Inspection on 26/10/05 for Overbury House Nursing & Residential Home

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

Overbury House Nursing &... 15/07/09

Overbury House Nursing &... 14/02/08

Overbury House Nursing &... 05/03/07

Overbury House Nursing &... 27/07/06

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

CARE HOMES FOR OLDER PEOPLE Overbury House Nursing & Residential Home Staitheway Road Wroxham Norwich Norfolk NR12 8TH Lead Inspector Hilda Stephenson Unannounced Inspection 26th October 2005 11:00 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 Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 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. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Overbury House Nursing & Residential Home Address Staitheway Road Wroxham Norwich Norfolk NR12 8TH 01603 782985 01603 783425 croftsandy@aol.com 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) Healthcare Homes Limited Mr Robert Buttifant Care Home 50 Category(ies) of Dementia - over 65 years of age (50) registration, with number of places Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/05/05 Brief Description of the Service: Overbury House provides nursing and residential care for up to 50 elderly people who have been diagnosed with a dementia. The home has recently changed Proprietors and is now owned by Healthcare Homes Limited. The home is a large detached building of traditional design with a number of modern extensions that have been added over the years. The resident’s accommodation is located on the ground and first floors. There is a large attractive enclosed garden at the rear of the building. There is parking at the front. The home is situated in a quiet residential area of Wroxham. The home is a member of the Registered Nursing Homes Association. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place as an unannounced inspection during the busy lunchtime period on 26th October 2005. A partial tour of the premises was undertaken visiting residents in their own rooms and observing staff’s interaction with residents during the mealtime. The home was found to be clutter free, with no lingering odour, the majority of the premises was clean and tidy, although some areas require redecorating. The home is separated into three units entering these through secure doors, where the dependency levels and needs of the residents are considered, before placing them in these different areas. There is a secure enclosed garden for residents situated at the rear of the building What the service does well: The home offers a comfortable environment, separated within three units with plenty of space for those who like to walk. There are organised social activities offered during the week, with the care staff maintaining individual sociable or distraction events at other times. The home has a long-standing loyal staff team working and caring for residents with some form of dementia. Communication between the home and relatives appears to be open and inclusive while continuing with the personal care offered to residents, who find making their own choices difficult. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 6 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. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 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 Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Residents are assessed prior to admission, with relatives or the social worker being involved with this process. EVIDENCE: The manager visits each resident after a referral has been made usually by telephone. The manager confirmed that relatives of the resident, or their social worker make the majority of enquiries. The manager arranges to visit the prospective resident with the relatives present to enable him to assess their care and mental health needs. The reason for a close relative or social worker is that the majority of residents have lost the ability to make decisions, although this is not always the case. The majority of residents come to the home from the assessment unit in the local hospital where a mental health assessment is carried out. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 9 Each resident is given a copy of the home’s terms and conditions including the fees and room to be occupied, although relatives are invited to be present. The assessment records and contract of the newest resident was seen and found to be in good order. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10 Care plans and mental health needs are identified, reviewed and are met, with knowledgeable staff who have a good understanding of the residents needs. EVIDENCE: A sample of care plans were seen and are kept in individual files. The trained nurses compile the care plans after the resident has had their initial review meeting, after admission. Several residents records contain some life stories containing relevant events from their past, that enable care staff to chat about, when they are with the residents. The manager confirmed that he had written to relatives to ask for a more comprehensive history of their relatives and explained the reasoning for this. Obviously some residents have no relatives, then the manager tries to include their close friends views. The care records have details from the Community Psychiatric Nurse if they are still under their care or GP who has continued to look after their health needs. The nurse on duty tends to the nursing care for those who occupy a nursing room and district nurses visit residents who occupy a residential room if they require any nursing care. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 11 The medication is stored and administered by the nurses, in a safe manner. The home’s medication policy is to review all medication on a regular basis and this is carried out. The home is supported by the local pharmacy. The staff continue to ask residents for their choice and assist with their daily living needs. It was evident that residents continue to choose their meals, when they wish to get up, what they wish to do during the day although some residents have lost this ability, staff receive guidance from relatives or their friends, in these cases. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15 Social activities are well managed taking into account both group and individual interests with meal times included as part of a sociable event. EVIDENCE: Sociable activities are arranged by the activities co-ordinator for three days a week with care staff organising sociable events during the other four days. For residents who find it difficult with memory, a group is organised each week to talk about past times. The co-ordinator jogs the residents’ memories with food items, machinery and pictures to help gain a better understanding of each resident’s past history. During these group session’s feedback for choices of meals is obtained and the cook can include these suggestions within the menu, which is good practice. There are several outings organised throughout the year for those residents who wish to go out, the latest outing was to visit the boats on Wroxham Broad. Several residents continue to go out with relatives, with one going out every weekend. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 13 The main dining room is situated next to the kitchen, the menu is displayed, for residents who have difficulty making a choice for their meal, pictures or plates are shown to help the resident see the food that is offered. The kitchen also holds records of residents likes and dislikes to ensure that they are not offered something they have disliked for years. The chef tends to make extra meals in case a resident changes their mind. The home is separated into three units and the meals are served at different times to ensure that residents can take their time with their meal, or have a member of staff assist them if this is required. One resident stated ‘I loved my lunch today, it was my favourite’. Several other residents were able to confirm that they enjoyed the meals. Occasionally, when the kitchen is short of staff a carer is taken off the floor to help in the kitchen and the proprietors must ensure they have adequate staff in the kitchen to cater for the residents’ meals. It was observed that several residents wore protective clothing and were offered adapted cutlery and crockery to enable them to continue to be as independent as possible, which is again good practice. The main meal is served at lunchtime, with the teatime meal being served by care staff, although it was noted that sandwiches are offered every day. This is not ideal and the proprietor should review this current situation so that staff can spend the time assisting residents rather than preparing and serving the meals, in a home of this size. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home has a satisfactory complaints system in place, where views of residents and relatives are listened too and the action taken. EVIDENCE: The complaints procedure is contained within the written documents that is given out during the admission process. The manager or nurse visits each resident every day to ensure they are comfortable. For residents who have lost the ability of choice and their cognitive skills, they rely on the empathy of the staff that looks after them, or their relatives when they visit. While speaking to several residents during this inspection several residents made comments that they were well cared for, while several were unable to communicate to the Inspector, and relied on the staff to assist. The residents appeared comfortable and well cared for. One resident became distressed when speaking to the Inspector, who was a stranger to her, she was attended to by a member of staff who empathised very well with the resident, by using a form of distraction, which was relevant to her. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,26 Residents live in a comfortable home, although several areas are in need of redecorating. EVIDENCE: A partial tour of the premises was conducted. The home consists of three enclosed units that can be entered by using a keypad system, this has recently been replaced. There are several lounges on the ground floor with one used as a smoke room. The main dining room is situated next to the kitchen with a combined dining room within the higher dependency unit. The first floor has no communal area and residents are assisted downstairs via the shaft lift. There is a staff room on the second floor with kitchen facilities and this was being redecorated. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 16 The carpets along the main corridors and lounges are looking rather grubby and need replacing. The main front entrance has been adapted to accommodate a seating area for residents, with some watching a video during this visit. The home was clean and tidy with no clutter in the corridors where residents walked. There was no unpleasant lingering odour. Residents can also walk safely in the rear-enclosed garden when the weather is fine. Several residents had gone out for a walk with staff members. The manager confirmed that the proprietor had plans in place to update the décor and carpets throughout the home. The fire records were checked and found to be satisfactory, although the home had not received a fire inspection this year. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 Staff numbers have increased since the previous inspection. Residents are cared for by staff who empathise very well with them. EVIDENCE: Since the previous inspection the care staff numbers have increased slightly, with plans to increase the numbers further. The manager is currently recruiting staff. Today the rota indicated that the manager was supported by seven care staff and one trained nurse, with a cook, kitchen assistant, maintenance and two domestic staff during the day. These were adequate numbers for caring for the 43 residents, although if the home was fully occupied the numbers would need to be increased further. The home has been a little slow to encourage the care staff to undertake the recommended NVQ training to help develop their skills, and this must be addressed. The training records of two members of staff were seen during this visit, which had completed fire training and food hygiene. The nurses continue to update their own PREP requirements by undergoing regular updates and attending relevant courses. They had recently completed a medication course. The home still falls behind when educating new staff; dementia training should be included, and the proprietor should address this. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,36,38 Residents’ interests are looked after with the home having good safe practices in place. EVIDENCE: The manager has worked at the home for several years and is a trained mental health nurse. He attends regular courses to maintain his own professional requirements, recently attending, with other senior members of staff to a company study day. The manager has recently commenced supervision with the trained nurses and this must cascade to care staff too, to ensure there personal, training and development needs are addressed. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 19 The fire records, risk assessments, care plans and training records were seen during this visit. The registration certificate and relevant insurance was in place. Overall, the home has been adapted to care for residents with dementia with satisfactory health and safety procedures in place. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 20 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 3 X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 2 X 3 Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 21 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. 1 2 3 Standard OP15 OP19 OP30 Regulation 16.2i 23.2d 18c(i) Requirement The proprietor must review the teatime menu to ensure a variety is offered to residents. The carpets in the corridors and lounges must be replaced. The proprietor must ensure all new staff undergo dementia awareness training during induction. Timescale for action 30/11/05 28/02/06 28/02/06 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 OP28 OP27 Good Practice Recommendations The proprietor must improve the option for care staff to undertake the recommended NVQ training. The number of care staff must not be reduced by them helping out in the kitchen. Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Overbury House Nursing & Residential Home DS0000065678.V260398.R01.S.doc Version 5.0 Page 23 - 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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