Inspection on 07/07/05 for Ormonde

This inspection was carried out on 7th July 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Ormonde 05/06/06

Ormonde 28/02/06

Ormonde 08/03/05

Ormonde 11/10/04

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

CARE HOMES FOR OLDER PEOPLE Ormonde 12 Pinewood Road Branksome Park Poole BH13 6JS Lead Inspector Amanda Porter Announced 07 July 2005 14:00 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ormonde Address 12 Pinewood Road, Branksome Park, Poole, Dorset, BH13 6JS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01202 760838 01202 760838 The Avalon Nursing Home (Dorset) Limited Care Home with Nursing 24 Category(ies) of DE(E) - 24 registration, with number of places Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To accommodate nine residents, as known to the CSCI, under the age of 65 years. Date of last inspection 8 March 2005 Brief Description of the Service: Ormonde is registered with the Commission for Social Care Inspection to provide nursing care for a maximum of 24 service users over the age of 65 years with dementia. A condition of registration is that the home can also accommodate nine residents known to the Commission, under the age of 65 years of age. The home is owned by the Avalon Nursing Home (Dorset) Ltd and Mr A H Jaffer is the Responsible Individual. The home is situated in a residential area of Branksome Park. It is set back from the road in pleasant gardens. There is a small enclosed patio area accessible from the dining room. Accommodation is provided on the ground and first floor with access via a passenger lift. On the ground floor there is a lounge and a dining room. There are also seven bedrooms of which three are single, with two of those having ensuite facilities, and four doubles, with one having ensuite facilities. On the first floor there are seven single bedrooms, three of which have ensuite facilities and three doubles, two of which have ensuite facilities. The home has assisted bathing facilities on each floor. Some recreational activities are organised by members of staff. These include arts and crafts, gentle exercise and games. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was given twenty four hours notice prior to this inspection which took place on the afternoon of the 7th July 2005 over a period of four hours. The purpose of the inspection was to review the requirements and recommendations made in the last report and to assess key standards. The manager, Mrs Bartlett, and the Director Of Care, Mrs Payne, were on hand throughout to aid the inspection process. Mrs Bartlett and Mrs Payne had been recently recruited to these posts. Four residents and four members of staff were spoken with and asked their views on the services provided at Avalon. Service users said “I like the staff” and “The staff are very kind and work hard”. Staff spoken with said that they liked working at the home and spending time with the residents. Some documentation was reviewed, including care files, staff files, policies and procedures. A tour of the premises was undertaken. What the service does well: The medication at this home is managed well promoting good health. The catering is of a good standard and the food was very much enjoyed by the residents. The quality assurance system in place takes in to consideration the views of residents and their families to get a picture of what people think of the home and what they could do better. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at Ormonde. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: As a result of this inspection seven requirements and three recommendations have been made. Each resident must be provided with a statement of terms and conditions of residency so that they are aware of any legal commitment. A full assessment of needs must be undertaken prior to any resident being admitted to the home so that staff can assure the resident their needs can be met. Further work needs to be done to make sure care plans give details of how residents’ needs are to be met. Residents and their chosen representatives must be invited to participate in the drawing up and review of plans of care that affect them and their views must be considered. Staff should be provided with suitable training so they understand the home’s policy and procedure for responding to suspicion or evidence of abuse or neglect so that the risks of residents being exposed to harm are minimised. Although new furniture was provided for each bedroom it was noted that the wardrobes were free standing and were not stable and a requirement has been made to ensure they are made safe. The home needs to provide adequate seating in the shared bedrooms so that the occupants could sit and receive visitors there. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 7 Some areas of the home had a distinctly unpleasant odour. The manager confirmed that arrangements had been made to clean the house throughout. The recruitment process followed at Ormonde must be improved so that residents can be assured suitable staff are providing their care. All staff must have satisfactory Criminal Record Bureau and POVA (protection of vulnerable adults) First checks. 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. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, & 3. Standard 6 is not applicable as the home does not provide intermediate care. The home’s statement of purpose and service user guide are good, providing prospective residents with sufficient details of the services enabling an informed decision about admission to be made. Some of the residents are not made aware of the terms and conditions of living at the home because they are not all issued with written contracts. The assessment process, prior to admission, is insufficient and does not enable the home to thoroughly assess a persons needs or establish whether those needs can be met. EVIDENCE: The statement of purpose and service user guide have been recently updated with clear information about the services offered at Ormonde and details of the newly appointed manager. This was readily available to residents and visitors to the home. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 10 The manager confirmed that since her appointment she had reviewed residents’ files and found that many of them did not have any written contract/statement of terms and conditions of residency. Three care files were reviewed and two contained pre-admission assessments. These documents had not been completed. Past medical history, including psychiatric history and continence were not always considered during these assessments. The assessments did not contain sufficient information on which to base a care plan. It was not clear where the information had been gathered from and whether the prospective resident and/or their chosen representative had been approached to give their views. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 There is no clear or consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents’ medication needs are met. EVIDENCE: Three care files were reviewed and each contained care plans. These gave general rather than specific instructions to care staff as to how needs were to be met and did not truly reflect the care needed by each individual. There was no evidence that either the resident or their chosen representative had been invited to give their views about the plan of care. The home has a well-written and informative medicines policy and procedure including reference to self-administration and associated risk assessment and arrangements for ordering, administration and disposal. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 12 Medicines were stored in a locked trolley. A lockable box is available for use in a refrigerator when particular medicines require cold storage. Records were kept of the receipt, administration and disposal of medicines. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 15. The social and recreational needs of the service users are not wholly satisfied, which results in some service users being bored and under stimulated. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: Each afternoon one member of the care staff was allocated to organise a group activity. On the day of inspection this was crafts and four residents elected to make greetings cards, which they enjoyed. Generally residents said that they were very appreciative of the efforts of staff. However the activities were not based on the assessed needs of individuals. For those service users who did not wish to take part in the organised activities no plan was evident for how their social needs were to be met. Residents said they enjoyed the food provided and the menu provided choice. Some residents chose to eat their main meals in the dining room and some in their rooms. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 14 The chef caters for the residents of Ormonde and the care home next door, Avalon. Usually the kitchen at Avalon is used to prepare all main meals but at the time of inspection that area was being refurbished and the Ormonde kitchen was being used. The area was clean, well equipped and well organised. The chef had a good knowledge of the dietary preferences of the residents. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18. The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to or acted upon. Adult protection training is not adequate to ensure that staff members are aware of issues of abuse. EVIDENCE: Residents spoken with said that they had no complaints to make but felt that if they did they would be happy to speak with staff about their concerns. Since the last inspection the complaints procedure has been reviewed and now clearly states how complaints would be dealt with, by whom and timescales were given. Since the last inspection the Commission for Social Care Inspection had received one complaint about the home, which was partially upheld. Elements of the complaint that were upheld related to the environment, cleanliness and laundry. The home had a policy and procedure to respond to suspicion or evidence of abuse or neglect. However some staff spoken with were not aware of the lead agency if an allegation of abuse was made in the home and it was evident that no recent training had been given. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 21, 22, 24 & 26. Ormonde has suitable and sufficient washing and toilet facilities to meet the needs of the service users accommodated in the home. Recent investment has significantly improved the appearance of this home creating a reasonably comfortable although not wholly safe environment for those living there. The presence of unpleasant odours in some parts of the home does not create a pleasing and pleasant environment. EVIDENCE: Since the last inspection the home has undergone a programme of refurbishment. Alterations mean that those residents using wheelchairs now have easier access to toilets and bathrooms. The provision of grab rails has also improved safety within the toilets. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 17 New bedroom furniture has been provided throughout the home. However it was noticed during the inspection that wardrobes were not stable or fixed to the wall, which was a risk to residents. It was also noted that in some of the double rooms there was little or no room for comfortable seating for the two people using the room and there was no seating for visitors. Touring the premises it was evident that some areas smelt very unpleasant. The manager confirmed that arrangements had been made for the home to be thoroughly cleaned. At the time of inspection new laundry facilities were being installed at Avalon for the use of Ormonde, which would improve the laundry service. This needs to be fully assessed at the next inspection. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 & 30 Major shortfalls in the recruitment procedure do not protect residents from risk. Some staff have not had sufficient training in caring for people with dementia to be fully competent to do their jobs properly or to ensure that residents are in staff hands at all times. EVIDENCE: Standard 28 was not assessed during this inspection and the recommendation made in the last report for a minimum of 50 of care staff to have the NVQ level 2 award, or equivalent, has been brought forward to this report. Staff recruitment files were not reviewed on this occasion. However the manager had recently audited these files and found that many did not contain evidence that a recent check through the Criminal Records Bureau and POVA (protection of vulnerable adults) first had not been undertaken, therefore subjecting residents to the risk that unsuitable staff could be employed. Training records showed that staff received induction and foundation training to National Training Organisation workforce training targets and staff spoken with confirmed this. The manager confirmed that specific training in caring for people with dementia was due to commence and a number of staff had enrolled on the “Positive Dementia Care” course run by a local college. The effectiveness of this training will be assessed at the next inspection. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 &38 The home regularly reviews aspects of its performance through a programme of self-review and consultations, which include seeking the views of residents and relatives. The health and safety of the residents and staff are generally protected by the policies and procedures followed at Ormonde. EVIDENCE: Ormonde had sought feedback about the home from service users and their families. This feedback had helped the management team develop an annual development plan, which the home is working to. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 20 Records showed that all staff had received recent training in fire safety, food hygiene, infection control and manual handling. Staff spoken with confirmed this. Substances hazardous to health were seen to be stored securely. Records showed that all nursing equipment had been serviced regularly. The fire safety records seen were complete and up to date. Some aspects of the safety of furniture have been highlighted under Standard 24. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 1 1 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x 3 3 x 1 x 1 STAFFING Standard No Score 27 x 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 3 x x x x 3 Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 22 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 OP2 Regulation OP5 Requirement The registered person must ensure that each resident is provided with a written contract/statement of terms and conditions with the home. The registered person must ensure that residents admitted to the home only do so after a thorough assessment of his/her needs is undertaken and assurance given that these needs will be met. The plan of care for each resident must be drawn up with the involvement of the resident and/or their chosen representative unless it is impracticable to carry out such consultation. Each care plan must set out in detail the care required to ensure that assessed needs in respect of the residents health and welfare are to be met. Wardrobes must be made secure so that they cannot fall forward. Suitable seating for residents must be made available in double rooms. All areas of the home must be kept clean and free from Timescale for action 07/10/05 2. OP3 14(1) 07/10/05 3. OP7 15(1) 07/10/05 4. OP7 15(1) 07/10/05 5. 6. 7. Ormonde OP24 OP24 OP26 16(2) 16(2) 13(3) 07/10/05 07/10/05 07/10/05 Page 23 D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 unpleasant odours. 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. 3. Refer to Standard OP18 OP28 OP30 Good Practice Recommendations Staff should receive training in the procedures for responding to suspicion or evidence of abuse or neglect. A minimum ratio of 50 care staff should have the NVQ level 2 award in care, or equivalent. All care staff should have an understanding of caring for people with dementia. Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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. Extracts may not be used or reproduced without the express permission of CSCI Ormonde D55 S20506 Ormonde V229021 070705 Stage 4.doc Version 1.30 Page 25 - 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. 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