Inspection on 16/05/08 for Ormonde Home For The Elderly

This inspection was carried out on 16th May 2008.

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

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

Other inspections for this house

Ormonde Home For The Elderly 21/05/07

Ormonde Home For The Elderly 15/12/05

Ormonde Home For The Elderly 29/09/05

Ormonde Home For The Elderly 27/01/05

Ormonde Home For The Elderly 16/09/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Ormonde Home For The Elderly 44 Westerfield Road Ipswich Suffolk IP4 2UT Lead Inspector Mrs Jan Sheppard Unannounced Inspection 16th May 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ormonde Home For The Elderly Address 44 Westerfield Road Ipswich Suffolk IP4 2UT 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) 01473 215073 01473 253969 ormonde.manager@virgin.net Ormonde Home for the Elderly Lois Hughes Care Home 14 new in post not yet registered. Category(ies) of Old age, not falling within any other category registration, with number (14) of places Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st May 2007 Brief Description of the Service: Ormonde Home for the elderly was first registered in 1978. The home is owned and administered by The Brethren, a Christian charitable non-profit making trust. The building is a large converted Victorian detached house, which overlooks Christchurch Park in Ipswich. The home is reasonably close to the town centre. There are twelve single bedrooms and one shared bedroom, with all rooms having en suite facilities. People have the use of a lounge, dinning room and a conservatory. The bedrooms are located on the ground and first floors; the home is equipped with a shaft lift. There is limited parking to the front of the property, with on road parking nearby. The large garden to the back of the property is attractive and enjoyed by the people living in the home. A statement of purpose, colour photographic brochure and a service user guide provide detailed information about the home, the services provided contractual arrangement and the level of fees. The current fees range from £350 to £550 per week with an additional care supplement for those with higher assessed needs. These charges do not cover additional services such as hairdressing, chiropody personal items such as toiletries, receipt of daily newspapers and personal transport. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3*. This means the people who use the service experience excellent quality outcomes. This unannounced inspection took place over 9 hours during a weekday. This was a key inspection that focused on the key standards of the Care Standards Act 2000 relating to Older People. In depth discussions were held with the Manager who was present throughout the day to assist with the inspection. Discussions were also had with one of the Homes Trustees who visited during the inspection. The detail in this report reflects the findings made at that time and also takes account of information sent periodically to the Commission by the homes management. Information contained in the AQAA,( Annual Quality Assurance Assessment), and in a number of pre inspection surveys sent to residents, relatives, staff and other professionals was also taken into consideration. During the inspection a number of residents’ and staff files were seen, a tour of the home was made and various policies and maintenance records were looked at. Part of a medication administration round was observed and spot checks were made on some medication administration records. A number of staff and visitors and all of the residents were spoken with about the care given in the home. Care practice throughout the day and the serving of lunch and the evening meal were observed. The inspection findings were positive. Although the inspection was completed by just one inspector the wording used in the report will refer to “we” as the report is written on behalf of the Commission. What the service does well: The home provides good quality personal and health care which meets the individually assessed needs of the residents and which is delivered by trained and experienced carers . Residents confirmed that being a Christian home their spiritual needs were also taken into consideration and are well met. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 6 Ormonde House is a fully adapted well maintained and very well appointed home which provides a comfortable homely and safe environment for its service users. The homes lives up to the claim made in its brochure that “Ormonde House aim is to provide a homely atmosphere which is in keeping with the individuals manner of life in the days when they were able to care for themselves in their own homes.” Staff were observed treating people living in the home with warmth, respect and dignity and the interactions between individuals and staff were observed to be friendly and appropriate . What has improved since the last inspection? Since the last inspection a new Manager as been appointed she commenced her duties in February 2008. The residents care plans have all been reviewed and risk assessments updated. Following consultation with the service users a revised menu has been introduced. An expanded Activities programme has also been introduced this following an individual assessment of the activity needs and interests of all the residents. Various works of refurbishment and upgrading have been carried out in the home these include redecorating of some bedrooms new carpeting and new furnishings in the lounges and dining room. The management make appropriate checks when recruiting staff and these offer safety and protection for the service users. Since the last inspection staffing levels in the home have been reviewed to ensure that there are sufficient staff at all times to meet the assessed needs of the residents. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable to this home which does not offer intermediate care. People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care needs of all prospective service users are fully assessed by the manager before admission is agreed. Prospective service users have good information about the home this to enable them to make an informed decision as to whether the home can provide the service they need. EVIDENCE: The homes pre admission policy and procedures are compliant with the requirements for these standards and were found to have been fully carried out for the resident recently admitted to the home. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 10 The manager carries out these pre admission assessments herself visiting the prospective applicant either in their own home or in hospital. Sometimes another member of staff will accompany the manager for this visit. Relatives and family are also invited to attend providing the prospective applicant agrees. A full assessment of care needs is commenced at that stage and other medical and social reports are always sought so that the home can be fully informed about the prospective residents circumstances. This assessment seeks detailed information about the individual’s health, social, spiritual and personal care needs this to determine if the home can fully meet these individual needs. A day visit to the home is then arranged so that the accommodation can be viewed, other residents met and a snap shot view of the day to day life in the home observed. Prospective residents are always welcome to join in with any activity on that day. All prospective residents are also visited independently by one of the homes trustees. The manager emphasised how important it was that this introduction should be carried out at a pace and within a time frame that suited each applicant. Residents spoken with during this inspection commented on the positive manner in which their admission had been arranged, one said “ right from the beginning I was made to feel very welcome” and another said “ as soon as I came to visit I knew that this was the place for me and I have been very happy here for several years now.” The home has a detailed statement of purpose, service users guide and brochure with coloured photographs this giving information concerning the aims and objectives of the home and the services it provides. Since the last inspection these documents have been up dated to accurately represent the changed management arrangements in the home. People’s files were seen to contain a written contract setting out the terms and conditions of residence, including a trial period, the method of payment and their current fee. At the end of the agreed trial period people have a review to ensure that Ormonde House is able to meet their needs and that they feel that this is the right home for them. Relatives will also be involved with this review process if they and the resident wish it. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to have their care needs fully documented and met. The homes robust policy and procedures for the storage and administration of medication offers protection to its residents. EVIDENCE: Personal care was seen to be being delivered by qualified and experienced staff in a kindly manner that respected the resident’s dignity and individuality. It was noted that staff of all grades worked very well together as a team and that they promoted a calm and relaxed atmosphere within the home. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 12 They all had a good knowledge of the resident’s individual needs, preferences and requirements and particular ways in which these care needs could best be delivered. Each resident has a nominated key worker who is responsible for maintaining their care plan. Residents were offered choice about where they wanted to be and what they wanted to do. The staff support residents and encouraged independence. The staff were also seen to be knocking on doors prior to entering bathrooms and bedrooms. Four care plans were examined and they were all found to be very well organised with the information kept in separate sections covering all aspects of the individuals health, personal and social care needs, to be maintained daily and to be subject to a regular review. The manager explained that since her arrival in the home, in February 2008, she had revised all the care plans and had updated them to include risk assessments for moving and handling, continence, nutrition needs and a falls risk assessment. Each file had a Waterlow score for tissue viability. Weights were regularly monitored and a risk monitoring system is in place to monitor residents whose needs are increasing and who are becoming increasingly frail. Evidence could be seen on the files of the involvement of other health professionals; visits from doctors district nurses and from the continence advisor were recorded. The manager has arranged for all staff to undertake training concerning the compiling and maintenance of care plans at the beginning of June. She is aware of the need for care plan records to accurately reflect all care actions taken. The home uses a Monitored Dosage System ( MDS ) for medication storage and administration and part of a medication round was observed during this inspection. Staff were observed to be administering medication appropriately and the medication administration record sheets were seen to be well maintained with good explanations given where the prescribed format could not be followed. Two gaps found in this recording had already been noted by staff and the appropriate action taken. The home uses a medication trolley which is securely kept in the ground floor office. A well equipped medication room is sited on the first floor this contains a sink an adequately sized flat working space and secure cupboards for the storage of records and supplies along with a Controlled Drugs cupboard. No controlled medication was being prescribed for residents in the home at the time of this inspection. The home does not have a medication fridge. Residents who administer their own medication have had an appropriate risk assessment and have a suitable lockable space in their room in which to keep their medication. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to be given every opportunity to make choices about their life style enabling them to lead meaningful lives. Service users are offered a range of activities both in the home and in the community to meet their individually assessed needs. They are provided with a well balanced diet with ample choice. EVIDENCE: Ormond House provides an excellent range of activities both inside and outside of the home. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 14 Each resident has an activity assessment setting out their likes and interests and evidence could be seen of this in the care files examined along with evidence of the activities in which they had participated and their enjoyment or otherwise of these. Residents confirmed that it was their choice whether or not to attend. The manager explained that since the last inspection and following consultation with the residents the variety of activities had been increased and that each member of staff leads an activity or class and that some outside organisers and volunteers for specific activities also visit the home regularly. On the day of this inspection a number of residents attended a card making craft class lead by an external volunteer who told the inspector that she had been visiting the home for this purpose for some time. One resident was seen to be being taken out into the town whilst another who has an electric buggy took herself off for a ride around Christchurch Park which is immediately opposite the home. Staff were observed to be undertaking puzzles and games with the residents one was seen to be assisting with The Times crossword and the many residents who were knitting ,making blankets to be sent to disaster areas, were also seen to be getting help if needed. One resident who still enjoys gardening and potting said that she sometimes assists the garden who was present on the day of this inspection maintaining the well kept and attractive gardens and preparing for the hanging baskets. The manager said that the home purchases fresh flowers each week from a local garden centre and that staff take one resident who is a particularly able flower arranger to choose these so that she can on their return enjoy arranging them. All the residents spoke very positively about these activities ;one explained to the inspector about the morning Bible Readings and evening Epilogue Service which is usually led by an external lay church visitor;” most of us choose to attend but there is no compulsion” she said. All the residents spoken with said that they chose the home because of its Christian ethos and that they found that their spiritual needs were very well met in the home and that staff would assist them to attend outside church services if they were able. The recently introduced chair exercise classes were appreciatively commented on by one resident with the comment “I never thought that I would enjoy doing such exercises!”. Another spoke of the Baking Class that also seemed to be successful and much enjoyed. A number of residents told the inspector about the river trip on a barge that they had planned for the following week. One said “ we have never done this before and because of the numbers we are going to have to go half at a time over two consecutive days .The Manager has visited already and has told us what to expect. The barge is fully equipped and is wheelchair accessible and she has hired a bus to get us there, we are really looking forward to it”. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 15 Visitors who were observed coming and going throughout the day reported that they were made to feel very welcome. The comments on one visitors survey spoke of the advantage of having the facilities of Christ Church Park so close by, “ we do use it when we visit our relative and I know that the new Manager often takes residents for a walk and ice cream in the park.” Without exception all the residents were complimentary about the food provided and confirmed that they always had good choices, food was served at the right temperature and that staff had good knowledge of individuals portion sizes and requirements. One said that there were plenty of fresh vegetables and that the meat was always excellent. The serving of lunch and tea were observed as part of this inspection. At lunch the choice was either a pork chop or a scotch egg salad with either apple pie and cream or custard or crème caramel to follow. The staff consult with residents as to their meal choices on a daily basis. Special diets are accommodated and where it is needed for a meal to be pureed this is done so that the individual components are kept separate. The dining tables were set with flowers crisp linen clothes fresh water and each resident had their own serviette held in a silver napkin ring. Recently purchased new dining chairs with arms and sliding feet had improved their accessibility so that more residents could manage independently. The dining room is about to be redecorated and residents confirmed that they had all participated in the discussions concerning the choice of colours and furnishings. Being a small home individual food preferences can easily be accommodated and it was noted that especially for the tea time meal that a number of special choice dishes had been prepared to meet the specific requirements of the individual resident. Both meals were very social and relaxed occasions in which the staff joined and the inspector too was invited to join by the residents. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to have any complaint handled properly and to be protected from abuse. EVIDENCE: There have been no incidents concerning Safeguarding Adults since the last inspection. Staff all attend training on the protection of vulnerable adults and whistle blowing procedures. Staff spoken with during this inspection were familiar with what action they should appropriately take if ever they had suspicions concerning possible abuse. Staff had a good understanding of what might be constituted as abusive practice, they said that they would go directly to the Manager if they were unhappy about anything. The home has a copy of the guidelines issued by the Vulnerable Adults Protection Committee of Suffolk and a comprehensive whistle blowing policy to protect staff. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 17 The home has a complaints procedure which is known to the staff and residents and is available to them. Relatives and residents who completed a questionnaire indicated that they were aware of how to make a complaint. The CSCI ( Commission for Social Care Inspection ) have not received any complaints about the care provided since the last inspection. The complaints log within the home was seen to contain one complaint made since the last inspection; this had been promptly dealt with and the problem resolved. There was evidence from the discussion with the Manager that the home are aware of how to access advocacy services should they need to. The home has a procedure for the management of people’s money and financial affairs. The home do not act as appointee for the financial affairs of the people using the service. Several residents manage their own financial affairs whilst others are supported by relatives or their representative. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to live in a spacious comfortable and well maintained home which is decorated and appointed to a high standard. EVIDENCE: Ormonde House is a large Victorian detached house over looking Christchurch Park and is within walking distance of Ipswich town centre. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 19 It has been operating as a care home for more than 20 years but has more recently been subject to considerable works of refurbishment which have given all en-suite single bedroom accommodation except for one room which is of sufficient size to be registered for double occupation and which was at the time of this inspection occupied by a married couple. The building provides spacious accommodation and having retained many of it’s period features high ceilings and large floor length windows has an airy and light ambience. There is good parking to the front of the home and a large well maintained garden to the rear with accessible sitting area for the residents. The ground floor provides a very large lounge facing the front of the home and a spacious dining room overlooking the garden to the rear. In addition there are toilet and bathing facilities, the laundry, a staff office and two ground floor bedrooms. A large modern and very well equipped kitchen with Aga is easily accessible being sited in the middle of the home and this adds to the homely atmosphere found at Ormonde. Further bedrooms and bathrooms are sited on the first and second floors all of which are accessible by lift. At the time of this unannounced inspection the home was found to be clean bright and tidy. Comments from residents and relatives confirmed that this is always the case. Since the last inspection a number of works of redecoration have been undertaken along with the provision of new chairs and floor covering in some areas. The manager has planned a programme for further such works and during the time of this inspection staff were seen to be discussing colours and furnishing options with one resident. All the residents were spoken with and without exception they all expressed their satisfaction with their bedrooms in which they all had items of their own furniture and other small possessions to personalise the room as their own. “ I am very comfortable here one said I have everything I need”. The married couple told the inspector how they enjoyed being able to sit together in the sitting area of their room and watch the birds in the garden beyond without having to worry about anything. The kitchen is subject to a regular programme of deep cleaning and was found on the day of this inspection to be clean tidy and with one minor exception well organised with clear instructions for staff and good records of menu choices and preferences and special diets clearly recorded. The accessibility of white coats for staff entering the kitchen could be improved. The manager explained that she had recently revised the cleaning programme with greater routine cleaning frequency and that the whole kitchen had been subject to a Deep Clean on 1/5/08. Staff who use the kitchen had all undertaken appropriate training ( Food Hygiene 2/08) and a Making Food Safer Food Diary is kept. The facilities and arrangements had met the standards required during a recent Environmental Health inspection. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 20 Appropriate risk assessments had been completed and training given to one younger staff member who prepares the afternoon tea meal. She confirmed that she felt well supported by the homes management and understood the tasks which she had to undertake. The home does all its own laundry. The laundry has adequate facilities including washing machines with sluice facilities that are used with red bags but is not ideally sited and is somewhat small. The residents all looked to have clothes that were well laundered and they confirmed that this service was always prompt with few if any mix up of individual clothing occurring. There appeared to be a good awareness of measures to prevent infection control and staff confirmed that there were always plentiful supplies of gloves and protective clothing. The provision of assisted bathing facilities is adequate for the number of residents but it is unfortunate that the assisted bath provided in the ground floor bathroom is of a design not liked by the residents and so is little used. The main assisted bathroom on the second floor is well equipped but had a somewhat institutional feel to it being used to store many items and to have a number of instruction notices inappropriately placed on the walls. The manager discussed with the inspector her thoughts on the redesign of the facilities in the bathroom on the first floor where a bath with integral hoist is positioned at floor level close to a wall a position which can be compromising to both resident and staff safety. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to be cared for by experienced and trained staff who have been recruited to the required standard of ensure their proper protection. EVIDENCE: The staffing levels examined as part of this inspection found that there were good staffing levels to meet the assessed care needs of the current residents. The manager explained that since the last inspection despite the home carrying vacancies staffing levels had not been reduced. Comments from the residents and relatives confirmed that staff were always available to assist with usually little waiting time. One new member of staff who had transferred from another home commented how much she enjoyed having sufficient time to care properly and to talk with the residents something she had not experienced in her previous job. The Manager explained that she had slightly rearranged the working hours patterns of the staff to provide a better night care overlap with day staff. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 22 All the carers were now involved in leading some element of the expanded activities programme and this move seemed to have been positively received. Staff spoken with during the inspection and those who completed questionnaires all confirmed that they felt themselves to be well supported by the homes managers and that they had good training opportunities. The home has reached and exceeded the National Minimum standard ( NMS ) target of 50 of care staff to hold a recognised qualification with 65 of care staff holding NVQ at level 2 and several also having achieved the level 3 qualification. The home is currently fully staffed so that agency staff do not have to be used. Recent staff appointments have been made from a choice of experienced and qualified applicants. Recruitment records checked were found to be well maintained with all the required personal identity security and CRB checks properly made and recorded. The manager confirmed that all existing staff and volunteers had now had an enhanced CRB check. New staff do not commence duties until POVA and CRB checks are returned and then work alongside an experienced member of staff until they have completed their induction training. Staff supervision is planned monthly and from this a training needs programme for each individual staff member is compiled. Since the beginning of 2008 the training programme has been somewhat accelerated to rectify what the new manager felt were some training deficiencies. Courses attended or planned for later in the summer include Moving and handling 21/1/08, Bereavement and Funeral Services 12/3/08, Osteoporosis and Falls training 7/4/08, First Aid Appointed person training 19/3/08, Fire awareness 5/12/07,with Food Hygiene planned for 2/6/08, Health and Safety 4/6/08 and Care Planning 9/6/08. All the homes staff have also recently undertaken refresher training on Risk Assessment and POVA issues. Several staff mentioned that they would like further training on Dementia. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of its residents. EVIDENCE: The new manager had been in post at Ormonde House for only three months at the time of this inspection. She is a trained nurse who is experienced and knowledgeable about the care of older people. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 24 She had previously been registered with the Commission whilst managing a much larger Nursing Home else where. Since her appointment she has arranged to attend training concerning Suffolk’s procedures for Safeguarding Adults and on The Mental Capacity Act. She has applied to complete the remaining modules of the Registered Managers Award. Her application for registration with Commission is being processed. The home clearly benefits from a stable and experienced Management team. The deputy manager holds the NVQ qualification at level 4 and during the months before the new manager was appointed competently managed the home through a difficult period of change. The ethos of the management and indeed of all staff spoken with was very clearly to put the needs of the service users first. The confident and calm approach to their work positively influenced the homely and relaxed atmosphere in the home. Staff interviewed as part of this inspection confirmed that they received regular supervision from a senior member of staff which they found helpful The Manager commented that she felt that further improvements could be made to the quality and delivery of this supervision and that she is taking steps to ensure that this improvement is achieved. Staff confirmed that regular staff meetings are held and minutes of these gave evidence of the good attendance and appropriate content. Spot checks made on a number of the homes records found them to be well maintained and kept up to date. He manager explained that she is gradually reviewing the keeping of all these records to identify any shortfalls. She is also gradually reviewing all of the homes policies and procedures some of which have not been subject to any review for some years. The records relating to fire testing, the monitoring of water temperatures, risk assessments for the environment and safety checks for the home equipment were spot checked during this inspection and seen to be well maintained this ensuring the safety of the residents at all times. The records relating to the monthly regulation 26 management visits to the home made by various of the trustees were also seen to be well maintained. The manager confirmed that the trustees are supportive towards her in her wish to promote improvements in quality and service delivery throughout the home. Quality assurance systems are in place and discussions with the manager evidenced that she is proactive in addressing quality issues within the home. The Trustees carry out regular checks each trustee has their own area of expertise and responsibility and together they produce a bi annual report. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 25 People who use the service and their relatives are asked to complete an annual quality survey the results of which contribute to this report. The Manager is committed to promoting equality and diversity in the service and in meeting the service users individual needs. Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ormonde Home For The Elderly DS0000024468.V364713.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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