Inspection on 06/06/05 for Overbrook

This inspection was carried out on 6th June 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Overbrook 22/01/07

Overbrook 10/10/05

Overbrook 08/03/05

Overbrook 21/10/04

Overbrook 19/03/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Overbrook 92 High Street Wootton Isle of Wight PO33 4PR Lead Inspector Liz Normanton Unannounced 6 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Overbrook Address 92 High Street, Wootton, Isle of Wight, PO33 4PR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 883390 01983 883390 Islecare 97 Ltd Care Home 4 Category(ies) of Learning disability (LD) (4) registration, with number of places Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8 March 2005 Brief Description of the Service: Overbrook is a small residential home for up to four adults with learning disabilities. The home is a two storey building and is situated in Wooton High Street on a busy main road close to local shops and ammenities. There is off road parking to the front and a private garden to the rear. There is level access to the front and rear of the property and a hand rail around the garden to assist residents with sight impairment. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken at the beginning of the week and the inspector arrived about mid morning to find all residents at home. The manager was not present at the inspection. The senior member of staff on duty assisted the inspector throughout the inspection. The inspector noted that the fire door leading to the lounge was propped open and the existing automatic door was not working. The inspector asked for this door to be closed and this was done immediately. There were three staff members on duty in the morning assisting residents with their care needs. After lunch three residents went out to day centre services. The inspector explained to residents who she was and the reason why she was there, she was able to consult with one resident who was able to say that they liked living at the home, one resident who would be able to consult preferred not to and two others were not cognitively able to express their views. The inspector had full access to the home, which was in a high standard of decoration with the recent introduction of new leather furniture in the communal lounge. The carpet in the dining area was found to be badly stained and the inspector was informed that the home plans to replace this. Resident’s bedrooms were furnished with their own furniture and personalised to reflect their individual personalities. The inspector was present at both the lunch and teatime meal and found that residents were offered choices. The meals were well presented and looked nutritious. One resident required full assistance with eating and help was given in a relaxed and unhurried way. The staff were meeting the day-to-day operations of the home but staff morale was low. Staff commented that they were feeling unsupported by management as the manager is spending a considerable amount of time at another home which she manages. The home has two pet rabbits, which are kept in the garden. The garden was well maintained. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2, Information is available in the Statement of Purpose, which would allow prospective residents the opportunity to make an informed choice. Service user guides were available but had a number of areas of information missing which would impede decision-making. Prospective residents can expect to have their aspirations met and needs assessed by the home’s manager. EVIDENCE: The inspector viewed the Statement of Purpose, which she found had now been updated since the last inspection. The home had a service user guide but this was lacking in information. The most recent resident has lived at the home for just under a year, this was an emergency placement. The senior member of staff was aware that individuals should be assessed when they move into the home and that this would usually done by a manager. The manager has drawn up a care plan with what information she received. The inspector viewed the residents care plan and found that there was information about the person’s health and personal care needs missing. The senior member of staff stated that requests have been for this information to be provided, but it appears to be have been misplaced. The inspector noted that the care manager had reviewed the placement following a two-month period. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 9 The inspector was informed that one resident has an independent advocate. Therapeutic needs of the residents are met following assessment from health professionals; one resident has visits from the district nurse every 3-4 weeks. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7, The home is able to recognise changes to residents care needs and update care plans accordingly. Residents are able to make choices within the limitations of their cognitive abilities. EVIDENCE: The homes manager ensures that each resident has a care plan which is generated from the Care Management assessment. The inspector viewed two care plans, which held the necessary information for care staff to meet the individuals, care needs. One care plan had information missing which would have been needed at admission, however this is beyond the home’s control. The resident’s care plans were seen to contain risk assessments and what action staff should take. The senior member of staff informed the inspector that care plans are reviewed monthly. The resident’s photographs held on the care plans need updating, existing photographs were last taken in 2003. The home operates a key worker system and key workers maintain their responsibility to one resident throughout the duration of their employment. