Inspection on 09/02/07 for Ormsby Lodge

This inspection was carried out on 9th February 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ormsby Lodge 04/12/08

Ormsby Lodge 13/03/06

Ormsby Lodge 14/06/05

Ormsby Lodge 11/01/05

Ormsby Lodge 02/09/04

Ormsby Lodge 07/05/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Ormsby Lodge 1 Ormsby Road Southsea Portsmouth Hampshire PO5 2AL Lead Inspector Nick Morrison Unannounced Inspection 9th February 2007 10:00 Ormsby Lodge DS0000011717.V327541.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 Ormsby Lodge DS0000011717.V327541.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. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ormsby Lodge Address 1 Ormsby Road Southsea Portsmouth Hampshire PO5 2AL 023 9273 8752 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Ernest Clarke Mrs Ninfa Clarke Sally Peta Fenner Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category LD are not to be admitted under the age of 18 years 13th March 2006 Date of last inspection Brief Description of the Service: Ormsby Lodge is a residential service providing care and support to twelve adults who have learning disabilities and complex behavioural needs. Ormsby Lodge is owned by Mr and Mrs Clarke who also own another residential service and a separate day service for service users with complex learning disabilities. Ormsby Lodge is a large period house set in a street of similar properties in a central location in Southsea. The house is set out over four storeys, the basement is used for storage and the service users accommodation is on the other three floors. The top floor has a small semi self-contained flat with a double bedroom and a single room, this can accommodate up to three service users who need limited support. There are further bedrooms on the first floor, two of which are doubles and there are four single rooms on this floor. There is one ground floor bedroom. The service does not accommodate people with physical disabilities or nursing needs. Service users are supported to use local amenities, which are a short walk away. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 9th February 2007 and lasted six hours. During this time the Inspector toured the premises, looked all service users’ files and met with four of those people. All records and relevant documentation referred to in the report was seen on the day of inspection. The Inspector spoke with the Manager, the Proprietors, three members of staff and seven service users. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 6 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 Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 7 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: Service users’ files showed that they all had assessments that had been completed prior to them moving into the home. Assessments were comprehensive and were undertaken either by a care manager or by the manager of the home. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 8 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported to make decisions but would benefit further from having care plans and risk assessments that were dated and regularly reviewed. EVIDENCE: All service users’ files contained care plans. The plans were informed by the initial assessments and by the ongoing needs and wishes of service users. The system in place for identifying needs and wishes was very good. Service users were involved in the process throughout and were supported to identify their own wishes and aspirations. The plans were recorded by service users with support from staff and made good use of pictures and diagrams so that they were easily understood and referred to by service users. Service users were also supported to identify their own circles of support. These were made up from friends and relatives who service users had identified as being important to them in identifying and meeting their needs. The plans described what Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 9 service users wanted to do in the future and how they wanted to achieve those aims. They were also clear about how the service user wanted to be supported and contained clear information about how each person communicated. The things that were important to each person on a daily basis were recorded along with daily routines. There were specific plans for support with particular health and personal care issues and service users were able to identify how they wanted to be supported in these areas. The care plans showed that service users were supported to make decisions for themselves about their own lifestyle and their chosen activities. They were able to choose what they did, where they went, who supported them and what was important to them. The care plans recorded all of this information so that all staff could be aware of individual choices. On the day of the inspection visit it was clear that staff were aware of personal choices and the right of service users to make their own decisions and time and support was given to enable service users to make choices. Staff were also skilled in giving advice so that service users could make informed choices. Service users spoken with confirmed that staff respected and supported their personal decision-making. Care plans contained risk assessments for each person and these had also been devised and recorded with full involvement from service users. They were clearly recorded and were accessible to service users. There had been a recommendation from the previous inspection that the home should monitor and evaluate the outcome of the residents’ personal plans to demonstrate that dreams and desires are being met and continued. This had not yet been fully addressed by the home. There was no record of what happened in response to the care plans. For example, where service users had highlighted that they had wanted to do a particular thing there was no record of what action had been taken in response to the aspiration and no record of what the outcome was. There were also no dates on the plans, so it was not possible to determine how long they had been in place or whether or not they had been kept under regular review. Discussion with some service users suggested that staff were supporting them to achieve their aspirations but the service was failing in recording what was happening in response to the care plans. This was unfortunate because the plans were very good and some of the work being done with service users in response to the identified needs was also very good. If the plans were dated, regularly reviewed and recorded against they would meet the standard very well and demonstrate the effectiveness of the service. A requirement has been made in respect of this. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 10 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from support to take part in activities and to be part of the community. They have their rights recognised and are supported to maintain contact with their families and friends. They also benefit from having a healthy diet. EVIDENCE: People living in the home were supported to attend a daytime service run by the same provider. This service was not based in the home and was also available to other people who did not live within the home. The day service had a programme of activities in place for each service user, which was reviewed every six weeks to ensure that doing the same activities all the time did not become tedious for service users. The day service provided recreational, social and educational activities based on the needs and wishes of service users. Service users spoken with said they valued the day service and felt that the Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 11 activities offered were suited to their own needs. Further activities, in the evenings and weekends were provided within the home. These included individual support for service users to access the wider community. This included clubs and some service users regularly attended a self-advocacy group. Service users were also supported to make use of local facilities such as the shopping centre, library, sports centres and pubs. There was support for service users to maintain contact with their friends and families and the home recognised the importance of this for each service user. Information about friend and families was contained within care plans and there were clear records about which people were particularly important in each service user’s life. They were supported to maintain regular communication and contact with those people and friends and families of service users were able to visit the home at any time. All service users spoken with said that the food in the home was of good quality and that they always had sufficient amounts. Menus were devised at weekly house meetings and all service users were supported to contribute to the process. Pictures were used to assist service users in identifying things they would like to be on the menu and there was input from staff to encourage service users to choose a variety of foods and ensure that the overall diet was well balanced. Individual dietary needs (e.g. diabetes) were catered for and service users were encouraged to try new and different foods from time to time. The pantry showed that fresh ingredients were used. Recipes for the meals that service users chose were kept and meals were homemade rather than bought in. There was little use made of convenience foods and night staff did a lot of preparation for meals. Records were kept of food provided in the home. Some service users were supported to be involved in food preparation if they wanted. There had been regular input from a dietician for particular service users and records showed that she was impressed with the food in the home and the significant progress made with one particular service user. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 12 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from receiving personal care in the way they prefer and from having their physical, emotional and medication needs met. EVIDENCE: Care plans clearly identified what personal care needs each person had and how they preferred to be supported. Staff spoken with were aware of the support needs for individual service users and aware of the importance of providing care in the way the person wanted it. Records in service users’ files showed that they were regularly supported to access relevant healthcare services and those spoken with confirmed that they received support from staff to attend healthcare appointments. Individual health needs were monitored on a regular basis and records were kept. Medication in the home was well managed. Accurate records were kept of all medication coming into and going out of the home as well as all medication administered to service users. The home had a comprehensive medication policy in place which promoted service users being involved in their own medication and staff were aware of the policy. There were individual policies in Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 13 place for service users administering their own medication. There were clear guidelines in place where service users required ‘as and when’ medication and GP’s had been involved in devising these. All staff involved in administering medication had received relevant training and understood their responsibilities within the process of administering medication. The Pharmacist updated training annually. All medication was appropriately stored in a medication cabinet. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 14 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having information on how to complain and are protected by the home’s adult protection policies and practices. EVIDENCE: Staff spoken with were very clear that their role was to support service users in a way that respected their right to make their own decisions. The care planning process placed a lot of emphasis on ensuring that service users were involved throughout the planning of their care and that their own views and decisions were to be respected. The home has an abuse policy in place to ensure that service users are protected from any kind of abuse. There was also a very clear whistleblowing policy which staff were aware of. Staff had received training on identifying and responding to instances of suspected abuse and those spoken with were clear about the relevant issues and their responsibilities in this area. The home had a very positive policy on service users looking after their own money as far as possible, with support being available where necessary. Service users spoken with felt that they were safe living in the home and that staff protected them from any kind of abuse. There was a clear complaints procedure in place that was written in a userfriendly way. It was also available on audiocassette to ensure that all service users had access to it. All service users spoken with were clear about the complaints procedure and were clear what they would do if they felt the need to complain. They were also clear that, if their complaint was not dealt within Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 15 the home, they could complain further. There were regular service user meetings once a week where people could identify things they were not happy about and records showed that these issues were recorded and responded to appropriately. Each service user also had a monthly meeting with their keyworker and records were kept of these. The provider monitored these records through staff support and supervision sessions. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a clean, comfortable and homely atmosphere. EVIDENCE: Being an old house, the home has high ceilings and intricate woodwork throughout and requires a lot of cleaning. Cleaners are employed in the home for ten hours a day. This ensures that the home is kept very clean throughout. The work done by the cleaners was impressive. Infection control procedures were in place, as were cleaning schedules. The laundry area was well managed and clean. The amount of living space within the home was adequate for the number of people living there and the home benefited from good natural lighting and ventilation. All parts of the home were accessible to service users. Furniture provided in the home was of very good quality. Wardrobes, chairs and tables throughout the building were well maintained and suited the age of the Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 17 building and the needs of service users. Records showed that maintenance was monitored regularly and issues were responded to in good time. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by well trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Rotas showed that sufficient staff were on duty at all times in the home. Service users spoken with felt that were sufficient staff and spoke very highly of the staff that supported them. During the inspection visit the Inspector observed staff interacting with service users in a very relaxed and supportive manner. The approach of staff observed on the day was wholly positive. They demonstrated that they understood the needs of service users and were skilled in communicating effectively with service users and supporting their personal development. Staff training records were good and showed that staff are able to access a wide range of training opportunities. Good, clear records were kept of all staff training, including induction training. Staff spoken with said that the quality of training within the home was very good and that it was quite freely available. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 19 They felt that the organisation supported them well in having the skills to do their job. Support and supervision sessions in the home were regular and clearly concentrated on the needs and wishes of service users. Support and supervision records clearly identified actions to be undertaken and timescales involved and these were followed up at subsequent sessions. The provider regularly monitored support and supervision records. Staffing in the home was organised around the needs of service users, with staff being required to be flexible in their hours according to those needs. The home does not employ agency workers, but has it’s own bank of staff to cover absences. Staff interaction with service users in the home was extremely good and demonstrated that staff receive very good training in communication, dealing with difficult behaviours, supporting service users to be in control of their own lives and encouraging personal development. Staff records showed that all necessary pre-employment checks were carried out on each member of staff prior to them beginning work in the home. The home had begun to involve service users in defining what attributes were important to look for in a new member of staff and some service users had been involved parts of the interview process. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a service that is responsive to their views and are protected by the home’s management of health and safety issues. EVIDENCE: The current manager is not yet registered but is in the process of making an application. The home is clearly run in the interests of service users and this was emphasised by outcomes of service user group meetings and individual meetings with keyworkers as well as by staff training, the approach of staff to supporting service users, the involvement of service users in staff selection and the care planning process based on individual needs and wishes. The home has a development plan in place and this showed that development issues had Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 21 been highlighted through a range of methods including direct and regular consultation with service users. All staff had received health and safety training and workplace risk assessments were in place and regularly reviewed. Staff spoken with said they knew about and understood these assessments. Records were kept to show that all equipment was regularly serviced. All accident and incident records were clear and the manager regularly monitored and reviewed these in order to look for patterns and plan to decrease future occurrence of these. Regular health and safety checks were made as part of the provider’s monthly assessment of the home. There had been a requirement from the previous inspection visit for the registered manager to ensure regular checks are carried out on fire call points and fire fighting equipment. This has now been addressed and clear records were kept. Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 23 No 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 YA6 Regulation 15 Requirement The home must ensure that all care plans and risk assessments are dated and that records are maintained to demonstrate that these are kept under regular review. Timescale for action 30/04/07 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 Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Ormsby Lodge DS0000011717.V327541.R01.S.doc Version 5.2 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. 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