Inspection on 18/08/06 for Osbourne Court Care Home

This inspection was carried out on 18th August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Osbourne Court Care Home 07/05/08

Osbourne Court Care Home 22/06/07

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Osbourne Court Care Home Park Drive Baldock Hertfordshire SG7 6EN Lead Inspector Claire Farrier Key Unannounced Inspection 18th August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Osbourne Court Care Home Address Park Drive Baldock Hertfordshire SG7 6EN 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) 01462 896966 01462 896967 Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Andrew Williams Care Home 69 Category(ies) of Dementia - over 65 years of age (34), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (69), Physical disability over 65 years of age (69) Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. This home may accommodate 69 older people with physical disability who require personal care. This home may accommodate 35 older people who require nursing care. This home may accommodate 34 older people with dementia who require personal care. This home may accommodate 69 older people who require personal care The home may accommodate one named service user with a learning disability. This condition will no longer apply once the service user ceases to reside at the home. 28th February 2006 Date of last inspection Brief Description of the Service: Osbourne Court is owned and operated by Four Seasons Homes Ltd, and it is registered to provide personal care and accommodation for 69 older people. The ground floor accommodates 34 residents who may also suffer from dementia, and the first floor accommodates 35 residents who need nursing care. Osbourne Court is a purpose built two-storey building situated in a residential area close to the centre of Baldock. It is adjacent to a health centre and a large superstore, which provide good access to medical and shopping facilities. Accommodation is provided in single rooms. All rooms have an en-suite toilet and washing facilities and there are a number of assisted bathrooms throughout the home. The first floor is served by a passenger lift. There is ample car parking space at the front of the building. There are two small gardens with patio areas to the rear and side of the home. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective clients. The current charges range from £590 per week for residential care to £630 per week for nursing care. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out this unannounced inspection in one day. The focus of this inspection was to assess all the key standards, and some additional standards were also assessed. An announced inspection of the dementia care provided by the home was carried out on 31st July 2006, in order to inspect the provision of dementia care in the home following an application to increase the number registered for dementia care to 34. This report includes evidence and comments from that inspection. On 31st July the inspector toured the ground floor dementia care unit and spoke to several residents and members of staff. A sample of care plans was inspected. The manager, the regional manager and the care services director for dementia care discussed the current arrangements for staffing and training, and the changes planned if the increase in numbers is agreed. On 18th August the majority of time was spent talking to residents and staff, and discussions were held with the home’s manager. Some time was also spent looking at records, care plans and staff files, and the inspectors made a tour of the premises. What the service does well: All the residents who took part in the inspection said that they are happy in the home and that the staff provide a good quality of care. One resident said that the best thing about moving to Osbourne Court is that they can rely on support form the staff and they feel safe. Another commented, “They can’t do any more than they do. The carers are very nice, they know what they are doing.” One person said, “It’s very good here.” On the dementia unit the residents spoken to were happy and sociable, and evidence of general well being was observed. The staff were observed to be patient and caring, and on the dementia unit there was evidence of a lot of one-to-one care and attention. The staff spoken to were enthusiastic about their work, and said that a good quality of training is provided for them. The manager was very enthusiastic about the changes taking place in the home, and particularly improving the provision of dementia care. The home has good procedures for administering medication, and the staff spoken to were aware of issues concerning individual medications. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Two requirements have been repeated from the last inspection, although some progress has been made to address both of them. As reported above, an activities organiser has been appointed, and evidence was seen of a programme of activities in the home. However there is a need for more specific activities for dementia care, and on the day of the inspection no activities were taking place because the activities organiser was working as a care assistant due to shortage of staff. Regular residents’ meetings take place, and it was reported that the company is working on clinical guidelines in order to establish a system of internal audits. But until these are in place there continues to be no structured system for monitoring the quality of the care provided by the home. Although maintenance in the home has improved, several further actions were identified during the tour of the premises. Both shower rooms were out of use because the showers were broken, and one resident who is unable to have a bath complained that there is no shower available in the home. One hoist was broken, and had not been attended to during the recent hoist service. There were noticeable offensive odours in the entrance hall and near some of the bedrooms on both floors, which causes an unpleasant environment for the residents. The door of one bedroom on the ground floor was held open by a chair, which could cause a risk to the resident in case of fire. The care plans generally provide good information for the staff on the needs of each resident and the actions needed to meet those needs. However there were no guidelines on the management of Parkinson’s disease, and one resident said that the staff did not understand their specific needs. The care plans and other personal information are not stored securely in the home. The care plans, bath rota and communication book were easily accessible for anyone who is in the area. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 7 Residents and their relatives are able to make their views known and to make complaints when they have any concerns, but there is no formal record of complaints. The staff files that were seen do not contain evidence of each member of staff’s identity. There are no photographs of the staff in the home so that they can be easily identified. There have been no recorded fire drills in the home for the past year. The staffing rotas showed that there is frequently a shortfall in the numbers of staff in the home. On the day of the inspection there were two fewer staff than normal, and the activities co-ordinator was working as a care assistant. 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. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment of the needs of the residents was seen to be in place, and appropriate risk assessments are carried out to ensure that the residents live in a safe environment. The home has sufficient information on residents’ needs and access to appropriate services to enable the needs to be met. EVIDENCE: The files of four residents were inspected, and each one contained a full assessment that was completed before the resident was admitted to the home. Care plans are written from the information in the assessments, and the assessments and care plans provide appropriate information so that the staff can meet each person’s needs. The assessments include risk assessments for moving and handling and the risk of falls, and other assessments are also Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 10 carried out when appropriate, for example for pressure area care and for nutritional needs. Since the last inspection an application was made to increase the number of beds registered for dementia care. In order to assess the application, a separate inspection of the provision for dementia care was carried out. It was found that the home meets the needs of the residents with dementia. There were plans in place for additional training for the staff and for some changes in the environment in order to ensure that the staff can meet the needs of additional residents with dementia. Sufficient qualified nurses are employed to meet the needs of residents who require nursing care, and the care plans that were seen contained appropriate information on health care needs and how they should be met. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans provide clear information on the residents’ care needs, which enable the staff to provide a good quality of care. However they do not adequately address the needs of people with specific conditions such as Parkinson’s disease. The home has good procedures for administering and recording medication safely. EVIDENCE: Detailed case tracking was carried out through the files of four residents on this occasion, and of two residents with dementia during the separate random inspection to assess the quality of dementia care. All the care plans seen contain clear and easily accessible information on the resident’s health and personal care needs, with comprehensive procedures for meeting the needs. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 12 The residents have appropriate access to medical care and to chiropody and other treatments. The home employs sufficient qualified nurses to meet the needs of the residents who need nursing care. There is appropriate monitoring of nursing procedures such as pressure area care, and regular assessments take place for moving and handling and nutritional needs. Care plans that are specific for dementia include specific risks, such as risks of falls and risks of behaviour, with measures to address the risks. The care plans are person centred and emphasise each person’s abilities, to maintain independence and to make decisions through ‘best interest’ discussions. The care plan for a resident with Parkinson’s disease was seen. There were no details of the person’s specific needs, in particular for management of “freezing”, when the person may become unable to take a step, or for the need for having medication at very regular times. There were no guidelines on the management of Parkinson’s disease in the care plan. It was reported that staff tend to rush this person when they “freeze”, and that medication is sometimes not administered on time. The home has good procedures for administering medication. A spot check showed no errors in recording, and the storage facilities are secure. There is a thermometer in both medication rooms, but the temperatures are not recorded. On the ground floor the thermometer showed a temperature of 23°C, but as the door to the room was open there was no assurance that the temperature remained below the recommended maximum of 25°C when the door was closed. In the dementia unit the staff were observed to have a good relationship with the residents. They spoke to them while assisting them, and were patient and caring. The staff spoken to said that they have time to spend with individual residents. The residents spoken to were happy and sociable, and evidence of general well being was observed. During this inspection one visitor said that the staff are very good with the residents; they give them one-to-one attention, and encourage them to eat and drink. One resident said, “They can’t do any more than they do. The carers are very nice, they know what they are doing.” Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Families and friends are welcomed into the home, and family members are consulted about the resident’s care. Wholesome and varied meals are provided within the home presenting a well-balanced nutritious diet for the residents. Residents maintain their independence by making choices about the food and how they spend their days. There is a range of activities to suit the needs of most of the residents, but no activities take place when the activities organiser is not available. There are insufficient activities for people with dementia. EVIDENCE: An activities co-ordinator has been appointed since the last inspection. An activities programme is in place, but on the day of this inspection no evidence was seen of any activities. It was reported that the activities organiser was working as a care assistant due to shortage of staff. The residents spoken to said that some activities do take place, and one said that they enjoy bingo, but this person doesn’t like going into the main lounge, so does not take part in many activities. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 14 Activities were taking place in the dementia unit during the random inspection of dementia care. The staff spoken to said that they have time to spend with individual residents. The residents spoken to were happy and sociable, and evidence of general well being was observed. The need for more specific activities for dementia care was discussed, and it was reported that plans were in place to implement this. Families and friends are welcomed into the home, and family members are consulted about the resident’s care. The home promotes the residents’ autonomy, and all the bedrooms seen contained evidence of the resident’s own furniture and decorations. Residents with dementia are enabled to maintain independence and to make decisions through ‘best interest’ discussions. Most of the residents said that the food provided is good, and that they have a choice of what they wish to eat. There is a four week revolving menu that provides a varied and balanced choice of meals. Hot and cold drinks are available at all times, and the staff were seen encouraging residents to drink. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to safeguard the residents from abuse, and allegations of abuse have been investigated and dealt with appropriately. Residents and relatives are confident that any complaints will be properly investigated, but there is no formal recording of complaints. EVIDENCE: The home has a satisfactory complaints procedure in place. Residents and their relatives are encouraged to make their concerns and complaints known. The complaints file contains letters of complaint and the responses. Recent complaints include concerns about care and communication. The regional manager responds to all complaints, but there is no formal record of the complaints. All complaints must be fully recorded, including the result of the investigation and any actions taken. The home has comprehensive procedures for prevention of abuse. Training in protection of vulnerable adults has been provided for all the staff, and the staff spoken to were aware of their responsibilities for whistle blowing. Some members of staff were not aware of the procedures for prevention of abuse, but they felt confident about reporting any concerns to the manager. Staff Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 16 have reported four incidents since the last inspection, of which three involved other staff and have resulted in disciplinary action. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained and provides a safe and comfortable environment for the residents. Individual and communal facilities are generally appropriate for the residents’ needs, but there is no shower available for the residents. There were noticeable offensive odours in some areas, which causes an unpleasant environment for the residents. EVIDENCE: Osbourne Court is a purpose built two-storey building. It is situated in a residential area close to the centre of Baldock. The home is generally well maintained. Access to the first floor roof terrace has been closed until a trellis is erected and it can be made safe, and it has not been available for the residents on the first floor for over a year. There is a small enclosed garden Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 18 with access from the ground floor lounge, but the frail residents on the first floor are not able to sit in the open air during warm weather. The shower rooms on both the first and second floors are out of order, and it was reported that first floor shower had been broken for the past ten days. One resident who is unable to have a bath complained that there is no shower available in the home. One hoist was broken, and had not been attended to during the recent hoist service. Some changes are needed in the dementia unit to ensure that the environment can promote independence and well being for the residents. The carpet in the corridors has a very bright and busy pattern, and there is no differentiation or aids for orientation in the unit. It was reported that provision has been made in the home’s budget to replace the carpet with one more suitable to the needs of people with dementia. It was reported that the Four Seasons care services director has conducted an environmental audit of the ground floor. The changes that are planned include the use of therapeutic colours and themed areas, in order to provide a suitable environment for residents with dementia. The home appeared to be clean throughout, and appropriate procedures are in place for the control of hygiene. The kitchen appeared to be clean and hygienic. The Environmental Health Officer carried out an inspection of the kitchen in July 2006 and made some requirements concerning cleaning. As a result, a cleaning plan has been put in place to ensure that the kitchen is thoroughly cleaned on a regular basis. There were noticeable offensive odours in the entrance hall and near some of the bedrooms on both floors, which causes an unpleasant environment for the residents. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff numbers in the home are frequently below the level that is sufficient to ensure that all the residents’ needs are met. The staff receive appropriate training. Good recruitment procedures and staff training make sure that, as far as possible, the residents are supported and protected in the home. EVIDENCE: The staffing rotas for two weeks were seen, which showed that there are ten or eleven staff on duty during the morning and nine or ten during the afternoon and evening. One registered nurse and five care assistants work in the home during the night. It was reported that on the first floor there should be two registered nurses and five care assistants on each shift during the day, and on the ground floor there should be two senior care assistants and three care assistants. Agency staff are occasionally used, and on the day of the inspection the activities co-ordinator was working as a care assistant. During the week of the inspection two staff had resigned and three were suspended (see Complaints and Protection). There were only five staff on the first floor, for 28 residents with nursing needs. Where possible there is flexibility between the floors to ensure that sufficient staff are available to meet the needs of the residents. However the staffing rotas show that there is frequently a shortfall. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 20 The manager reported that there is a continuous recruitment programme, and five new care assistants were ready to start when references and other checks were completed. During the random inspection of dementia care in July there were sufficient staff on the ground floor, and the staff were observed to provide one-to-one care and attention for several residents. The senior staff are specific to the dementia unit, but the care assistants may work anywhere in the home. All the members of the care staff and domestic staff spoken to during the inspection were enthusiastic about their work in the home. The company provides a comprehensive training programme that covers all the statutory training, and other training as required for the specific needs of the service users. Further training is needed in some specific needs, such as Parkinson’s disease (see Health and Personal Care). The staff confirmed that they have appropriate training. All the care staff are encouraged to undertake NVQ qualifications, and there is an expectation that new staff will register for the qualification. Seven of the 28 care staff currently have a NVQ in care at level 2 or level 3, and three are waiting to start the training course. A two day dementia care training is being rolled out for all the staff in the home, including the domestic staff. It was reported that the senior staff on the dementia unit would undertake a more comprehensive training programme, including dementia mapping, in order to assist them to understand each person’s individual needs. The home has robust policies and procedures for recruitment. Three staff files were seen for recently recruited members of staff. They contained most of the required information, including good references and a satisfactory CRB (Criminal Record Bureau) disclosure. However there were no photographs of the staff to aid identification, and two files had no evidence of identity. (See Management and Administration). Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Appropriate records are maintained for the effective management of the home and monitoring of health and safety procedures, but there is a need for regular fire drills to ensure the safety of the residents in case of fire. Procedures are in place to ensure that the personal money of the residents is looked after and recorded appropriately. An effective quality assurance system is required, to ensure that views of the residents and their families underpin all selfmonitoring, review and development of the home. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager has worked at the home for 18 months, and has been registered by the CSCI. He has completed the Registered Managers Award (RMA). The manager’s qualifications and style of operation of the home ensures that the home is run in the best interests of the residents. He is enthusiastic about the developments taking place in the home, in particular for providing a good quality of dementia care. There is no structured system for monitoring the quality of the care provided by the home. The regional manager of Four Seasons Healthcare makes regular monitoring visits to the home. Residents meetings take place in the home every four to six weeks, and the minutes of the last meeting showed that there were discussions about activities, care, food and housekeeping. Two relatives meetings have taken place, one in the afternoon and one in the evening, and it is planned that these should be a regular event. These meetings seem to be a more successful way of consulting the residents and their families than questionnaires, as only two questionnaires were returned to the home last year. A robust system of quality assurance that is needed that is based on the views of the residents must form the foundation of the service, and lead to a cycle of planning, action and review for developing the services provided by the home. It was reported that the company is working on clinical guidelines in order to establish a system of internal audits. The