and domestic staff, have had training in protection of vulnerable adults. The Manager discusses safeguarding issues with the staff at meetings and recently held a quiz for the staff to help highlight issues. The home has copies of the organisation’s and the local authorities protection of vulnerable adult procedures. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 19 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, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe and well maintained environment. EVIDENCE: Communal rooms include a lounge and conservatory area on the ground floor, lounge on the second floor and dining room. There were flowers and pictures on display in these rooms. People have personalised their bedrooms and some have brought their own furniture. 9 bedrooms have en suite facilities. There is an additional small communal room, generally used for meetings, on the ground floor. The Manager said that she would like to make this area into a sensory room. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 20 The communal lounge on the first floor has been fully redecorated with new flooring, new furniture and new lighting. There is a kitchen area in the lounge where people can help themselves to drinks. The dining room has also been redecorated and there has been new flooring in some of the bathrooms. Bathrooms have been equipped with handrails. The Manager has requested that other areas of the home are redecorated. In particular new lighting is needed in the corridors, walls need to be painted and carpets need to be replaced. The building would look nicer if the dark woodwork throughout was replaced. There is an attractive and well maintained garden which has seating areas. There is a chapel in the garden where services are held and which people can use for private worship. All first floor windows have been risk assessed and equipped with suitable devices to restrict the amount they open. Exposed hot water pipes have been covered and some of these have been boxed in. The Manager needs to make sure all pipe work is boxed in. The Manager told us that a new call bell system was going to be installed at the home and that this would give printed information for each time a call bell was activated and how long it took for the staff to answer each call. People told us that they liked the home and garden. One person said, ‘I love this garden it is such a nice place to sit’. One person told us, ‘sometimes laundry isn’t always returned to the right person’. We saw that the home was fresh and clean throughout on the day of the inspection. People who live at the home said that the home was always clean and fresh. We saw that the kitchen was clean and hygienic. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 21 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are cared for by staff who are well trained and supported. Recruitment procedures are designed to keep people safe. EVIDENCE: Many people told us that the staff were kind and thoughtful. Some people told us that some of the staff were better at listening to them that others. Since the last inspection a new Deputy Manager has started work at the home. She is going to undertake NVQ Level 4. The Manager has organised two recruitment days and filled all of the staff vacancies. Four of the new staff have completed their inductions. A number of part time (relief) staff have also been recruited so that the home relies less on agency staff. The Manager has changed the staffing rota so that the needs of people at the home are better met. All the staff have achieved or are working towards NVQ Level 2 or higher. People living at the home told the Manager that they wanted to be able to identify staff more easily. The Manager has introduced staff name badges. These are designed so that people can read staff names easily. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 22 There are appropriate procedures for the recruitment and selection of staff which include references and criminal record checks. We looked at a sample of staff recruitment files and saw evidence of thorough checks and interviews. The Deputy Manager has been trained to provide training for other staff. Since the last inspection a number of external training courses have been organised by staff. The local authority have provided some training. Some staff need support with their English language skills. The Manager told us that the Deputy Manager is investigating special courses to support these staff to improve their English. Some of the people living at the home and their relatives said that they found this a problem. One person told us, ‘language can be a problem as my relative is hard of hearing and sometimes cannot understand staff whose English is not good’. We saw records of staff training and these showed that the staff had undertaken a range of different training. This includes supervision training for senior staff, first aid, protection of vulnerable adults, manual handling, food hygiene, fire safety and inductions for new staff. Staff complete induction work books and shadow experienced staff when they start work at the home. They undertake training and are closely supervised by senior staff. One member of staff we spoke to said, ‘I have had some good training and feel that it has helped me in my role’. The Manager is working with the senior staff team to help them improve their skills and knowledge. Some staff need to have training to help them learn computer skills so that they can write and update records more easily. There are good systems for the staff to communicate with each other including handovers of information when the staff change over. There are regular staff meetings and these are recorded. We saw records of these. We saw that there were opportunities for staff discussion, that staff were given information about changes and ideas and that complaints were discussed so that people could learn and improve practice. There are shift plans to help organise the duties which staff need to do each day. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 23 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, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a service which is well managed. EVIDENCE: The Manager started working at the home in 2007. When she started work there were a lot of outstanding issues and requirements made by the CSCI. She has worked really hard to address these concerns and improve the service. There have been staff shortages, vacant bedrooms and some of the record keeping at the home was poor, she has managed to overcome these barriers and make the improvements needed. She has plans for continued improvements. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 24 The Manager is experienced in work caring for people and is qualified to NVQ Level3, in social work and as a psychotherapist. She has arranged to start her Registered Managers Award later in the year. The organisation has a small number of other residential homes. The Manager works closely with other managers to share ideas and improve practice. The Manager told us that her line manager is very supportive and that he is very experienced in residential care. We spoke to some of the staff on duty. They told us that they were happy working at the home. One staff member told us that the Manager was very organised and this helped the smooth running of the home. The senior manager visits the home each month to conduct a quality inspection and writes a report on his findings. The Manager distributed customer satisfaction surveys to people living at the home and their relatives earlier in the year. People were generally positive about the home and answered questions about food, care, staff attitude and what they wanted to see improved. We saw evidence that the Manager had acted upon concerns people had raised and suggestions they made. Everybody living at the home has representatives who manage their finances or they manage their own finances. Small amounts of cash can be held at the home for day to day purchases such as hairdressing, newspapers and toiletries. The Manager and Deputy Manager are the only staff who have access to this. The Manager has changed the way in which people’s money is looked after to make this safer. We saw that money was held securely. We looked at a sample of money held on behalf of people living at the home. We saw that records were accurate and there was a clear audit trail with receipts for purchases. The Manager has introduced new systems to help provide a better service. These include systems to help staff update and review care records. She has updated records and the way in which information is stored. The record keeping at the home is now very good. Information is clear, up to date and easily accessible. The Manager has reorganised the way in which health and safety is monitored in the home. Information including the policy and health and safety checks are organised and accurately recorded. We saw a detailed risk assessments on the building and on fire safety. We saw that action had been taken to reduce identified risks. The Manager has completed individual evacuation plans for each person living at the home in event of a fire. All staff have had fire safety training. The Manager told us that the fire officer would return to the home to train staff in different scenarios. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 25 We saw evidence that the electrical appliances, electrical wiring, gas safety and water safety had all been checked by appropriate professionals. There was also evidence of equipment checks. The Environmental Health Officer visited the home earlier in the year and felt there were good hygiene standards and procedures in the kitchen. We saw evidence of regular health and safety checks by staff on water, fire equipment and general safety. We saw that appropriate action had been taken to address any identified areas of concern. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 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 3 3 3 X 3 3 4 4 Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12 15 Requirement Timescale for action The Registered Person must 31/08/08 make sure people sign their care plans and are given a copy so that they know what is written about them. The Registered Person needs to 31/08/08 make sure individual interests, hobbies and social needs are recorded and that people are supported to meet these needs. The Registered make sure: Person must 31/07/08 2 OP7 12 15 16 3 OP9 13 1. People’s allergies are recorded on medication administration records. 2. All medicines are appropriately labelled with people’s names and administration details. 3. Medicines with a limited shelf life are labelled with the date of opening. Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 28 4 OP12 12 16 The Registered Person needs to 30/09/08 make sure there is a wide range of different organised activities which reflect the needs and interests of people living at the home. The Registered Person needs to 31/08/08 make sure all hot water pipe work is boxed in. 5 OP25 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 Refer to Standard OP7 Good Practice Recommendations The Manager should consider how best care plans could be recorded and presented to people who cannot understand them in their current format. The staff should talk to individual people and find out about their lives before they moved to Orione House. Information should be recorded so that the staff can better understand about the things which are important to each individual. The Manager needs to make sure everyone is aware that they may have a bath or shower everyday if they wish. The staff need to make sure the menu is advertised and displayed in advance so people know what food is being served each day. 2 OP12 3 OP14 4 OP14 Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 29 5 OP15 The Manager and chef need to look at ways to address some of the negative feedback about food and meals in particular look whether people feel that they are getting enough choice about food and portion sizes. The Manager should compile a log to record all complaints and concerns. The Manager should make sure everybody feels that their concerns and complaints are heard and appropriately dealt with. 6 OP16 7 OP16 8 OP19 The Registered Person needs to continue to improve the building. In particular new lighting is needed in the corridors, walls need to be painted and carpets need to be replaced. The building would look nicer if the dark woodwork throughout was replaced. 9 OP26 The Manager needs to make sure people always receive their own clothes back after they have been laundered. The Manager needs to make sure all the staff listen and respond to people’s needs. The Manager needs to make sure all the staff have good English language communication skills so that they can understand and support the people living at the home. Some staff need to have training to help them learn computer skills so that they can write and update records more easily. 10 OP27 11 OP27 12 OP30 Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Orione House DS0000017385.V364500.R01.S.doc Version 5.2 Page 31 - 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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