Inspection on 08/05/06 for Orla House Care Home

This inspection was carried out on 8th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Orla House Care Home 03/04/07

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 Orla House 317 Mapperley Plains Mapperley Nottingham NG3 5RG Lead Inspector Rehana Rashid Key Unannounced Inspection 8th May 2006 10:50 Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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.V293701.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 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.V293701.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Orla House Care Home Address Orla House 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.V293701.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 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. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector and took place over five hours on 8th May 2006. This was the homes first inspection for this financial/inspection year. The main method of inspection was case tracking, which involved randomly selecting three residents and examining care records for these individuals. The method of case tracking is adopted to establish if the needs of the residents are being catered for. As part of the inspection methodology indirect and direct observation of interaction between staff and residents was also carried out. The inspector had part tour of the premises, which included viewing 2 shower rooms, 1 bathroom, dining area, kitchen, and 4 bedrooms. The provider showed the inspector around. During the course of the inspection the residents were all out to day care. Towards the end of the inspection the residents were returning to the home and one resident was spoken with. The feedback from the resident was positive regarding the level of care received and the care staff. As the Registered Manager was on annual leave on the day of the inspection the registered provider assisted in the inspection process together with the staff on duty. The provider and staff members were helpful and pleasant to the inspector throughout the inspection. The focus of the inspection was to concentrate on the key standards, which were assessed under the new methodology of Inspecting for Better Lives (IBL). Requirements and recommendations made at the previous inspection were also explored with the registered provider. What the service does well: Orla House provides its residents with a clean well-maintained environment, which is free from mal-odour. It is homely, decorated and furnished to a good standard. One resident spoken with expressed satisfaction with the service provided by the home and stated the meals are good, staff are helpful and that visitors to the home are welcomed. A warm and welcoming environment is evident at the home. The building and the gardens are generally well maintained. Staff are clearly aware of the residents needs and are competent in their jobs. Members of staff spoken with stated the manager provides good support and training opportunities. Towards the end of the inspection residents were returning to the home from day care, interaction between staff and residents was observed. Staff were interacting with residents in a respectful manner, the atmosphere was relaxed. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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.V293701.R01.S.doc Version 5.1 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): 2 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to this service. Prospective residents individual aspirations and needs are assessed prior to moving to the home. EVIDENCE: There has been no new admission to the home for sometime. One of the case files viewed confirmed prior to the commencement of a placement, the home liaises with the placing local authority and obtain the residents comprehensive community care assessment. This process ensures the home are able to meet the individuals identified needs. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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): 6,7,9 Quality in this outcome area is good this judgement has been made using available evidence including a visit to this service. Individual care plans reflect resident’s needs and how needs will be met. Staff encourage residents to make own decisions about their lives with assistance as needed and to take acceptable risks as part of promoting independence. EVIDENCE: Three care plans were randomly selected and inspected. The files were well organised and information was easily accessible. These records contained contact details including next of kin details and resident photographs. The care plans covered assessments of health, personal care and social activities. This information was useful and detailed providing information on resident’s individual needs and preferences. As part of the residents care plans risk assessments are incorporated. There was evidence on two of the care plans viewed that they had been reviewed following requirement set at the last inspection. This information was clearly documented at the front of the care plan. Each area that was reviewed clearly indicated if there had been a change, where there had been a change this was highlighted in the care plan. The third care plan was reported by the registered provider to be reviewed Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 10 sometime in May 2006. Daily communication records were fully complete containing details of significant events and all entries were signed and dated by the author. During the inspection the residents were out, later on in the afternoon residents were observed returning from day care. At this stage Staff were observed interacting with residents in a respectful manner, allowing residents to make their own decisions. For instance a staff member asked a resident who agreed to speak with the inspector whether he wanted the member of staff to be present or not. The resident was able to make his own decision and informed the staff member he would be fine speaking with the inspector. Some residents were observed to go into the kitchen for a hot drink and there appeared to be no restrictions on residents they came in and out of the kitchen as they pleased. One resident spoken with confirmed he was supported to make decisions for himself and was supported by the staff team. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. The Residents are given opportunities for personal development and are able to participate in appropriate activities. Residents at Orla House are encouraged to maintain appropriate relationships with family and friends. The home is committed to respecting resident’s rights. Residents are provided with a healthy and varied diet. EVIDENCE: For the majority of the inspection residents were all at day centres. They started to arrive back towards the end of the inspection. One resident was spoken with who is a keen football supporter; he stated he has been able to go to football games with his family. He also advised that he enjoys attending day care. He stated the home have adequate social activities including board games, a DVD player, karaoke machine. There is a social activities book, which contains details of events taken place, which include details of activities, which have been organised outside the home. For instance residents are taken out to the local pub. On the day of the inspection the residents and staff were arranging a birthday tea for the evening, as it was one of the residents Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 12 birthday. The home has a minibus, which is used when residents are taken out. Staff were observed speaking with residents in a respectful manner, they were asking residents about their day. One resident spoken with confirmed staff treated the residents with respect. He stated staff knock on his door before they enter. The menu was seen which is four weekly, this shows that the residents are offered healthy balanced meals. A resident spoken with stated the food was very good. The menu book was viewed which contains details of the meal provided on the day and those residents who have had an alternative meal is documented together with the residents name. One member of staff confirmed residents tend to have an alternative on the day when they have a meal from the local fish and chip shop. The food preparation area was observed to be clean as well as the food storage area. The fridge and freezer temperature are taken regular and are recorded on sheets attached to the side of the fridge/freezer. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to this service. Personal support is provided in the way that is preferred and required. Resident’s health and emotional care needs are met at Orla House. The arrangements for the administration, storage and recording of medicines in the home is appropriate, ensuring residents safety. EVIDENCE: During the inspection process the resident spoken with was able to confirm that he preferred to have a shower and there was no restrictions as to how often he has a shower. Care plans included details of individual preferences, which were documented well. There was evidence in the files, which confirmed residents receive input from health care professionals including the dentist and chiropodist as and when required. Visits to the GP are clearly recorded in the communication sheets. The process for the administration and storage of medication in the home was inspected. The medication was stored appropriately and in a locked cupboard. A monitored dosage system is used for the administration of the majority of medication. Medication Administration Record Sheets were seen and were found to be correct. Photographs of all residents who are prescribed medication are attached on the inside of the cupboard door with the residents Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 14 name, date of birth and any known allergies. Temperature for the cupboard is taken daily and recorded on a sheet attached on the inside of the cupboard door. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to this service. Residents feel their views are listened to and acted upon. Residents are protected from abuse, neglect and self-harm. EVIDENCE: The complaints procedure was displayed on the notice board. One resident was asked about the complaints procedure, which stated he was able to raise anything with the staff and was confident he would be listened to. Two members of staff were spoken with and they were able to describe the protection of vulnerable adults procedure. One member of staff confirmed she is currently undertaking the NVQ course and one of the modules relates to the protection of vulnerable adults. There was evidence in the staff files, which indicated some staff had received training in the area of adult protection. The home has a copy of the Nottinghamshire Committee for Protection of Vulnerable Adults policy and procedure. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment. Orla House is clean and hygienic. EVIDENCE: Orla House offers its residents a clean and well-maintained environment. The atmosphere in the home is welcoming and homely. During the partial tour of the premises it was evident that the home was clean and free from offensive odours. The home has a laundry room, which is outside and has industrial driers and washing machines with sluicing facilities. The home has a stair lift fitted. The dining room is spacious and well decorated and contains a piano. The kitchen has a homely feel to it with a large dining table located in the centre. There is a separate lounge which contains a television, video and DVD player and there is a quieter room available should resident want to meet with their relatives and friends. Four bedrooms were viewed these were personalised to meet individual needs. The standard of cleanliness in the rooms viewed was good. During the tour of the premises it was observed paper towels are not used in the home to dry hands. In the bath/shower room’s towels are being used to Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 17 dry hands. This was discussed on the day of the inspection with the registered provider regarding prevention of cross infection. She explained the environmental health officer had advised them it was fine to use towels. The registered provider stated they had no written confirmation from the Environmental health officer advising them of this. The home is advised to obtain written confirmation from the environmental health officer regarding this issue. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is poor this judgement has been made using available evidence including a visit to this service. Residents are supported by competent and qualified staff. Improvements are continued to be required in the homes recruitment process ensuring that residents are protected. Staff are given training opportunities. EVIDENCE: The staff rota was viewed, which was found to be an actual record of who was on duty on the day of the inspection. Three staff files were examined at the time of the inspection, one of the files contained photographic identification. The homes recruitment practices and polices need to improve ensuring residents are protected. Two of the files contained satisfactory CRB disclosures. Under no circumstances must a new member of staff commence employment until at least the return of a POVA First check and then they must be appropriately inducted and supervised until the return of a satisfactory CRB. One staff member has been working in the home without a CRB disclosure from the UK or POVA first check. A requirement was set and the registered provider has agreed the member of staff will not have unsupervised access to the residents. Two references were on two of the files viewed. Two staff members spoken with knew the needs of the residents clearly and appeared to be competent in their roles. Certificates were seen on staff files, which confirmed they are in receipt of appropriate training. One staff file viewed contained a certificate in Adult Abuse and in another file there was evidence to indicate the member of staff had received training in violence and Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 19 aggression. The staff training and development contained a list of staff member who attended the moving and handling course during February 2006. The Registered Provider confirmed staff are still in the process of completing NVQ 2. She also stated the home have taken the decision staff will not undertake the Learning Disability Award Framework (LDAF) as they are undertaking NVQ training. The provider stated there had been a delay in staff completing the NVQ’s as the assessor has had other commitments. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate this judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home. A quality assurance system to be implemented to ensuring views are obtained from residents and residents. This will enable the home to review and develop the service. The health, safety and welfare of residents are promoted and protected through regular health and safety checks. EVIDENCE: On the day of the inspection the registered manager was on annual leave. The home continued to operate at an acceptable level and the two seniors’ assisted with the inspection had an understanding of the functioning of the home. At the last inspection a requirement was set to ensure the home implement a quality assurance system obtaining views for instance from residents and relatives, to develop the service provided. However this requirement remains outstanding. No evidence was viewed to confirm how the home is progressing with setting up this system Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 21 The inspector viewed a range of records relating to health and safety. The provider was able to locate the majority of the health and safety documentation, however some information she was unable to locate as the registered manager organizes the filing system. During the inspection the Employers Liability Insurance Certificate was viewed which was displayed on the notice board together with the certificate of registration. Fire system testing including door closure tests, emergency lighting, means of escapes takes places monthly as logged in the fire book. Fire alarm is tested weekly. The inspector viewed PAT-testing records, which confirmed this, took place December 2005and is due for re-testing again December 2006. Gas servicing is due July 2006. 2006, which was recorded in the homes diary. The provider was unable to locate the stair lift service certificate. The oxford mermaid bath was serviced January 2006 as it is serviced six monthly next services is due July 2006. No documentary evidence was seen to confirm whether or not electrical systems have been tested as the provider was unable to locate this information. Water outlets temperature is recorded monthly. Records were seen which confirmed freezers are taken on a daily basis. temperatures of refrigerators and A written risk assessment has been devised by the home to focus on legionella prevention measures, the registered provider this was devised with input with the environmental health officer and a plumber. No evidence was viewed to confirm this consultation. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 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 X 2 2 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 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 1 X X 2 X Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 23 Yes 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. 1. Standard YA34 Regulation 19 Requirement Ensure that all staff are not employed at the home until the return of a satisfactory CRB disclosure, and that if staff commence employment before the return of a CRB then this is only on return of a POVA First check, and that the new member of staff is supervised by an appropriately skilled and experienced staff member. Ensure that staff are suitably qualified. This refers to continuing staff with their NVQ training. Implement quality assurance system that includes seeking the views of residents and their representatives. Outstanding from last inspection. Timescale for action 08/05/06 2. YA32 18 31/08/06 3. YA39 24 30/06/06 Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 24 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 YA30 Good Practice Recommendations Obtain written confirmation from the health and safety officer regarding control of cross infection in the bathroom/toilet in relation of most appropriate facilities/equipment to use when drying hands. Orla House Care Home DS0000008730.V293701.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 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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