arrangements for management of residents’ money were inspected and appeared to be accurate. Money is stored safely and adequate records are maintained in order to protect service users from financial abuse. The care plans and other personal information are not stored securely in the home. On the ground floor the residents’ care plans are stored in an unlocked filing cabinet by the nurses’ station. The bath rota file and the district nurses’ communication book were seen on the desk of the nurses’ station. These contain personal information, including requests for the district nurse to visit certain residents with the reasons for the visit. The care plans, bath rota and communication book are easily accessible for anyone who is in the area, and the nurses’ station was not supervised by the staff. The staff files that were seen contained most of the required information, including good references and a satisfactory CRB (Criminal Record Bureau) disclosure. However there were no photographs of the staff to aid identification, and two files had no evidence of identity. Satisfactory evidence of identity must have been provided for the CRB application, but it must also be maintained in the home. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. All fire equipment is checked regularly and the home has procedures for protecting the residents from the risks of fire. However the door of one bedroom on the ground floor was held open by a chair, which could Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 23 cause a risk to the resident. There have been no recorded fire drills in the home for the past year. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X 2 2 X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 2 Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP8 Regulation 12(1) Requirement There are no guidelines in place to ensure that staff meet the healthcare needs for residents with specific needs such as Parkinson’s disease. The registered person must ensure that training and guidance is provided to staff for on how to meet the needs of residents with specific conditions. Activities suitable to meet the needs of the service user must be provided in a manner and form suitable to need, including specific activities for people with dementia. Records of activity engagement to be recorded. Previous timescale of 15/03/06 partially met. There is no formal record of complaints in the home. A record must be maintained of all complaints, which includes the result of the investigation and any actions taken. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 26 Timescale for action 31/12/06 2. OP12 12(2) & (3) 31/10/06 3. OP16 OP37 22 Schedule 4 31/12/06 4. OP19 23(2)(a) 5. OP21 23(2)(j) Measures must be taken to 31/10/06 ensure that that the environment of the dementia unit meets the needs of the residents. This could include the use of colours and textures for differentiation, and visual aids to orientation. Two showers have been out of 30/11/06 use for over ten days. Sufficient numbers of showers must be made available to meet the needs of the residents without further delay. One hoist was broken, and had not been attended to during the recent hoist service. All equipment provided for the use of residents must be maintained in good working order. There were noticeable offensive odours in some areas, which causes an unpleasant environment for the residents. Measures must be put in place to identify and keep the home free from offensive odours. Staff numbers in the home are frequently below the level that is sufficient to ensure that all the residents’ needs are met. 6. OP22 23(2)(c) 30/11/06 7. OP26 16(2)(k) 30/11/06 8. OP27 18(1)(a) 30/11/06 9. OP33 24 The registered person must ensure that sufficient staff are available at all times to meet the needs of the residents. There is no structured system for 31/12/06 monitoring the quality of the care provided by the home. A system for monitoring the quality of care must be established, that focuses on the consultation with the service users and other involved people, Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 27 10. OP37 17(1)(b) and provides feedback on the process and the results of the consultation. Previous timescale of 30/06/06 partially met. Care plans and other personal information are stored openly and available for anyone to see. Personal records, including care plans and other records that contain personal information, must be stored securely. The staff files contained no photographs or evidence of identity. 30/11/06 11. OP37 17(2) Schedule 2 30/11/06 12. OP38 All the required information on staff, including evidence of identity and a recent photograph. 23(4)(c)(ii The door of one bedroom on the i) ground floor was held open by a chair. The registered person must consult the fire authority concerning adequate precautions against the risk of fire, in particular with regard to the use of door wedges on bedroom doors, and take action on any subsequent recommendations. There is no record of any fire drills in the home during the last year. The registered person must ensure that every member of staff takes part in at least one fire drill every year. 30/11/06 13. OP38 23(4)(e) 31/12/06 Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 28 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 OP9 Good Practice Recommendations The temperature of the medication storage rooms is not monitored adequately. The temperature of all rooms used to store medication should be monitored to ensure that it is below 25ºC at all times, in order to ensure that there is no risk of medications deteriorating. Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hertfordshire Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Osbourne Court Care Home DS0000068298.V319226.R01.S.doc Version 5.2 Page 30 - 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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