Inspection on 25/01/08 for Ormidale House

This inspection was carried out on 25th January 2008.

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ormidale House 24/01/07

Ormidale House 09/05/06

Ormidale House 13/12/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Ormidale House 41 Woodgreen Road Wednesbury West Midlands WS10 9QS Lead Inspector Mrs Mandy Beck 25 and 30 th th Unannounced Inspection January 2008 09:30 Ormidale House DS0000065596.V358616.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 Ormidale House DS0000065596.V358616.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. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ormidale House Address 41 Woodgreen Road Wednesbury West Midlands WS10 9QS 0121 556 0567 0121 556 0567 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) Chuhan Limited Brian Turney Care Home 11 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (2), Physical disability (4) of places Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The outstanding requirements from previous inspections are addressed within stated timescales as detailed in the action plan provided by Mrs Freeman, signed by her and dated 10th October 2005. 6th August 2007 Date of last inspection Brief Description of the Service: Ormidale House is a large detached house on the main road from Wednesbury to Walsall. It is on a dual carriageway, a few hundred yards from junction 9 of the M6 and there are a number of local shops and pubs located close by. There are parking facilities for a limited number of cars at the front of building. Bedrooms are located on the ground and 1st floor. It has two shared bedrooms. There is a bathroom on the ground floor and a shower room on the 1st floor. There is no lift available but a stair lift has been fitted. A smoke room is provided for service users separate to other facilities. Lounge and dining facilities are sited within one main area and the dining area has views of the rear of the property. To the side of the property there is an outbuilding, which is currently used as storage space. Access to the garden is limited for service users with mobility problems. The fees are not included in the Statement of Purpose or the Service User Guide. People are expected to pay for extra services such as taxi fares, hairdressing, non NHS chiropody, newspapers and magazines. They may also be expected to contribute to the cost of their annual holiday. Ormidale House DS0000065596.V358616.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 visit to the home. It took place over two days. In this report we have made judgements using the evidence made available to us. This included the Annual Quality Assurance Assessment (AQAA) completed by the manager (Mr Turney). The AQAA tells us how the home feel they have improved since their last inspection and the things they still need to do to make things better for the people who live there. We looked at some of care plans of two people who live there in some depth. This is our case tracking process and enables us to make decisions about whether the home is meetings the needs of the people who live there. We also spent time talking to some of the people who live at Ormidale, the staff who work there and the manager. We did this so we could find out their views of living and working in the home. We looked around the home to make sure it is still a homely place for people to live. We sent surveys to all of the people who live in the home, some of their relatives and some of the staff. We received a small number of replies and comments from the surveys have been included in this report. The inspector would like to thank all of the people who live at Ormidale and the staff for their hospitality during this inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes What the service does well: What has improved since the last inspection? The home has worked hard to meet the requirements from the last inspection. They have updated the Statement of Purpose and Service User Guide this means that new people thinking of using this service will have up to date Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 6 information about it. This will help them to make decisions about living in the home. Some of the staff have had training in nutrition and health eating. This means that they have a greater understanding of health eating and the importance of health promotion. The medication policy has been updated to include details of transporting medication and informing staff that medicines must not be double dispensed. For example dispensing medication from blister packs to other containers for people to take out with them. The manager has bought new training materials for staff to use. This includes the Protection of Vulnerable Adults, Moving and Handling and Food Hygiene. Staff have also had training in “promoting excellence in the care of older people”. Staff now have a greater understanding of the needs of older people living in the home. The roof of the home has been repaired. This was a major piece of work but means that now the rest of the home can be improved. Other improvements this year have included a re fitted bathroom, some bedrooms have been redecorated and new carpets and flooring have been provided. Recruitment of staff has taken place and over the last three months there has been a greater stability in the staff group. This will help provide the continuity of care that people living in the home need. What they could do better: The registered provider (Mrs Freeman) has undertaken some improvements in the home that have made Ormidale a more pleasant place to live for the people who are there. Mrs Freeman told us that the repairs to the roof were very costly and she is continuously trying to improve the home but she does have a budget with which to do this. There are plans to replace the windows throughout the home. This will need to be done as some windows do not close properly, other windows have large amounts of condensation on them that obscure the view and from the outside some of the window frames appear to be rotting. There are a number of people living in the home who are older and becoming more frail. The home must be able to satisfy itself it can meet the needs of these people in there entirety. They must take steps to ensure that people are assessed and where necessary alternate placements are arranged for people to reduce the risks of possible harm to them. Staff have received training in nutrition and healthy eating. The people that live in the home would benefit if some of this knowledge were put into practice when planning menu’s. We looked at the menus and found that there is little variety and this should be reviewed. For instance there are sandwiches on the Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 7 menu everyday for lunch with the same fillings on offer. One comment we received said “it would be nice to see the fresh fruit on the tables so they can easily access it if they wanted to, they say they offer brown bread but I’ve never seen any”. When we arrived to do the inspection there were only two members of staff on duty. Care staffing hours were raised as an issue during the last inspection. It is acknowledged that new staff have been recruited and there is more stability in the staff group. However the people who live in the home would benefit from greater numbers of staff on duty to enable them to have the assistance they need and to go out when they choose. At present care staff are once again completing the domestic chores in the home this also means that they have less time to spend with the people who live there. The home has purchased a new Quality Assurance System. It is not yet fully up and running. The manager is aware that this will need to be a focus of his time for the coming year so that he can assure himself that the service is being run in the best interests of the people who use it. 