Inspection on 30/12/08 for Osborne Lodge

This inspection was carried out on 30th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Osborne Lodge 30/01/07

Osborne Lodge 06/09/05

Osborne Lodge 14/04/05

Osborne Lodge 13/09/04

Osborne Lodge 12/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Osborne Lodge 30 Osborne Road New Milton Hampshire BH25 6AD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ian Craig     Date: 3 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Osborne Lodge 30 Osborne Road New Milton Hampshire BH25 6AD 01425618248 Telephone number: Fax number: Email address: Provider web address: osborne_lodge@btconnect.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Maureen Gladman Type of registration: Number of places registered: Vauxian Hotels Ltd care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Osborne Lodge is registered under Vauxian Hotels Limited, and situated close to local amenities in New Milton. The home sits in well-landscaped gardens and provides accommodation on two floors for 24 older persons in 22 single bedrooms and 1 double bedroom. All bedrooms have an en-suite toilet and bath/shower facilities. Residents are fairly independent but have varying needs with aspects of daily living. The weekly fees range from 550.00 to 750.00 pounds sterling a week. 0 Over 65 24 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection consisted of a site visit to the home which lasted 5 hours. This consisted of discussions with the manager and 2 of the staff. 4 residents were interviewed. A tour of the home took place. records, policies and documents were looked at. Surveys were sent to residents, staff and health and social care professionals asking for their views on the service. These were returned by 9 residents, some of which were completed by residents relatives. Three staff returned surveys. Information from the surveys has been used for this report. Care services are required to complete an Annual Quality Assurance Assessment. This was completed and returned to the Commission and has been used for this report. Care Homes for Older People Page 5 of 26 Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The home needs to ensure that when it assesses someone for possible admission that this is recorded. Procedures for predispensing some medication needs to be changed. Care Homes for Older People Page 7 of 26 The homes staff recruitment needs to ensure that staff only start work after the required checks have been completed. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential residents are able to make an informed choice about whether or not they want to move into the home. The home only accommodates those whose needs it can meet although some improvements are needed in the recording of assessments before someone moves in. Evidence: The home has a Statement of Purpose and a Service Users Guide. These documents give information about the services provided by the home as well as details of the staff, complaints procedure, a copy of the last inspection report and a sample contract. The home also has its own brochure with details of the fees, meals, staff, activities and facilities. The manager explained how these are given to prospective residents. Each of the residents who returned a survey state that they received enough information about the home before moving in which helped them decide if it was the right place for them. Care Homes for Older People Page 10 of 26 Evidence: Residents spoken to on the day of the visit said that they, or their next of kin, looked around the home before moving in. The process of assessing the needs of those referred to the home for possible admission was looked at. The manager states that a visit is made to the person at their home, or in hospital, where an assessment is carried out using a pro forma called Initial Resident Assessment. This includes details of religious and cultural needs, physical health, mental health, mobility, personal care such as dressing and family involvement. Records of these assessments included a date of completion after the person was admitted to the home for 2 people. One of these admissions was arranged at short notice due to circumstances and the home was unable to complete the assessment before the person moved in. For a third person the assessment was completed before the person moved in but on the same day. Each of the residents, or their relatives, who completed a survey state that they have a contract with the home for their stay, except for one person who states that he or she has not had a contract. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the health and personal care needs of the people who live there although some changes are needed to ensure that the handling of medication is safe. Residents are able to exercise choice and their privacy and dignity is promoted. Evidence: Assessments and care plans were looked at for 6 residents. Assessments of need are comprehensive and include the following: mental health, physical health, personal risk, moving and handling, behaviour, pressure sore, nutrition screening, falls risk and care needs. Corresponding care plans are recorded for each of the above needs. A social history is also recorded depending on the information available. Care records include individual preferences for care and daily routines such as individual times for getting up and what the person likes for breakfast. Care plans are reviewed on a regular basis. Those completing the care plans record their signature and the date of completion. The home has a keyworker system whereby each resident had an allocated member of staff who takes key responsibility for overseeing care arranagements. Details of this Care Homes for Older People Page 12 of 26 Evidence: arrangement is displayed in each residents room. Records show that care needs are monitored when a record is made of personal care such as shaving, bathing and other personal care. A document called, Care Plan Diary includes details of the residents needs and prefereces as well as daily runing records which are signed and dated by the person entering any record. Care plans could be improved by the greater involvement of residents and monthly reviews. Each of the surveys returned by residents, or their relatives, state that they always receive the care and support they need. Residents spoken to on the day of the visit described the care staff as helpful, kind and responsive. One