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 11 The senior staff member believed that the residents would develop a sense of awareness of the role of the key worker due to the close contact, and additional support provided. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15,17, Residents are given the opportunity to be part of the local community. Residents are able to maintain contact with their families and would be supported in intimate personal relationships. The home provides residents with a choice of healthy meals. Mealtimes are relaxed with residents being given the time to enjoy their meals. EVIDENCE: The senior staff member informed the inspector that residents go out into the community, to shops, pubs and for outings to fetes/fairs etc. Some residents attend St.Johns Club weekly on a Sunday. The inspector viewed care plans which detailed resident’s likes and dislikes which are taken into consideration when planning activities. The inspector observed residents going out to the day centre. Two of the staff consulted knew about the Disability Discrimination Act and said they would challenge people who were being discriminatory. The home has a mini-bus, which enables staff to take residents out. The senior staff member informed the inspector that all residents were registered to vote but that nobody was able to exercise this right. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 13 Staff, are able to spend individual one to one time with residents during the week on resident’s home days. The inspector viewed the visitor’s book, which confirmed that residents do have visitors. The inspector was informed that one resident visits home once a fortnight. The senior staff member stated that staff would protect residents from unwanted visitors. Menus are planned weekly and take into consideration the likes/dislikes of residents and cater for specialist diets. All staff are involved in food preparation, the residents are not able to prepare meals. Meals are offered four times a day with drinks provided during and in between meals. The inspector looked at menus and observed lunch and tea and was satisfied that residents had been given choices. Meals are usually taken sitting up to the dining table. Residents were seen to receive the help/assistance they required to eat their meals. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, Residents are well supported by staff and receive the care they require in a preferred way. EVIDENCE: The inspector observed staff positively interacting with the residents and noticed that personal support was given in private. The senior staff member informed the inspector that residents could chose when to get up or go to bed and this was confirmed by staff members. Residents are in need of assistance in all aspects of personal care, details are written in individual care plans giving guidance to staff. The home operates a key-worker system, which provides consistency and continuity of care to residents. Where necessary the home liaises with health professionals to meet the care needs of residents. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23, The home has complaints policies and procedures, however residents may not be aware that they can complain or due to communication difficulties would find it hard to get across their views. The staff endeavour to protect residents from abuse, neglect and self-harm. EVIDENCE: At the time of the inspection the homes service user guide was found to have information on complaints missing. The information in the Islecare policy on complaints was out of date. The inspector was informed that there had been no complaints for over three years either from residents or their families. The senior staff member was aware that complaints have to have been responded too within 28 days. The home’s adult abuse policy and procedures did not incorporate the Isle of Wight adult protection procedures. The senior staff member was aware of the whistle blowing policy and stated that there had been no allegations made for over four years. Residents’ needs re: challenging behaviour are written into care plans. The handling of residents’ financial affairs is undertaken appropriately and records are kept. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30, The home is pleasantly decorated and furnished and provides a warm comfortable friendly environment. There were some concerns about fire safety. Resident’s bedrooms reflect their differing tastes and personalities. The home has sufficient toilets/bathing facilities to enable residents to have privacy. The communal living area was spacious and complimented residents individual space. The home is kept generally clean and hygienic overall however the inspector had concerns regarding the kitchen. EVIDENCE: The inspector found the home to be suitable for its stated purpose; it was accessible, well maintained clean and free from offensive odours. The kitchen fire doors were seen to have a gap at the bottom which the inspector believed would not prevent smoke escaping from the kitchen and that air could get underneath which would fuel a fire. The fire door leading into the lounge from the hall was propped open, the automatic doorstopper was broken, the, senior staff member said it had been reported. The door was closed immediately. The senior staff member informed the inspector that Somerset Care undertake an audit of the house annually and that the fire service visit quarterly. Staff had concerns that the hand basin in the kitchen is situated next to the washing up sink and could lead to contamination. The Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 17 inspector noted that the kitchen floor