Inspection on 20/09/06 for Osborne House

This inspection was carried out on 20th September 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Osborne House 28/09/07

Osborne House 07/11/05

Osborne House 12/07/05

Osborne House 07/12/04

Osborne House 27/05/04

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 Osborne House 90 Osborne Road Windsor Berkshire SL4 3EN Lead Inspector Tracy McGuire Brown Unannounced Inspection 20th September 2006 11:00 DS0000011278.V306074.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 DS0000011278.V306074.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. DS0000011278.V306074.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Osborne House Address 90 Osborne Road Windsor Berkshire SL4 3EN 07845 996807 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) Advance Housing and Support Limited Mrs Malama Pieridis Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (9) of places DS0000011278.V306074.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 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 is an old Victorian building, which has recently been completely renovated. The home is situated close to Windsor town centre and in walking distance of many local amenities. The home has 4 floors and each single bedroom has its own en-suite facilities. There are separate kitchens on each floor in addition to the communal kitchen and lounge. To the rear of the property there is a large garden. The home has wheelchair access throughout including the installation of a lift. There are small balcony areas located on some of the floors. The home is bright and airy throughout. Fees are £709 per week. DS0000011278.V306074.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service was inspected over a period of 4 days between 24th August and 20thth September with a visit to the establishment taking place on 20th September between 11.00am and 4.00 pm. The Inspector spent some time talking to 5 service users; staff and management.3 Resident files and care plans were seen. Information from providers and inspection records were used. A pre- inspection questionnaire was completed and surveys were received from 8 residents. The Inspector toured the building and observed practice throughout the visit. What the service does well: What has improved since the last inspection? Since the last inspection the residents have moved from the Oscars hotel back in to the refurbished home. Each resident has their own room with en- suite facilities. The home has bright new decoration and is well equipped and furnished throughout. DS0000011278.V306074.R01.S.doc Version 5.2 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. DS0000011278.V306074.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection DS0000011278.V306074.R01.S.doc Version 5.2 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 the following standard(s): 2 The quality outcome in this area is good. Service users are assessed prior to admission to the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There have been no new service users admitted since the previous inspection. The organisation has admission and referrals processes which the Manager informed the Inspector include gaining detailed assessments DS0000011278.V306074.R01.S.doc Version 5.2 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 the following standard(s): 6,7,and 9 The quality outcome in this area is adequate. Service user needs are not accurately reflected in current care plans. Service users are supported to take risks but some risk assessments need to be updated. Service users make decisions about their lives with support where required. This judgement has been made using available evidence including a visit to the service. EVIDENCE: 3 service users records were cased tracked during the visit to the home. Whilst there were care plans in place these had not been updated since 2004. There was evidence of annual reviews having been undertaken and some care plans were signed as having been reviewed. It is essential that all care plans are up to date and reflect current care practice. It will be a requirement of this report that all care plans are further developed and updated .The staff undertake monthly checklists and these are records about all aspects of each individuals health, care, well being and social life for the month. These were complete for the current month for all 3-service users case tracked but it was also evident that these had not been completed every month. Service users spoken to were positive about the care they receive. This was also reflected in the 8 out of the 8 surveys completed by service users DS0000011278.V306074.R01.S.doc Version 5.2 Page 10 Observation and discussion with service users indicate that the home is very service user focussed, the Inspector observed staff supporting service users to make decisions about food, going out, day care and relationships. Service users all have keys to their own doors. He home has a volunteer advocate who supports service users. On the day of the site visit staff in the home were working hard developing a complex risk assessment in respect of a potentially challenging relation ship issue. All relevant parties had been included in the development of this risk assessment. Service users spoken to informed the Inspector that they had been fully consulted in the development of this risk assessment. Each service users has risk assessment in place and there is evidence of the updating of these. Due to the need to update care plans it is also essential that risk assessments are developed and updated alongside and will be a requirement of this report. DS0000011278.V306074.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16,and 17 The Quality outcome in this area is good. Service users benefit from a range of day activities and engage in the local community. Service users are supported to maintain important relationships. The home promotes the rights and independence of service users and they enjoy a healthy well-balanced and chosen menu. This judgement has been made using available evidence including a visit to the service. EVIDENCE: On the day of the visit to the home all service users were out attending individual day activities, one service user was in hospital. Several service users were attending the local Oakbridge day centre. Some service users had laminated cards, which detail their daily activities in picture and word format. Among the activities available for service users were: drama, farm, sensory, interactive story telling, ASDAN, cookery, pop culture, dance and swimming. One service user was proudly told the Inspector about a job working in a café. Service users spoken to were happy with their day care plans and theses included time at home for one to one shopping or similar activities. On the notice board in the home there are various