person said that he/she has only used the call point on one occassion and that staff responded within seconds. Residents also said that they always receive the medical support they need. Care records include details of needs such as continence and how staff are to provide this for this need. Each person has a record of health appointments and these include medical appointments with a general practitioner, district nurses and physiotherapy services. Regular optican and dental services are available to residents either in the home or at a local surgery. Staff expressed the view that residents care needs are met and that they receive training and instruction in how to meet care needs. Residents confirmed that they are able to spend their time as they wish and that they can have their breakfast when they like. Records are made so that staff know when the residents have their breakfast and what food is to be provided. These show that residents have breakfast at times between 6.30am and 9.15 am. Each resident has their own room which they are able to lock if they choose. Residents are asked if they want to have a key to their room and this is recorded. It was noted that the privacy and security of rooms could be enhanced for some rooms. The homes medication procedures were looked at. Staff sign a record each time medication is administered to a resident. Staff receive training in medication; this was confirmed from training records and discussions with staff and the manager. A staff member was observed giving resients their midday medication. Residents are supported to handle theur own medication based on an assessment and agreement with the resident. For 12 residents some of their medication that is not supplied in the blister packs is predispensed into a dosset box for the forthcoming 24 hours. This is contrary to current pharmaceutical guidance. The manager stated that she would change the system so that all medication is only dispensed from the pharmacists container at the time it is to be given to the resident. Care Homes for Older People Page 13 of 26 Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a range of activities, outings and entertainment. Meals are nutritious and choice is available. Evidence: 7 of the 9 surveys returned by residents or their relatives state that activities are always arranged by the home that they can take part in. 2 surveys said they are usually arranged. Additional comments include the following: the activities are very entertaining, and, activities are provided 5 days a week. The home has a staff member who organises activities and outings. A notice in the home gives details of the various activities which include the following: a monthly church service, weekly nail care, live music every 2 weeks, bingo, keep fit, boat rips, and card and board games. Residents spoken to on the day of the visit said that activities are of a good standard. One person said, The activities organiser is marvellous. She organises entertainment and trips out for us. Another person said that he/she joins in with some of the activities that he/she enjoys and another person described various trips out to shopping centres and to tea rooms. The home hires a mini bus for trips out. There are photograph displays around the home of various outings. Care Homes for Older People Page 15 of 26 Evidence: Details of each residents personal preferences and interests are recorded in the individuals care records and a record is made of any activities that the person takes part in. 10 residents have a daily newspaper and one person enjoys taking the papers to each person after they are delivered to the home. Books and magazines are available in several areas for the residents to read. Visitors are able to see residents at any reasonable time. A resident described how he/she is able to go out indepently as well as being taken out by his/her relatives. Residents preferences and dislkes for food are recorded. 5 of the 9 surveys returned by residents state that they always like the meals and 4 answered usually. One person said there are lots of choices. Residents spoken to said that there is always an alternative meal to the one on the menu. Details of the midday meal are displayed for the residents to see. Meals are said to be traditional English food. Sherry and wine are provided if the residents wish to have this with their midday meal. The time that each person likes to have their breakfast is recorded along with the breakfast food they prefer. Residents have breakfast at times between 6.30am and 9am. Fresh fruit is available for residents to help themselves from a bowl in the dinining room. Dining tables are set with napkins, table cloths and flower arrangements. A resident described how he/she has a special diet which the home caters for. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an effective complaints procedure and takes steps to protect residents from possible harm. Evidence: The homes complaints procedure is contained in the Service Users Guide and the Statement of Purpose. Each of the residents, or their relative, confirmed that they know what to do if they wish to make a complaint and that they always know who to speak if they are not happy. The home has not received any complaints. Staff receive training in adult protection matters. This was confirmed from training records, discussions with the staff and the manager. The 3 staff who completed a survey also said that they know what to do if a residents expresses concerns about how he or she is being treated. The home has literature on adult protection procedures and how to recognise and prevent abuse. