Inspection on 03/04/07 for Orla House Care Home

This inspection was carried out on 3rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Orla House Care Home 08/05/06

Orla House Care Home 16/02/06

Orla House Care Home 16/09/05

Orla House Care Home 16/11/04

Orla House Care Home 19/04/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Orla House Care Home 317 Mapperley Plains Mapperley Nottingham NG3 5RG Lead Inspector Rob Cooper Key Unannounced Inspection 3rd April 2007 10:30 Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 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 Orla House Care Home DS0000008730.V334850.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 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. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orla House Care Home Address 317 Mapperley Plains Mapperley Nottingham NG3 5RG 0115 920 3754 0115 9267325 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) Mr J & Mrs M Dobbin & Mr S & Ms S Dobbin Miss Sinead Maire Aine Dobbin Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th May 2006 Brief Description of the Service: Orla House is a care home registered to provide support and accommodation for up to thirteen adults with a learning disability. The home is a large detached property on Mapperley Plains, down the road from Mapperley and all its amenities. The communal space in the home is very comfortable and homely. As well as a separate lounge and dining room there is also a very pleasant smaller quiet room where residents can meet their family and friends in private. There are well kept gardens both to the front and rear of the property. There is some parking to the front of the house and an attractive garden to the rear, which residents have access to. There is a small supermarket close by and the home has its own vehicle. Fees: £368 – 835.25 Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection – so that no one at Orla House knew that the inspection was going to take place. The inspection took approximately four hours through the middle of the day, with one inspector present. The method used to carry out the inspection was to send out a questionnaire, which asked questions about the service, to gather statistics, such as how many service users there are, the numbers of staff etc. This was followed with a visit to Orla House, where a method called case tracking was used; this involved identifying three residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of Orla House, looking at the activities on offer, and talking to staff and one resident. The people living at Orla House have a learning disability, and this can make communication difficult. As a result the resident who was spoken with was unable to answer any questions, although they appeared well cared for and relaxed and comfortable with the staff who were present. The Registered manager – Sinead Dobbin was present throughout the inspection and supplied much of the information provided for the inspection. What the service does well: What has improved since the last inspection? At the last inspection three requirements were set, relating to Criminal Records Bureau checks, NVQ training and implementing a quality assurance system. All three requirements have been met. In addition the one recommendation relating to contacting the Environmental Health Officer has also been met. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 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 Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Prospective residents at Orla House have the information they need to make an informed choice about where to live. Prospective residents at Orla House have their individual aspirations and needs assessed. EVIDENCE: The Service User Guide and the Statement of Purpose were both seen. Both documents contain all of the information that Care Homes Regulations say that they should. Three service user’s files were seen as part of the case tracking process. One file contained an Extended Community Care Assessment completed by the service user’s social worker; a second had an Extended Community Care Assessment also completed by a social worker, while the third contained an inhouse assessment. The information contained within the assessments was found to be the basis on which further assessment work and the service user’s plan had been developed. All three files contained evidence of further assessments by health care professionals. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 67&9 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents know their assessed and changing needs and personal goals are reflected in their individual plan of care at Orla House. Residents at Orla House make decisions about their lives with assistance if needed. Residents at Orla House are supported to take risks as part of an independent lifestyle. EVIDENCE: Each of the three files seen as part of the case tracking process contained a clear individual plan of care. The plan was in a logical format, with resident’s needs identified and evidence of reviews of the plans responding to changes. Within resident’s files likes and dislikes were well documented. The communication difficulties that many of the residents have means that they are unlikely to express their preferences in words, but rather through their actions: ‘voting with their feet’ is how the manager described it. In effect residents will through their behaviour, their mannerisms, and other non-verbal communication methods make their views and opinions known. Each of the Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 10 three files contained information about resident’s communication difficulties, and ways in which they make their views known. The resident’s files contained risk assessments, which identified risks in the resident’s lives, these were contained in ‘Maintain a safe environment’ part of the file, and contained action plans which were developed from the risk assessments. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 & 17 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents are able to take part in age, peer and culturally appropriate activities. Residents at Orla House are part of the local community. Residents at Orla House have appropriate personal, family and sexual relationships. Resident’s rights are respected and responsibilities recognised in their daily lives. Residents are offered a healthy diet, and enjoy their meals and mealtimes. EVIDENCE: At the start of the inspection there were no residents in Orla House, as they were all out at various daytime activity. Orla House is well equipped with activities and karaoke evenings are very popular. An activities diary is kept which evidenced all of the different activities residents are engaged in. Next week a small group are going to Llandudno for a short break (Monday to Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 12 Friday) and there is a strong emphasis on getting out and ‘doing things’ for the residents. The resident’s files and the activities diary show that resident’s are involved in the local community, using local shops and services, and attending a local church. There was also evidence of residents attending local social groups, and using local pubs and restaurants. The three case files seen as part of the case tracking process all had ‘Expressing Sexuality’ care plans which detailed the residents sexual awareness and any specific issues or information relating to their sexuality. Orla House strives to be a family home for it’s residents, and as such family members are always welcome. Each of the resident’s files contained information about family contact, and there was evidence that the staff at Orla House had gone to some lengths to make contact with the Godmother of one resident who has no immediate family. The residents at Orla House have learning disabilities, and as a result no expectations are put on to them to undertake any specific roles within the house – for example cleaning, cooking etc. However a number of residents choose to involve themselves in laying the table, and other simple domestic tasks around the house. There is an open kitchen and residents are able to make themselves drinks and snacks if they so wish. Orla House has a comfortable dining kitchen, with a separate large dining room next to it. Residents choose to eat their breakfast at the table in the kitchen, as this is a more comfortable and social area. Dinner is usually taken in the dining room, which is a large and comfortable room, with plenty of space for all of the residents. The kitchen is well equipped, and there was evidence that the food provided is of a good quality and variety. Records relating to food storage, and preparation were seen, and all found to be correct. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 & 20 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Orla House receive personal support in the way that they prefer. Resident’s physical and emotional health needs are met at Orla House. Residents are protected by Orla House’s policies and procedures for dealing with medication. EVIDENCE: Each of the three files that were seen identified individual preferences, and the methods by which the residents communicate those preferences. Orla House are able to offer residents a choice between a bath and a shower, and staff were aware of which usually residents would prefer. The case tracking of the resident’s files showed that healthcare was well documented, and good records were kept, to keep abreast of any healthcare issues. Visits to the GP and hospital appointments were recorded, and there was evidence that staff were aware of specific health related matters for individuals. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 14 Boots the chemists supplies the resident’s medication at Orla House. They use a monitored dosage system (each resident having their medication dispensed into a blister pack on a series of cards), which makes dispensing the medication easier. The documentation relating to medication administration were seen, and there were no obvious errors or omissions. Boots carried out an audit of the medication on 19th March, and everything was found to be correct. They will also be returning on 2nd July 2007 to carry out staff training in medication procedures. Storage was secure, and there were clear records for medication coming in and out of the building. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Orla House feel their views are listened to and acted upon. Residents are protected from abuse, neglect and self-harm. EVIDENCE: Most of the residents at Orla House have communication difficulties which make it difficult to gain their views formally. In many cases residents will show their pleasure or displeasure through non-verbal communication methods. However Orla House has found advocates for some of the residents, and families are encouraged to express their views. Since the last inspection there have been no complaints, and the feedback from seven relatives through the quality assurance system was all very positive. The complaints procedure is displayed within Orla House, and forms part of the Service User Guide. Three members of staff were asked about safeguarding adults, and issues relating to abuse. All three said they had received formal training in safeguarding adults (the training records showed that ten staff attended a course on 12th February 2007), and were able to answer questions about the procedure, which showed they had an understanding and knowledge of the issues involved. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is excellent; this judgement has been made using available evidence including a visit to this service. Residents at Orla House live in a safe, homely and comfortable environment, which is clean and hygienic. EVIDENCE: Orla House is a very comfortable home, with plenty of communal space. The garden is private and attractively landscaped with patio sitting areas, lawn and flowerbeds. A number of bedrooms were seen, and these were decorated and personalised by residents to their own taste and requirements. One bedroom is shared, although the two residents, who are sharing, have done so for many years, and it is their wish to share a bedroom. The whole building is furnished and decorated to a high standard, and the impression is that this is ‘home’ to the people who live there. During the inspection Orla House was found to be clean and fresh, with cleaning routines in place, and being implemented by the staff. At the last inspection a recommendation was made with regard to obtaining written Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 17 confirmation from the environmental health officer regarding control of cross infection in the bathroom/toilet in relation of most appropriate facilities/equipment to use when drying hands. This has been done, and the letter from the environment health officer was seen, in which it is stated that they are happy with the current arrangements at Orla House in respect of hand drying. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 & 36 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Competent and qualified staff support the residents. Resident’s rights are supported and protected by Orla House’s recruitment policies and procedures. Residents at Orla House have their individual and joint needs met by appropriately trained staff. Resident’s at Orla House benefit from well supported and supervised staff. EVIDENCE: A review of the staffing rota showed that there was enough staff on duty to meet the resident’s needs, and that there was a structure through the team, which helped decision-making and directed the efforts of the staff. Discussions with three staff members evidenced that they all thought there were enough staff to meet the resident’s needs, and that their team was well organised and managed. Three staff files were seen, and they all contained evidence that all of the necessary pre-employment checks to ensure resident’s safety had been carried out (two written references, criminal records bureau checks and written Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 19 application forms for example). Each of the three members of staff who was spoken with said that they had been through a formal interview process, and had undergone pre-employment checks. A requirement set at the last inspection relating to Criminal Records Bureau checks was found to have been met. A review of the staff training records showed that there is an ongoing programme of staff training, which also covers the mandatory training courses. Discussions with three members of staff showed that they thought they were well trained, and had access to all of the relevant training courses. The staff files contained information relating to formal supervision, and showed that staff have a regular formal supervision session with a senior member of staff. Discussions with three members of staff confirmed that there is regular staff meeting, and all of the staff members said that they felt very well supported within the team. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 & 42 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Orla House benefit from a well run home. Residents are confident their views underpin all self-monitoring, review and development by Orla House. The health, safety and welfare of residents and staff at Orla House are promoted and protected. EVIDENCE: Orla House has a Registered manager who has been in post for since 1997. Evidence seen in staff files and training records together with a discussion with the manager indicated that she is suitably qualified and experienced to fulfil the role of Registered manager. As already identified elsewhere within this report most of the residents at Orla House have communication difficulties, which make it difficult to gain their views through verbal communication. Great store is put into the fact that the Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 21 residents are relaxed, happy and that their behaviour, and non-verbal communication suggests that Orla House is being run to their liking. In addition there is a quality assurance system in place, which relies on questionnaires being completed by relatives, who are able to comment on issues, which affect the resident’s welfare. A number of questionnaires were seen, and these reflected positively on the way that Orla House is run. A requirement set at the last inspection in relation to quality assurance was found to have been met. A range of health & safety records were seen during the inspection including fire records, Control of Substances Hazardous to Health (COSHH), water temperature testing and Legionella water testing, and these were all found to be in order – all checks and tests had been carried out and recorded in an appropriate manner, and records showed that the fire alarm system and fire extinguishers had been maintained appropriately. Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Orla House Care Home DS0000008730.V334850.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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