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. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 8 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 Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 9 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): 1,2,3 Quality in this outcome area is adequate. People who may choose to live in this home will have information upon which to make their decisions. They can feel confident their needs will be assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has updated the Statement of Purpose and Service User Guide since the last inspection. This means that the information about the home and the service it provides is now up to date. Prospective service users will have the information they need about the home to be able to make a decision about living there. We looked at the service user plans for two people living in the home. It was pleasing to see that they both have assessments that detailed their needs. The manager told us that they are currently updating all of the assessments for each service user. In addition to the homes own assessment a copy of the care manager assessment is also made available. The manager also told us that some of the service users have restrictions on their choices and freedom as part of their continuing care. When this is the case the decisions made by the multi disciplinary team are fully recorded in each persons file. The Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 10 information from each person’s assessment will form the basis for the person centred care planning. Some of the people who live at this home are over 65 whose needs are changing. The manager told us that he has concerns about some of the people currently living at the home being at risk. He has attempted to contact social workers to have people’s needs re assessed. He must make further attempts to action this in order to reduce the potential risks to service users. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 11 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): 6,7,9 Quality in this outcome area is adequate. People living in this home are involved in some day to day decision making but improvements could be made. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has their own individual service user plan. These plans are being updated to make them more person centred in their approach. Of the two plans we looked at one had been completed, the other was still in progress. The plans are clear and describe the care the service users need. There is evidence that service users have been involved in the planning of their own care. Some of the plans we saw had not been regularly updated or reviewed. For instance some of the care plans and risk assessments for one person had not been reviewed since June 2006. This was bought to the manager’s attention during the inspection. Despite some care plans not being reviewed staff were able to tell us about the care and attention each service user needs. The home needs to improve its Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 12 keyworker system at present only the manager and a senior carer provide this role. The home must develop ways to include other staff in this process. The manager told us that he meets with service users on at least a six monthly basis to discuss their care and their needs. This helps service users feel part of their care planning and enables them to make decisions about their care. None of the current service users make use of the local advocacy service. Staff do record some choices made by service users in daily notes but these are very basis and limited to phrases such as “didn’t want to sit in the lounge” and “didn’t want to join in activity today”. None of the service users currently manage their own finances completely the home keeps money for safe keeping on their behalf. Risk assessments are completed by the staff and form part two of the person centred plan “assessment of risk in my life”. The home records restrictions on freedom and choices and other risks to service users. They must make sure they keep all risk assessments up to date so that any changes in service users needs are recognised and addressed. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 13 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 adequate People in this home could be better supported by staff to build on their skills and develop their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the people living in the home are now over 65 and as such not all of them wish to pursue educational or occupational activities. The home does try to provide activity for the people who live there but this can prove difficult with the limited number of staff on duty at times. Other service users who are younger are encouraged to attend day centres and colleges. One person has an opportunity of employment once they have completed their current college course. We looked at the activity records for one person and we found only one recorded activity in a period of three months. The manager told us that this was not the case, the service user had been out of the home but staff had failed to record this. We recommended that staff be given further training on the importance of accurate record keeping. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 14 People living in the home do have limited opportunity to go out with staff and on their own, either shopping or to the local pub for a drink and meal on occasion. The home had also arranged a Halloween evening for service users, the manager reported that this had been a success and as such he was now in the process of planning more evening like it. Each year the home arranges an annual holiday for service users. The manager told us that some of the service users had said that they didn’t want to go on holiday this year. The holiday last year had proved to be very stressful because of the bad weather and cramped accommodation meant that there was little opportunity for enjoyment. The manager thought that this may have put some people off going this year. He also told us that staff were not keen to go because of their family commitments. We recommended that service users are consulted individually about their wishes and the home should make arrangements to take those people who wanted to go on holiday away for their break. People living in the home are encouraged to maintain their relationships with family and friends. Most of the people living in the home get along with each other; some of the service users still share a room. One person told us “I like my room and xxxx sleeps there, its nice”. We saw staff talking with service users throughout the inspection politely and in a friendly manner. Staff were seen to be knocking on doors and waiting for service users permission to enter. Not all of the service users are involved in the housekeeping tasks needed around the home. We recommended that those service users who are more independent should be encouraged to take part in more household chores such as doing their own cooking one or two days a week and their own laundry. The manager felt that this would be hard to do because many of the people living in the home have lived in old institutions and had become institutionalised over the years. Staff have undertaken training in nutrition and healthy eating with the local college. They now have a better understanding about the nutritional needs of the people they care for. Little has changed in the way menus and food is provided. The owner continues to buy food on the Internet that is delivered to the home on Mondays. This shop is supplemented by two visits to the shops for added extras during the week. Staff told us that some of the service users join them on these trips and they take the opportunity to eat lunch out and do some shopping. We saw an example of the four week planned menus. They show very little variety in choice. For example; evening meal one day is either sausage casserole and potatoes or bangers and mash and another day fish chips and peas or egg chips and peas. Daily food records of service users show that sandwiches are provided every day for lunch and staff are recording Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 15 that supper usually consists of crisps and a cup of tea. We received comments about the food in the home, “it would be nice to see fresh fruit available and the offer of brown bread every now and again”. “the staff have said they had training it would be nice to see some promotion of healthy eating going on for the residents”. These comments were discussed with the manager and the owner during the inspection. They said that they find it difficult to offer choice because service users don’t always tell them what they would like to eat. The manager told us that recently they had tried “special events” where staff had encouraged service users to try foods from different cultures such as Caribbean food. This had been a success with service users trying food they had never tasted before. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 16 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 adequate. People have access to health care within the home and the local community. The home is generally able to meet the needs of the people who live there but more attention needs to be paid to the changing needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Everyone who lives at the home has access to the health care they need. Service user plans show that people are seen by their doctors when they are ill and by other health care professionals when they need them. The manager must make sure that staff keep health care records up to date. For example we looked at two people’s care records there were gaps in recording for both of them. Both the waterlow risk assessment and nutritional screening assessment had not been completed for one person. This means that staff could potentially be unaware when a service user is at risk of becoming malnourished or developing pressure sores. As the population of Ormidale house grow older, healthcare needs change and these risk assessments will help staff identify risks it is important that they are completed and kept under regular review. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 17 Another service users moving and handling risk assessment had not been reviewed since 2006. This was especially concerning when we found this person’s needs had changed and in fact was now being cared for at night in a hospital bed with bed rails in place. The home had no bed rail risk assessment in use or a record of safety checks for the bedrails. This was immediately bought to the manager’s attention and an explanation given as to why this was necessary. It was pleasing to see that on the second day of this inspection new bedrail risk assessments had been sourced and were now in place. This will help to ensure that service users risk of entrapment and other injury from bedrails is minimised. Medication systems in the home are satisfactory. We saw a member of staff administer medication safely to service users. At present none of the service users administer their own medication. The manager has updated the medication policy so that staff are aware of the dangers of double dispensing. This means removing medication from the blister packs into another container so that medication can be removed from the home. The pharmacist that supplies medication to the home does a check of medicines on a six monthly basis. This check allows them to see if medicines are being managed safely on behalf of the people who live there. The manager told us that staff have had appropriate training in administration of medication, although a few of them are still waiting for their certificate of confirmation to come through. Training staff means that service users are protected from unsafe medication administration. At the present time the home does not complete their own medication audits. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 18 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 adequate There are systems in place to give people the opportunity to make their concerns known. Staff have received training in adult protection to give them a basic understanding of people’s rights. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is displayed in the entrance hall of the home. The manager told us that they have received no complaints during the last twelve months. There have been no concerns raised about the home with the CSCI. when we asked staff what they would do if people were unhappy they told us “try to sort the problem out and tell the manager”. People who answered our questionnaires told us that they knew how to make a complaint if the need arises. Since the last inspection the manager has bought DVD training in Adult Protection for staff to watch and understand. The DVD contains information about the different types of abuse people may experience. The manager must make sure that in addition to this training staff are also aware of the local authority guidance and of the people who will need to be contacted in the event an allegation or suspected abuse occurs. We looked at the care plan for one person and found that the home has worked well with the local adult protection team in providing a structured care plan for dealing with allegations. At present only a few of the people living in the home manage some aspects of their money. Such as paying for their trips and meals out. The home keeps Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 19 money on behalf of service users and we spot checked some of these to make sure that things were in order. We found that all the monies were correct, the home obtains receipts for all transactions and maintains records. The manager told us that he is about to change the system slightly with the addition of new numbered receipt books that will enable an audit of money a lot easier to do. Some of the people living at the home are under the appointeeship of the local authority and as such their money is regularly checked to make sure everything is in order. Other people have their money managed by their families, the manager said that they ask for money when they need it. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 20 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 adequate. People live in a home that needs a lot of repair work and maintenance to keep it safe for them. Work is progressing to make the home a pleasant place to live for people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection we said that the owner should consider reducing the number of shared rooms in the home. This has not been done the owner has decided not to do this. We spoke to one person who shares a room, they told us “I like my room and xxx shares with me, I like it”. We also said that the home would need to be upgraded to meet the changing needs of the people who live there. This will need to be given more consideration. The manager told us that he is concerned about some of the people living there because they are physically becoming more frail and need more assistance. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 21 There have been improvements to the home. Most recently the roof has been repaired. The owner told us that this had been an expensive job and as such the budget has to be reorganised for the coming year. She will consider replacing the windows, this will need to be done. We saw windows that didn’t close properly, others had condensation on them and from the outside it appears that window frame are rotting. Comments we received “there is a delay in getting things done, things can be left for weeks before they are repaired”, “the new owner has a lot to do before it can feel like a home for the residents but she is trying to get things done”. We saw the new refitted bathroom downstairs. It is bright and clean, there is also a bath chair to enable people to get in and out of the bath safely. One service user said “it is very nice”. The kitchen has been refitted with new units and work surfaces. This improves the cleanliness of the kitchen for food preparation. Service users have had new bedroom furniture to replace old worn wardrobes. This process is on going. During the inspection two bedrooms were being redecorated, there are plans to complete the redecoration of the remaining bedrooms within the year. The home provides a smoke room for those people who choose to smoke. When we looked in the room there was no working ventilation the room was thick with smoke. The carer on duty then turned on the extractor fan but this appeared to be insufficient in removing the amount of smoke in the room. On the second day of this inspection the room was much clearer, the manager explained that they had found another extractor hidden behind a cupboard and now it was working smoke extraction was much more effective. One person commented about the smoke room they said “it would be nice to see the staff be more proactive and do some health promotion about the dangers of smoking with the residents”. This comment was shared with the manager at the time of the inspection. We noticed a toilet was not in working order on the first floor, care staff told us it had been like it for a week. We noticed in some people’s bedrooms there was no hot water, some taps were loose and water was not draining from the hand basins. This was discussed with the manager, it was pleasing to see that on the second day of inspection the toilet and hot water problem had both been addressed. There was still a problem with loose taps and ineffective drainage. The owner told us that new taps had been purchased and they were waiting for them to be fitted. The plumber was also due to return to the home to look at the insufficient drainage of water from the hand basins. The laundry is clean but the floor will need attention to make sure that it is impermeable and this will also reduce the risk of cross infection. It was recommended that the manager obtain a copy of the Essential Steps guidance for infection control from the Department of Health. There are some infection control measure around the home such as the use of liquid soap and paper towels for hand washing. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 22 Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 23 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 Quality in this outcome area is adequate. People in the home can feel assured that new staff will be recruited safely and staff will have training. People could be better supported by greater numbers of staff on duty. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection we recommended that care staff have more training in care of the older person. The manager told us that this has now been done. Staff have had training at the local college and are now more aware of the needs of older people. Care staff have also completed training in National Vocational Qualifications. At present there are 5 of the current staff team with either an NVQ level 2 or NVQ level 3 in health and social care. The remaining staff have recently enrolled on the course. This means that all of the staff will shortly have the qualifications needed to care for the people living in the home. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 24 The manager also showed us DVD’s he has purchased to provide staff with training. There are gaps in training for staff but the training programme will deal with this. We looked at the recruitment files for two new workers and found that they home is continuing to employ new workers safely. We spoke to new workers during the inspection, they said they were enjoying their new role and that they were supported by the home. People living in the home said “the home is perfect and I like it here all the staff are very helpful” and “ I am happy enough with the staff”. Relatives told us “they could do with more staff on duty so people could go out more”. “the staff are very polite and try the best they can but it would be nice to see them help with more health promotion for the residents”. We observed that only two staff were on duty on the first day of this inspection. Two staff are not enough to meet the needs of all the people who live there all of the time. This was raised as an issue at the last inspection. When there are limited numbers of staff on duty the people living in the home have reduced choice and limitations on the things they can do. When we looked at the staff rotas we saw that staffing levels change between two and three care staff on a shift. The manager’s hours are also included in this number. Over a four-week period the manager has not had any shifts where he is able to devote time to the management and improvement of the home. The recently employed domestic worker is no longer working at the home in this role. Staff told us that they are now completing household tasks such as cleaning and laundry. It is recommended that the number of supernumery hours be increased to enable him to move this service forward for service users benefit and that more domestic assistance is sought so that care staff are free to care for the people who live there. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 25 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 adequate. People who live in this home are supported by a manager who wants to run the home in their best interests. People’s health and welfare is promoted by safe practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of Ormidale House is Brian Turney. Since the last inspection he has completed his National Vocational Qualification level 4. He has also worked hard to address the outstanding requirements from that inspection. The Annual Quality Assurance Assessment (AQAA) was completed on time by the manager and it gave us a reasonable picture of the service although there were areas where more supporting evidence would have been useful to show what the home has achieved in the past year. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 26 In order for the service the home provides to go forward, the number of supernumery hours Mr Turney has available to him should be increased. These extra hours will give him time to fully introduce the quality assurance system the home has purchased, to deliver staff training and to support staff. The quality assurance system has been purchased by the home. The manager showed us the folder which included audits for health and safety, the environment and care planning. As yet none of the audits have been completed but the manager is hopeful that they will be started in the near future. The home has taken steps to consult with the people who live there about the service they receive. Questionnaires were given to all of the people living in the home, they were helped to complete them by care staff. We discussed the problems with care staff assisting service users to do this. For instance, service users may not feel that they can state their true feelings as they may not wish to disclose this information to care staff. The manager was asked to consider the use of the advocacy service or other independent workers who may be able to assist service users in completing their questionnaires in the future. The home will also need to show how it is acting on any issues raised from the service users questionnaires. We spot checked the health and safety certificates and maintenance checks for the home. Generally they were all up to date and in order. We have asked that hot water temperatures be appropriately recorded and when an issue arises staff must record the action they have taken to rectify it. Staff do receive fire training however the manager must ensure that all staff do receive a fire drill and that he keeps records of this. This must also include night staff and agency workers. New training materials bought by the manager include moving and handling, and food hygiene. Other training is sourced from the local college; this included first aid and infection control. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 27 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 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 2 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 2 15 2 16 2 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 x 3 X 1 X X 2 x Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? yes 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 YA33 Regulation 18 Requirement The registered person must ensure that Care staffing hours provided per week are sufficient on each shift to take residents out. Housework must not be undertaken by care staff at the expense of resident need for community contact and activity. (previous timescales of 01/04/07 not met) The registered person must ensure that the current approach to food, eating and nourishment at the home is put under review and quality and choice is improved in the best interests of residents individually and collectively. (previous timescale of 01/04/07 part met) Peoples care plans and risk assessments must be reviewed regularly and changes in condition clearly recorded. Daily notes should be a reflection of the care that each person has received. DS0000065596.V358616.R01.S.doc Timescale for action 30/03/08 2 YA17 12 30/03/08 3 YA9 13(4) 30/03/08 Ormidale House Version 5.2 Page 29 4 YA42 13(4) Hot water temperatures must be kept under review and action must be taken promptly when there is a fall in temperature. The home must also address the inadequate drainage and water pressure in some of the service users bed rooms. Bed rail risk assessments must be reviewed regularly and reflect changes in the peoples wellbeing. The home must also record the maintenance checks on the bed rails to reduce the risk of injury to service users. 28/02/08 5 YA18 13(4) 01/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA1 YA6 Good Practice Recommendations The Statement of Purpose should include the range of fees that people will be expected to pay, should they choose to live at Ormidale House. Plans of care should reflect service users individual interests and outcomes must be monitored. More regular community access should be facilitated and evidenced in line with individual service users specific interests People who are capable of planning, preparing and cooking their own meals should be supported by the home to do so. The home should obtain a copy of the Department of Health publication “essential steps for infection control”. The manager’s supernumery hours should be increased to enable him to progress with the development of the service and the staff team. Staff should be encouraged to attend staff meetings so that they are aware of changes in policy and practice in the home. The manager should continue to develop the quality DS0000065596.V358616.R01.S.doc Version 5.2 Page 30 3 4 5 6 7 YA17 YA30 YA37 YA38 YA39 Ormidale House assurance system within the home. He must also be able to demonstrate service user involvement in this process. Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Ormidale House DS0000065596.V358616.R01.S.doc Version 5.2 Page 32 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!