newspaper articles, which include pictures of, service users achievements and activities in the local community. Service users in the home have excellent knowledge of the local area and told DS0000011278.V306074.R01.S.doc Version 5.2 Page 12 the Inspector about shopping trips to Slough and Windsor. Service users also told the Inspector about various local facilities and amenities. Service users in the home are supported to maintain relationships of their choice, two service users told me about their relationship of 20 years and how staff support them, this support is very important to them. Service users files sampled detail relationships. Service users also talked to the Inspector about visits to and from families and friends. The home has a choice of areas where service users can entertain friends or family. Service users informed the Inspector that they have keys to their individual rooms. Service users were seen chatting to each other and to staff on their return home. Some chose to go into the lounge and others went to their rooms. Service users were seen using their own individual keys to enter the house. The Inspector was supplied with individual menus for each service user. The service users all shop separately and choose their own individual meal each day, this was clearly the preference of service users and was observed to work well. The home has 3 kitchens so there is plenty of space and opportunity for service users to practice and develop their cooking and independence skills. It also means a greater choice of where and who to eat with. On a Sunday service users will get together to cook and eat a roast meal of their choice. Service users were very enthusiastic about the food I the home and said; “I have lots of food, pork chops, sausage, chicken and vegetables” “I can make an omelette too”. “I like to choose what to eat, I am having fish tonight” “I can make drinks and snacks when I want to”. There was plenty of fresh fruit available throughout the home and menus seen were well balanced. DS0000011278.V306074.R01.S.doc Version 5.2 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 the following standard(s): 18,19 and 20 The Quality outcome in this area is adequate. Records need to be developed to demonstrate how service users receive personal care and healthcare records need to be more robust. Medication procedures and practice are satisfactory. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Personal and health care records were examined as part of the case tracking process. Due to the fact care plans are not up to date it was difficult to assess and evidence personal support. This needs to be reviewed and added to the care plans. The 8 surveys completed by service users and the 4 service users spoken to all stated they were happy with the personal care they received. Staff spoken to clearly demonstrate sound knowledge of service users individual care needs and communicate well between the team, however this needs to be detailed on records to meet regulations. Files sampled also contained healthcare detail, including appointments with health care professionals such as, podiatry, dermatology, hearing aid clinic and nurse appointments. The healthcare records were poorly organised and need to reviewed. Healthcare needs are detailed on the monthly monitoring sheets but there is little cross-referencing and these do not correlate with care plans. One service user told the Inspector about his appointment at the hospital that afternoon, staff were supporting. The Inspector observed good practice from a DS0000011278.V306074.R01.S.doc Version 5.2 Page 14 member of staff who was concerned about the condition of a service user who was in hospital; the staff member undertook a number of calls to other professional to detail the concerns. Staff are trained before administering medication. Exampled of training certificates were seen. Medication is stored securely in locked metal cabinets. The home operates a blister pack system and stock sampled was satisfactory. Mar sheets are completed and the medication is checked at each handover. DS0000011278.V306074.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23 The quality outcome in this area is adequate. Service users views are listened to and acted upon but records are poor. Staff work to promote that service users are safeguarded. This judgement has been made using available evidence including a visit to the service. EVIDENCE: 6 service users out of 8 who completed surveys were confident about who and how they could complain. Of The 5 service users spoken to on the day of the site visit all were confident about whom to talk to if they had any concerns or worries. One service users informed the Inspector “ I have a choice of what I do, if not I complain” The home has an volunteer advocate who assisted the service users to complain to Advance Housing about the fact they were relocated to Oscars hotel for 19 months instead of the planed 6 months. The Housing Director who shared lunch with the service users and offered a full apology with compensation drew the complaint to a satisfactory conclusion following a positive visit. Service users were supported throughout the process and were happy with the outcome. It would be beneficial to see such issues recorded in the complaints log. The last recorded complaint was a number of years previously. The home has a detailed complaints policy and procedure in place. The Inspector discussed the need to keep a comprehensive log of any complaints and relevant action taken. This will be a recommendation of this report. The home has policies and procedures in place in respect of safeguarding adults. The home is currently working with the local authority under the protection of vulnerable adults; this is a positive piece of work in respect of safeguarding the individuals concerned. Staff spoken to at the visit to the home demonstrate good knowledge of safeguarding adults, although it was difficult from training records to establish how many staff have attended relevant training. Paper work evidence was seen of training courses planned DS0000011278.V306074.R01.S.doc Version 5.2 Page 16 revealed that the following courses are planned in September for staff to work towards safeguarding adults; Risk Practice, Recognising and Responding to Abuse in Learning Disability DS0000011278.V306074.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 24,25,26,27,28 and 30 The Quality outcome in this area is excellent; service users live in a homely, comfortable environment. Their bedrooms are designed to maximise choice and independence. There are sufficient bathroom facilities and plenty of communal space. The home is clean and tidy throughout. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Since the previous inspection the service users have returned to the completely refurbished Osborne House. Service users spoken to were really positive about the home; “I didn’t like it at Oscars it but it is very good I like it here, my bedroom is good” “I like living here and I like my bedroom” I really like living here”. The Inspector had a tour of the premises. The home has 4 floors and each single bedroom has its own en-suite facilities. There are separate kitchens on each floor in addition to the communal kitchen and lounge. To the rear of the property there is a large garden. The home has wheelchair access throughout including the installation of a lift. There are small balcony areas located on some of the floors. The home is bright and airy throughout. The home has been completely redecorated and recarpeted and is maintained to a high standard. The home has a separate laundry area and the washing machine has sluicing facilities if required. The organisation has liaised with the fire and other relevant authorities to meet the required standards. DS0000011278.V306074.R01.S.doc Version 5.2 Page 18 The organisation has fitted window restrictors to the large floor to ceiling window/doors in service users bedrooms. Service users were involved in the choice of decoration throughout the home and their bedrooms are all individual and personalised. The home is clean and tidy throughout and well lit. DS0000011278.V306074.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33, 34 and 35 The Quality outcome in this are is adequate. Service users are supported by a staff team who which could be more effective. The recruitment processes protect Service users. Staff are offered ongoing training to support service users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has a minimum of 2 staff on duty at all times; the home currently has a vacancy of 28 hours. The Inspector discussed with the Manager the apparent lack of time available to undertake paperwork and hence the records are in need of reviewing and updating. It will be a requirement of this report that the staffing structure is reviewed to ensure sufficient staff time available to complete records. Service users commented, “I like my key worker, all the staff do very good work, they are always very busy” “the staff are nice here, they help me” In 1 survey a service users commented that the “staff are very busy and have no time to talk” The Manager supplied the Inspector with a sample of recruitment records for staff; all the relevant documents were available, application forms, 2 references, medical checks, and CRB checks. There were also copies of relevant personal documentation required. Staff discussed with the Inspector that service users are involved in the interview process. Time was spent with service users developing questionnaires and samples of these were seen. Service users confirmed in their discussion that they had an important part in the interview process and selection of staff. DS0000011278.V306074.R01.S.doc Version 5.2 Page 20 Training records requested were poor, there were copies of certificates retained on some staff files but others chose to keep theirs at home, their was no detailed profile in place for each staff member. The Inspector was supplied with details of a number of courses planned, which confirmed the named member of staff due to attend the course. Courses included, Risk Practice, Recognising and Responding to Abuse in Learning Disability, Effective Communications all in September. It will be a recommendation that training records are improved. DS0000011278.V306074.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41 AND 42 The Quality outcome in this area is adequate. The Manager has the relevant skills and qualifications to manage the home. Service users views need to be incorporated into a formal Quality Assurance system. Record keeping is not up to date or well organised. Health safety and welfare needs to be promoted. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Discussion with the Manager and review of documentary evidence detail that since the Manager has completed the registration process and is currently completing the Registered Mangers award. The Inspector viewed the records of the service users meeting; these demonstrate that service users views are sought in aspects of the running of their home. The home has supplied the CSCI with the recorded visits made on behalf of the Registered Provider. The home still does not have any further comprehensive Quality Assurance process in place. The Manager advised the Inspector during the visit, that a formal Quality Assurance system is currently being developed at the organisations Head Office. It will be a requirement of this report that this is completed and put into action. DS0000011278.V306074.R01.S.doc Version 5.2 Page 22 Record keeping in the home is not up to standard. Records are disorganised, not up to date and not consistent. It will be requirement of this report that this is addressed. Health and safety records were seen by the Inspector although most checks had been completed there were some not available e.g. the PAT test records. The health and safety file was also poorly organised and needs to be reviewed to ensure all up to date information is available. DS0000011278.V306074.R01.S.doc Version 5.2 Page 23 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 2 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 X 30 4 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 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 2 2 3 X 3 X 2 X 2 2 X DS0000011278.V306074.R01.S.doc Version 5.2 Page 24 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. 3. Standard YA6 YA9 YA18 YA19 Regulation 15, 17(3) Sch 3 13(4) 12 (1a) (3) 17(1) sch 4 24 17 Requirement . Review and update all service users care plans Review and update necessary risk assessments Update health and welfare records to promote service users choice and preference. Review staff structure to ensure sufficient time available to complete required records Develop formal Quality Assurance system Review, organise and update records in the home. Timescale for action 31/12/06 31/12/06 31/12/06 4. YA33 31/12/06 5. 6. YA39 YA41 31/03/07 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA22 Good Practice Recommendations Ensure all complaints dealt with are detailed in the homes DS0000011278.V306074.R01.S.doc Version 5.2 Page 25 complaints log. 2. 3. 4. YA33 YA35 YA42 Ensure relevant records are updated to allow full assessment of qualifications and qualities of staff. Ensure all training records are organised and updated to include a profile on each staff member. Ensure all Health and safety records are up to date. DS0000011278.V306074.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford, OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000011278.V306074.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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