CARE HOME ADULTS 18-65
OSBORNE HOUSE (OSCARS HOTEL) 65 Vansittart Road Windsor Berks SL4 5BN Lead Inspector
Susan Burton Unannounced 12 July 2004 at 09:25am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Osborne House Address 65 Vansittart Road Windsor Berks SL4 5BN 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) 01753 857610 Advance Housing and Support Limited vacant Care home only (PC) 10 Category(ies) of Learning disability over 65 years of age (LD)(E) registration, with number of places OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 Service users are only to be admitted under the age of 65. Service users users who attain the age of 65 years and over can continue to remain resident as long as the service meets their individual needs. 2 The Oscars Hotel is to be used for a period of up to eighteen months from 30 January 2004 to allow for the refurbishment of Osborne House. Date of last inspection 7 December 2004 Brief Description of the Service: Osborne House in Windsor is registered to provide accommodation for 10 adults with a range of learning disabilities age between 18 and 65 of both sexes. The home was an old Victorian building badly in need of renovation.Advance Housing which own the property are investing in a complete renovation of the building that has resulted in its temporary closure.The organisation managed to find temporary accommodation nearby in Windsor that has enabled the group to stay together, the majority of whom have lived together since 1984. The accommodation known as “Oscars Hotel” is rented temporarily while the refurbishment takes place, (the hotel is closed to paying guests and has been taken over in its entirety by the organisation). Changes have been made by the organisation for the comfort and safety of the service users.The home has three floors, which now provides a small dining room, lounge and eight bedrooms for the 9 service users. All rooms except the shared one have an ensuite shower room. The location of the building is a short walk away from the original home and is closer to some of the amenities and facilities enjoyed by the service users. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place on Tuesday the 12th of July between the hours of 9:25 a.m. and 13:05 p.m. Since the last inspection in December 2004 a new deputy and a new manager had been appointed. The deputy manager took part in this inspection. The majority of residents in the home were out taking part in college or leisure activities, the inspector met and spoke to one of the residents remaining in the house. The inspection focused the inspection on the records of one resident present in the home, and the records of one of whom had deteriorating health care needs. What the service does well: What has improved since the last inspection?
Information on recruitment checks had improved but was not consistent. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 6 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. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) There have been no new admissions to the homes since the last inspection therefore none of these standards were inspected on this occasion. EVIDENCE: OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 Residents are aware that their changing needs and personal goals are reflected in their plans. Residents make decisions about their lives with support from staff. The residents are consulted and participate in all aspects of life in the home. Risks are taken as part of an independent lifestyle. EVIDENCE: The individual plans of two residents were examined at this inspection. The younger residents care plan reflected his aspirations goals and development for the future; the care plan was signed/acknowledged by the individual resident. The changing needs of the older resident are covered in more detail under standard 19. The inspector observed staff respecting the residents right to make decisions and enabling him to make effective choices about finance and leisure time. Documentation evidenced and demonstrated that individual choices were made and issues around those decisions are recorded where necessary. The staff team have consulted at length with all of the residents in regard to the choice of décor in the newly refurbished Osborne House. Documentation from the residents meeting and in plans evidenced the consultation process
OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 10 and the choices made. Residents had chosen the colour of the walls the kitchen furniture and carpets. The homes risk assessments were examined; there are generic risk assessments in place and also individualised ones for each resident. One individual resident enjoys his independence and likes to walk to college, the risk assessment reflected appropriate hazards to his personal safety and the actions required by staff to minimise those hazards. Discussion took place with the deputy manager in regard to the consideration of risk assessments for those residents that smoke and the subsequent health hazards, the efforts of staff to educate and reduce any risks while acknowledging choice would be recorded. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,16,17 in part Opportunities for personal development are noted. Staff support residents to enble them to take part in appropriate activities. The residents are enabled to become part of and participate in the local community. Residents are encouraged to support and pursue their own interests and hobbies. Residence rights and responsibilities are recognised and independence promoted. Residents are encouraged to shop and cook their meals as independently as they are able. EVIDENCE: The inspector reviewed the care plans of one young resident and one much older resident. Observation, discussion and documentation supported that the younger residents personal development needs were recorded by the staff. Staff are supporting the individual to consider moving into employment or volunteering. Long-term goals for independent living were documented. The older resident had recently had to give up small part-time job, which he had enjoyed; he was also no longer able to attend his day centre. The staff
OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 12 team were aware of the gentlemans social needs and were trying to find a replacement activity for him. The younger resident has a hobby, which he is passionate about; he was looking forward to a weekend away and attending an organised air display. He spoke to the inspector about how much he was looking forward to attending the event in which aspects of the event he enjoyed most. A member of staff will be accompanying him and has helped him to choose the most appropriate overnight accommodation. The inspector was able to observe the discussion that took place between the resident and the staff in regard to the costs of the event and the management of his finances. Care plans evidenced acknowledgement of the individuals need to be independent and the staff efforts to support him. Each individual resident has their own cupboard in the kitchen with a lock; residents hold their own keys to ensure only they and the staff have access to the food items they have purchased for themselves. Menu plans were examined, discussion took place with the deputy in regard to the poor recording of meals taken. One individual resident with poor health did not appear to be having enough to eat to maintain his well-being. See standard 19. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21 One individual residents health care needs were not appropriately documented. Medication administration procedures were satisfactory. The changing needs of an older resident are not reflected in his care plan. EVIDENCE: The inspector focused on the health care needs of one of the resident who was in poor health. The staff team had called in other health professionals such as a dietician and community nurse to make assessment of his health-care needs. Those needs had not been reflected into the individuals care plan or monitoring of his nutritional intake. Examination of the menus showed the individual on the majority of days of the week was only having one meal a day, and one meal replacement drink. The deputy advised the inspector that the individual had snacks throughout the day, but acknowledged this was not documented. Monitoring of the individuals weight had not taken place. The deputy and the staff team on duty agreed to resolve these issues straightaway following the inspectors concern. The deputy advised the inspector that they were waiting for more detailed guidelines from the dietician in how best to support the individual. The staff were advised to improve their monitoring and documentation straight away. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 14 The deputy manager advised the inspector that all staff have recently attended medication training. Examination of the drug cupboard and medication administration records demonstrated satisfactory procedures in place. One of the residents in the home is over retirement age; consideration of the ageing needs of this individual had not been fully explored or documented. The residence wishes concerning funeral/religious and cultural requirements had not been explored or discussed with him. The individual is in poor health and his changing needs had not been fully acknowledged or documented. The deputy manager advised the inspector that consultation with the community nurse had taken place and that it was envisaged that she would provide further information on the individual’s specific health care needs to the staff team. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 There is a clear and effective complaint procedure in the home. Residents are generally protected, see standard 19. EVIDENCE: The inspector examined the homes complaints procedure and complaints log, there had been no entries since the last inspection. Residents in the home are given a pictorial complaints procedure to enable them to understand how complaints are made and acted on. The home has a policy and procedure on the protection of vulnerable adults, local guidelines were also seen in place. The deputy manager of advised the inspector that POVA training is given on induction for all new staff. There had been an issue in the home recently where one resident who shares a room with another had become very aggressive. Discussion and examination of records evidenced that the manager and staff team and acted appropriately and responsibly to protect the other residents in the home and support the individual following the crisis. The monitoring of one individuals nutritional needs was not seen as satisfactory, see std 19. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected at this time in the temporary accommodation. EVIDENCE: OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 Residents in the home of protected by the homes recruitment policies and practices. EVIDENCE: The home had received a requirement at the last inspection about their recruitment practices, records had not been made available to evidence procedures met regulation. The recruitment records of two new employees were examined, one file was able to evidence confirmation of CRB check, references, proof of ID and appropriate work permits. The second file had no confirmation of ID, only one reference and no evidence of immigration status. The staff in the home rely upon the organisations head office to ensure records are correct and meet regulation. The manager needs to ensure that all records are consistent in the information they provide to enable satisfactory confirmation that procedures have been followed. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The home has an open and positive atmosphere. EVIDENCE: A new manager and Deputy have been appointed since the last inspection. The home has retained its friendly and homely atmosphere. From discussion and observation there is a clear sense pf direction and leadership with the staff team. OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
OSBORNE HOUSE (OSCARS HOTEL) Score x 2 x 2 Standard No 37 38 39 40 41 42 43 Score x 3 x x x x x H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 20 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. 2. Standard 34 19 Regulation 19 12 (1) a & b Timescale for action Recruitment information required 12/9/05 by regulation is to be consistently maintained. The nutritional needs of 12/8/05 residents are to be effectively monitored and documented. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 21 Good Practice Recommendations The changing needs of older residents are appropriately assessed and documented OSBORNE HOUSE (OSCARS HOTEL) H52 H01 11278 Osborne House (Oscars Hotel) V232211 120705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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