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained with good quality furnishings which promotes the dignity of the people who live there. Evidence: A tour of the home took place. This included a number of residents bedrooms and the communal areas. There are 24 single bedrooms each with its own en suite toilet; some have an en suite bathroom. Rooms are decorated in neutral colours and are furnished with chairs, carpets and items that residents have brought to the home. Locks are fitted to bedroom doors and residents can have a key so that they can lock their bedroom door. This is assessed and recorded at the time the person moves into the home. It was noted that for some bedroom doors the locks could be improved to give more privacy and security. This was discussed with the manager. Residents said how they like their bedroom. One person said, Its clean and well furnished. Its home from home. There is an ongoing programme of redecoration and improvement of the facilities. The home has landscaped gardens with trees, shrubs and flowers. Each ground floor bedroom has a patio door which opens onto the garden. The manager said that there are plans to develop the garden by creating a sensory area for those with hearing and Care Homes for Older People Page 18 of 26 Evidence: sight difficulties. Books are available for residents to read and the home has plans to create a library area. Signs and notices are used to help residents find their way around. This includes details of forthcoming appointments and the name of the residents keyworker in each of their bedrooms. Residents were observed using the communal lounges to relax, read or to watch television. The home is clean and free from offensive odours. Each of the residents who returned a survey states that the home is always clean and fresh. The home has a laundry area with specific staff for washing clothes. A staff member was observed ironing residents clothes. Staff receive training in infection control. There is a passenger lift. Lifting aids are used for those with mobility needs and 2 bathrooms have a specialist bath. The home intends to fit a third specialist bath. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well trained, motivated and responsive staff team. The homes recruitment procedures need to improve so that residents are protected. Evidence: The home aims to provide the following staffing levels each day: 7.30am to 2pm, 6 care staff and 2 managers. 2pm to 8pm, 3 care staff and 2 managers. Night time, 2 waking staff. In addition to the above, the home employs an activities coordinator, a cook and kitchen assistants and domestic staff. The home is maintaining these staffing levels which was evidenced from the staff rota, observation, discussions with the manager and the staff. Residents said that there are enough staff on duty to meet their needs and that staff are quick to respond when residents ask for help. The surveys from residents state that staff are always available when needed, although one person said they are usually available. The staff spoken to on the day of the visit said the home has sufficient staff to meet residents needs and that the staff work as a team to meet residents needs. The manager states that the home has a low turn over of staff. The 3 staff surveys state that there is either always or usually enough staff to meet residents needs. Care Homes for Older People Page 20 of 26 Evidence: Staff confirmed that they had a period of induction when they started work and this involved shadowing more experienced staff. The manager has several induction checklist pro formas but is still in the process of implementing full records of induction. Records show that staff have supervision and appraisals, which was also confirmed by the staff surveys and discussions with staff. It was also said by staff that the homes management are always available for support and advice. Each staff member has attained the National Vocational Qualification (NVQ) level 2 in care and 15 of the 18 care staff have NVQ level 3. Additional training is provided in dementia, equality and diversity, adult protection, moving and handling, health and safety, food hygiene, infection control, the Mental Capacity Act 2005 and promoting continence. Staff said that they are supported to attend training courses and that this has in turn enhanced their skills and knowledge base as well as their own personal development and motivation in the work place. Staff recruitment procedures were looked at for the 2 staff who have started work at the home in the last 12 months. Each person has completed an application form. Two written references are obtained and criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks obtained. It was noted that both members of staff started work before the home had obtained either the POVA first or the CRB check. For one of these staff the POVA first check was not obtained until 3 months after the person started work although the home had a copy of a CRB checks from the persons previous employer. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and looks to develop and improve its facilities and services for the people who live there. The health and safety of the people who live at the home is promoted. Evidence: The manager is qualified at NVQ level 4 in care and has also attended other training courses. Staff describe the manager, and the management team, as supportive and as always being available for advice and support. The home has a quality assurance folder containing the homes system for monitoring its own performance, which includes obtaining surveys from health and social care professionals, residents and relatives. The home has a new responsible individual and the manager confirmed that there are plans to improve the homes facilities. Care Homes for Older People Page 22 of 26 Evidence: The home does not handle or look after residents valuables or money. Training in fire safety is provided. This was evidenced from training records and observation of the staff and management dealing with an unplanned activation of the fire alarm system. This showed that staff responded very quickly and in a coordinated manner, and that the emergency fire doors closed. All staff receive training in emergency first aid and moving and handling. Measures are taken to protect residents from scalding hot bath water by the installation of temperature controls. Records are kept to show that the water temperature of every bath a resident has is monitored. Radiators are covered to prevent any possible burns to residents. Window restrictors are installed on the first floor to prevent possible falls. Where residents have a bath facility in their en suite it was suggested that a risk assessment should be completed regarding any risks to the rooms resident. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Medication must be administered from the pharmacists container at the time it is due to be taken. So that medication is safely administered to residents. 30/01/2009 2 29 19 Staff must only start work after a POVA first or CRB with a POVA check has been obtained. So that the home carries out the required checks on new staff for the purposes of protecting residents. 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!