Inspection on 09/07/08 for Ottley House

This inspection was carried out on 9th July 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ottley House 17/07/07

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Ottley House Corporation Lane Coton Hill Shrewsbury Shropshire SY1 2PA Lead Inspector Pat Scott Key Unannounced Inspection 9th July 2008 09:15 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 Ottley House DS0000069245.V368072.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. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ottley House Address Corporation Lane Coton Hill Shrewsbury Shropshire SY1 2PA 01743 364863 01743 244651 Jane.Sagar@barchester.com www.barchester.com Barchester Healthcare Homes Ltd 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) Elizabeth Jane Sagar Care Home 72 Category(ies) of Dementia (36), Old age, not falling within any registration, with number other category (26), Physical disability (10) of places Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admmission to the home are within the following categories:dementia, DE, 36 old age not falling within any other category, OP, 26 physical disability, PD, 10 The maximum number of service users to be accommodated is 72 2. Date of last inspection 17th July 2007 Brief Description of the Service: Ottley House is a purpose built home situated in a residential area on the edge of Shrewsbury town. The home is set in established secure grounds that are accessible to service users and car parking facilities are provided for visitors. Access in and out of this home does not restrict liberty. The dementia suite is accessed via a keypad system, the code for which is on display above the doors. The range of fees charged by the home varies according to the nursing needs of the individual and whether the individual is cared for in a single or shared room-weekly fees currently range from £419 to £700 (high dependency). The inspection report is available for people to read. There is no restriction on entry or Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is *TWO star good service. This means the people who use this service experience good quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication audits, survey results from people who use the service, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: Records show that people and their families are consulted about care at reviews. Care needs are known and understood by staff but have not always been recorded in enough detail in some plans. Some matters of (minor) dissatisfaction may have been overlooked by staff for recording purposes. The service is aware of this and intends to address it. The re-written plans are good. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 6 Care needs to be taken in communication between staff and relatives so that there are fewer misunderstandings between them and a better understanding of how, what may seem small issues, can escalate if not acknowledged and addressed at the time. This will be achieved through confirmation of roles and responsibilities of staff through staff training and supervision. It will also be achieved through robust recording of all aspects of care/communication and consultation with residents and their supporters. 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. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 7 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 Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 8 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): Key Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective people can be confident that the care home can support them. This is because there is a complete assessment of their needs that they, or people close to them, have been involved in. Prospective people will be able to feel that they can live the life they choose in the home. This is because the assessment is person centred and shows an understanding and respect for their diversity. EVIDENCE: Admission ‘total care assessments’ of four people needing dementia care and three requiring nursing care were read. They relay the service is taking into account the individual physical care needs of a resident in a person centred way. Information is written about the person’s life and staff assess a persons future plans and concerns with them. All clinical assessments are very clear. The total care assessments had been reviewed six monthly or sooner when Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 9 circumstances change. Signatures of relatives are in place on the care profile review which shows that staff have consulted others who wish to be involved in a resident’s care. Ottley House admits people with dementia and provides staff with training and guidance to enable them to be responsive to individual needs. This dementia service is established with staff having built their expertise in this area of care. The provider has invested in good training resources for staff to build on current knowledge and best practice. The regional clinical development nurse was in the home conducting an Alzheimer training day. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 10 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): Key Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ care needs and risk assessments are set out in their individual plans of care which ensures that care needs have been addressed and will be met. The manager understands the need to comply with safe medication systems and staff practice ensures that the home’s procedures are complied with and that residents’ health matters are safely addressed. The actions of staff and their approach to care ensures that people are treated with respect and their right to privacy is upheld. EVIDENCE: The care plans were examined in detail for seven residents. All have care plans derived from the initial assessments. Each plan has a recorded monthly evaluation of the elements of care. They provide detail as to how most care is Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 11 to be delivered by staff in a way that the person prefers. The recording of clinical interventions in care is good. Staff spoken with state that the plans are being updated so that the information is clear in every one. It is acknowledged that the review of all plans will provide staff with a clear picture of the person’s needs and progress. Sometimes entries are written in general terms and staff feel they need to be more specific and directive. Staff provide some complex care which needs to be recorded in the detail that they practically provide it. The provision of clinical care is regularly audited by internal assessors and action plans are developed for any shortfalls in documentation. Examples were seen. People are attended to promptly by staff. Staff were observed on each unit conducting the medicine round. Medication audits are undertaken and action taken to improve areas e.g. trolleys and drug fridges have been replaced on the units. Mistakes have been identified and addressed through communication and re-assessment of staff. Daily records monitor the progress of individuals which provide clear indications of how a person has spent their day. The plans demonstrate contact with healthcare professionals such as the community psychiatric nurse or general practitioner. People spoken with stated that support is flexible as they spoke of the various bed/rising times which are accommodated and always delivered in a way that respects their privacy. Another comment includes ‘the staff are very nice and always help you in a kind way.’ A revised care plan seen is written in a person centred way, for example, ‘involve X with choosing clean clothing whenever X gets up’. Service users all appeared well groomed with their hair, nails and clothes looking clean. No issues were identified in discussions regarding approach of staff or being assisted with intimate tasks. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 12 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): Key Standards 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support people to keep in touch with family, friends and representatives so that they have appropriate relationships. People state they are as independent as they can be, and the service demonstrates that they lead their life in a chosen way so that they have the opportunity to make the most of their abilities and interests. The food in the home is of good quality so that the dietary needs of people are met. EVIDENCE: Menus seen are nutritionally balanced and food and drinks are readily available. Visitors have the use of kitchenettes on each unit. The service employs two activity co-ordinators and is seeking to have a third. Staff will drive the minibus so that outings are more spontaneous. They hold a drop-in session for residents or their relatives to discuss ideas as the formal Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 13 meetings were not well attended. The monthly newsletter and July calendar of events is on display in the foyer with a choice of indoor an outdoor activities. The service conducts a ‘nutrition and dining experience’ audit regularly, the last being June 2008. An audit regarding the provision of activities is also conducted. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 14 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): Key Standards 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is up to date and accessible so that anyone associated with the service can complain or make suggestions for improvement. EVIDENCE: People spoken to say they would go to the manager or one of the staff if they had a problem. All expressed confidence that issues would be dealt with. Concerns spoken about by people had been promptly dealt with and a satisfactory outcome reached. There is a good level of accessibility to the management at this home which ensures that concerns can be dealt with very quickly. The service has identified it needs to record ‘minor dissatisfaction’ so that it can demonstrate how all concerns are dealt with. A comment on a survey states;’ we have never had to raise any concerns about care, very pleased with the way my father is looked after.’ Adult protection is covered after recruitment and discussed at supervision. Staff training records seen show that staff are provided with regular updates in adult protection. Staff also receive training in ‘customer care’ which informs them how to address any concerns quickly and thoroughly. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 15 The service acknowledges that there have been recent complaints allegedly concerning standards of care at the home. These are being addressed through the multi-agency adult protection procedures. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 16 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): Key Standards 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The up keep of the environment is good so that people are provided with an attractive, clean and homely place to live. EVIDENCE: Ottley House is a purpose-built care home. The service has a rolling programme of refurbishment and improvement. Equipment assessed as being required for people is provided. The home is clean and hygienic. Infection control is monitored. A survey comment states;’ I do not think my friend could find a better place.’ Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 17 Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 18 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): Key Standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff get access to training, supervision and support they need from the manager so that people receive planned care. Staff in the home are trained and recognise the importance of care planning so that peoples’ changing needs are identified and acted upon. EVIDENCE: There are NVQ, qualified and experienced staff employed to provide care to people at the home. The staff have good managerial support to develop their experience in the service they are delivering. The manager reported some problems in providing a full staff compliment but agency staff have been deployed across the rota. Recruitment has been successful and so agency use has now reduced. Staff are also aware of the procedures that affect their roles such as complaints and adult protection. Re-written care plans show that there is understanding of the person centred way of delivering care and support which is supported by training. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 19 People using the service tell us that staff working with them provide safe and appropriate support. A relative commented; ‘the family cannot fault any member of staff at any time’. The service has a regional clinical development nurse. There is also a home trainer four days a week who works with an individual during their shift. Three staff personnel files were selected for inspection. All the necessary identity checks have been carried out and returned before the start of employment. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 20 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): Key Standards 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. People’s opinions are central to how the home develops and reviews it’s practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. EVIDENCE: Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 21 Through discussion with the manager customer satisfaction is high on the agenda. This is evidenced by the commitment to conducting surveys, resident meetings and drop-in sessions, staff surveys and provision of a monthly newsletter. The manager and her staff have attended many training events and updates to complement their roles within the home. Staff files seen record all training activity. The home does not manage any personal monies of people. Equality and diversity for service users is promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that resident satisfaction is at the heart of the service. The manager and her deputy with administrative support implement plans for improvement The provider produces a monthly report to the manager to demonstrate that the overall conduct of the service is being managed well. It covers areas such as; interviewing residents, relatives, staff, catering, complaints, health and safety. The home keeps records to show that the health and safety of service users is promoted and protected. The service conducts fire drills, regular alarm tests and has a fire risk assessment. Each unit has a personal evacuation plan for each resident detailing how they are to be assisted to get out of the home in case of fire. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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. 2. Refer to Standard OP7 OP16 Good Practice Recommendations To continue the task of re writing care plans in a person centred way. To record minor concerns/complaints on how the service has dealt with them. Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Ottley House DS0000069245.V368072.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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