covering is ripped at the entrance into the dining room. The home is situated in a residential area and is in keeping with other properties in the area. It is close to local shops, residents do not use public transport as the home has a mini bus. The home does not have a planned maintenance programme; requests have to be submitted to Islecare. Residents each have their own bedrooms, which are furnished with their own belongings. All rooms are lockable. The home has a downstairs toilet/shower room; the inspector was informed that the shower is not being used. Upstairs there is a bathroom/toilet. There is a bath seat available to meet the needs of one resident. The communal living space is provided in an open plan arrangement, which houses the lounge and dining area. The garden is to the rear of the property and is mainly set to lawn with flower borders. Residents can meet visitors in private in their bedrooms or the manager’s office if it isn’t occupied. The inspector found that the home was kept clean and hygienic and that procedures where in place to prevent the spread of infection. The laundry is sited away from food preparation areas. The floor is impermeable the washing machine reaches the appropriate temperature for washing soiled clothing. Staff place soiled clothing into a red bag to prevent contamination. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,36 Residents are supported by an established staff team, who have worked at the home for a number of years. Residents benefit from a well trained staff team. EVIDENCE: The senior staff member informed the inspector that she believed that the staff team had the necessary skills and experience to meet the needs of the residents. The inspector observed the staff to be patient, good listeners, understanding and supportive when engaging with residents. The senior staff member has had training in the area of person centred planning, and will be working towards filtering this philosophy down to the staff team when reviewing care plans. The homes manager is qualified to NVQ level four and two staff have completed NVQ level 2 in Care. Staff have received training in relation to Downs Syndrome and Epilepsy this is in addition to mandatory training. The senior staff member felt that the home had positive relationships with external health professionals, the home can contact the Community Nurse for the Learning disability and Care Managers for support advise. The home currently employs eight female staff, two full-time and six part-time. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 19 The inspector viewed the roster which showed that three staff are usually on duty am and two staff pm. The roster showed that the manager was down to work some morning shifts but was informed that she hadn’t, leaving staffing levels reduced to two. Staff felt that three people needed to be on duty on a morning to allow residents to have uninterrupted time on a one to one basis and to meet their care needs. The senior staff member told the inspector that this had been a previous requirement. The senior staff member told the inspector that she has difficulty in undertaking her administration duties when on shift with only one staff member as she has to concentrate on meeting the needs of the residents. The staff team usually have a staff meeting on a monthly basis. This is a briefing session to receive and give information about the running of the home. The inspector saw evidence that the last one was held in April 2005 The senior member of staff stated that staff had not been receiving regular, supervision her last supervision was held last year. She has been asked by the manager to supervise two team members and feels competent to do this but has not received formal training. The inspector was informed that the manager undertakes staff annual appraisals. Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The above standards were not inspected at this inspection. Three of the above standards were assessed at the last inspection two were met and two were just met. EVIDENCE: Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 2 Standard No 11 12 13 14 15 16 17 x x 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Overbrook Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4 Sch1(14), 5 & 6(a) Requirement The homes Statement of Purpose requires updating to reflect the accurate details of the Registration Body. The service user guide requires information with respect to contract terms, fees and complaints procedure. Islecare adult protection policy and procedure to be updated to incorporate the Isle of Wight adult protection procedures. The kitchen requires refitting, Islecare to provide CSCI with an action plan detailing when the work will be undertaken. Fire doors to be assessed by fire officer and replaced if considered a risk. NVQ level 2 training to be available to all staff to bring the quota up to 50 The homes manager to ensure that three staff are on duty in a morning as previously agreed and acted upon. The homes manager to be available to provide at least the minimum level of supervision expected per year. Storage cupboard in bathroom requires repainting. Timescale for action 30/09/05 2. YA23 12(a) 30/09/05 3. YA24 16(2)(g) 30/09/05 4. 5. 6. YA24 YA32 YA33 23(4)(c)(i v) 18(a) 18(1)(a) Immediate 30/09/05 Immediate 7. YA36 18(2) 30/09/05 8. YA24 23(2)(b) Immediate Page 23 Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 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. 3. Refer to Standard Good Practice Recommendations Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Overbrook H55 H04 S12520 Overbrook V218534 060605 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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