CARE HOMES FOR OLDER PEOPLE
Overcliff House 2 Cellars Farm Road Southbourne Bournemouth Dorset BH6 4DL Lead Inspector
Marjorie Richards Unannounced Inspection 22nd February 2006 11:15 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 Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Overcliff House Address 2 Cellars Farm Road Southbourne Bournemouth Dorset BH6 4DL 01202 424929 01202 426523 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) Mrs Marilyn Cooper Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (18) Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10th May 2005 Brief Description of the Service: Overcliff House is a care home providing personal care and accommodation for 18 older people who have mental disorders or dementia. The home is owned and personally managed by Mrs Marilyn Cooper. It is situated in a pleasant residential area of Southbourne, Bournemouth in an elevated position (sloping walk up to front entrance,) offering views of the sea. Local amenities, e.g., shops, post office, churches, doctors surgeries and cliff top walks are all within easy reach. Car parking is provided for visitors to the home and further parking is available on nearby roads. A bus stop is situated close to the home with buses from Southbourne into Bournemouth, Christchurch and beyond. Overcliff House is a large detached property that has been adapted to provide residential care. Accommodation for residents is provided on the ground and first floors, with a stairlift to assist access between floors. All residents have single bedrooms, seven of which have en-suite facilities. The home also has a dining room and separate lounge, which overlooks the sea and sufficient baths, a shower and WCs to meet the needs of residents. The home has very attractive gardens to the front and rear of the property, which are well maintained, easily accessible and well used by residents. Overcliff House is also home to two pet cats, a cockatiel, a tortoise, two hamsters and three ducks. Overcliff House provides 24-hour care, all meals, laundry and domestic services. The home offers stimulation in the form of regular activities and occasional outings. Entertainment, garden barbeques etc are also arranged. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours on the 22 February 2006 and was one of two statutory inspections carried out each year. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for. The previous inspection took place during May 2005; since that inspection no complaints about the home have been received or investigated. The inspector spoke to four residents, two visitors and three staff and together with registered provider, Mrs Marilyn Cooper, considered other evidence relating to the National Minimum Standards, as described in this report. In recognition of the history of this home, which is known to meet most of the National Minimum Standards, this inspection was brief in duration and focussed on assessment of only the most essential Standards. The majority of Standards assessed and found met during the previous inspection were not reassessed during this inspection; this report should therefore be read in conjunction with the report of the previous inspection of 5 May 2005. As part of the inspection process, comment cards were distributed to the care home for completion by residents, relatives, G.P.s, health and social care professionals etc. The following comment cards were received; 1 from resident, 11 from relatives, 2 from care managers, 2 from health/social care professionals and 3 from General Practitioners. All expressed satisfaction with the care provided. Those comments received were all very positive in their views of the home. (E.g., An excellent home with a good understanding of dementia care.(Care manager). This is an excellent care home for which I have nothing but praise. (Relative). I commend Overcliff House most highly. (Relative). Excellent home. (GP)). What the service does well:
The home promotes a homely, relaxed, non-institutional family atmosphere, which is beneficial to residents, staff and visitors alike. A resident commented, I like it here. This place suits me very well. All residents at Overcliff House are issued with terms and conditions of residence. This document is clearly laid out and easy to read. Prospective residents and their relatives or representatives are invited to visit the home prior to admission to enable them to assess the facilities and services provided. A trial period is also available before making any decision about whether or not to stay. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 6 There are satisfactory arrangements in place for managing medication and ensuring that the medication needs of residents are met. Residents are encouraged to maintain contact with family and friends and the wider community. There are no restrictions on visiting at Overcliff House. Visitors confirm that they are always well received when visiting the home: I always feel at ease coming here, everyone is very friendly and welcoming. Flexibility of lifestyle is encouraged and residents have the opportunity to choose their own way of living in the home. They are able to bring their own possessions into the home to personalise their bedrooms. Residents confirmed that their individual preferences and routines are respected. Overcliff House has an Adult Protection policy in place to protect service users from possible abuse. All staff have received Adult Protection training to ensure a proper response to any suspicion or allegation of abuse. Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for residents, where standards are constantly improving. There are sufficient communal bathrooms and toilets to meet the needs of residents. Care is provided by a stable staff group and no new staff have been employed since the last inspection in May 2005. Residents are assured of sound management of their financial interests. What has improved since the last inspection?
Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for residents, where standards are constantly improving. Since the last inspection, the programme of window replacement has been completed. Six bedrooms have been redecorated and the ensuite facility in one bedroom has been refurbished. 30 of radiators have now been replaced. A new sink, tiles and cupboards have been provided in the laundry room. In the kitchen, stainless steel splash backs are now in place, along with new sinks and tiling. A new cooker is to be fitted shortly. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 7 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. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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 Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 (Standards 1 and 3 were found met at the previous inspection) The home does not provide intermediate care so Standard 6 does not apply. Residents are issued with a contract describing Terms and Conditions of occupancy at the point of admission to Overcliff House. Prospective residents and their relatives or representatives are invited to visit the home prior to admission to enable them to assess the facilities and services provided. A trial period is also available before making any decision about whether or not to stay. EVIDENCE: All residents at Overcliff House are issued with terms and conditions of residence. This document is clearly laid out and easy to read. The terms and conditions are signed by the resident or their representative and the registered provider. The resident and/or their representative retain a copy and a copy is held on file. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 10 Mrs Cooper says she always encourages prospective residents and their relatives to visit the home prior to admission. She feels it is helpful for them to have opportunities to look round the home, perhaps enjoy a meal and meet with other residents and staff, assess facilities and ask any questions. It also helps with the assessment about whether the home can provide for the prospective residents needs. A trial period is available before taking any decisions about making residence permanent. Residents were able to confirm that they or their relatives were able to visit the home before making any decisions about admission. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 (Standards 7, 8 & 10 were found met at the previous inspection) There are satisfactory arrangements in place for managing medication and ensuring that the medication needs of residents are met. Records indicate that residents receive their medicines as prescribed. EVIDENCE: Medication is stored securely within the home. There is a separate cupboard available for Controlled Drugs if necessary. A sample of Medicine Administration Record (MAR) charts was checked. A monitored dosage system is in use. One senior member of staff is appointed as Medication Manager and is responsible for ordering and recording all medicines received and for all unwanted medication sent back to the pharmacy. Staff sign to record that medicines have been given as prescribed or record the reason for non-administration. All staff that administer medicines have received training on medicines, how they are used and how to recognise and deal with problems in use. Information on the medicines used is available for the resident or their representative and also for staff reference. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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): 13 and 14 (Standards 12 and 15 were met at the previous inspection.) Residents are encouraged to maintain contact with family and friends and the wider community. Residents are encouraged to choose their own lifestyle within the home and their individual preferences and routines are respected. EVIDENCE: There are no restrictions on visiting at Overcliff House. Visitors confirm that they are always well received when visiting the home: I always feel at ease coming here, everyone is very friendly and welcoming. I always get a cup of tea and biscuits when I visit Overcliff House. Residents records and the visitors book confirm contact with family and friends as well as visits by professionals. A telephone is available so that residents can maintain family and community links. Residents are encouraged to choose their own lifestyle within the home and make choices wherever possible. These include choosing when to get up or go to bed, what to wear, what to eat or drink and freedom to come and go as they please around the home and garden. They are able to bring their own possessions into the home to personalise their bedrooms. Residents confirmed
Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 13 that their individual preferences and routines are respected. I come in and out as I please. I can go where I like. I like to see what is going on in the kitchen. I got up late this morning. It is nice to stay in bed sometimes. The home has an open, relaxed atmosphere, which is beneficial to residents, staff and visitors alike. A resident commented, I like it here. This place suits me very well. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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): 18 (Standard 16 was met at the previous inspection) The home has an Adult Protection policy in place to ensure residents are protected from possible abuse. EVIDENCE: Overcliff House has an Adult Protection policy in place to protect service users from possible abuse. This makes reference to the Department of Health No Secrets guidance, which is also available to staff. All staff have now received Adult Protection training to ensure a proper response to any suspicion or allegation of abuse. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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): 21 and 22 (Standards 19, 20, 24, 25 & 26 were met at previous inspection) There are sufficient communal bathrooms and toilets, which meet the needs of residents. Residents have specialist equipment available to help maximise their independence. However, the premises and facilities have not been assessed by a suitably qualified person to ensure the necessary equipment and adaptations are in place to meet the needs of residents. EVIDENCE: There are two communal WCs and two bathrooms situated on the ground floor at Overcliff House, including one assisted bath (Parker bath.) There are two communal WCs and a shower room on the first floor. In addition, seven bedrooms have en-suite facilities. WCs are accessible and close to communal lounge and dining areas. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 16 The home has an alarm call bell system, which enables residents to summon assistance from staff if required. Few of the current residents are able to use the system. Appropriate aids are in place for residents living at the home. These include grab rails, raised toilet seats, toilet frames and commodes to assist residents, as necessary, in maximising their independence. A stair lift is also available, to assist access between floors. Mrs Cooper seeks the advice of an Occupational Therapist to meet the needs of individual residents within the home. However, the Overcliff House premise as a whole has not been assessed by a suitably qualified person, including an Occupational Therapist, to ensure any necessary equipment and environmental adaptations are in place to meet the needs of the resident group. It is recommended that such an assessment be completed, as this Standard cannot be fully met without an assessment in place. Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for residents, where standards are constantly improving. Since the last inspection, the programme of window replacement has been completed. Six bedrooms have been redecorated and the ensuite facility in one bedroom has been refurbished. 30 of radiators have now been replaced. A new sink, tiles and cupboards have been provided in the laundry room. In the kitchen, stainless steel splash backs are now in place, along with new sinks and tiling. A new cooker is being fitted tomorrow. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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): 29 (Standards 27, 28 & 30 were found met at the previous inspection) Employment and recruiting procedures are in place, but some work is still needed to ensure the protection of residents. EVIDENCE: The home has a thorough recruitment procedure in place, based on equal opportunities and ensuring the protection of residents. However, the three staff files examined demonstrated that not all of the necessary documentation was in place to ensure the protection of residents. Records show that an application form is completed by applicants, detailing the names of two referees. There was evidence that two references had been sent for, but sometimes only one had been received. There had not always been any further follow-up to ensure a second reference was obtained. From 26 July 2004, all care staff applying to work in care homes with adults are required to have a satisfactory Protection of Vulnerable Adult (POVA) check before they can take up employment. However, examination of one Criminal Record Bureau (CRB) disclosure demonstrated that the CRB and POVA check had been received some weeks after the employee had commenced working in the home. There was no record of any POVA first check being made prior to employment commencing. Mrs Cooper explained that this employee was supervised until the receipt of the CRB disclosure and POVA check, however there was no documentary evidence to support this.
Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 18 No further staff have been employed since this time. Mrs Cooper demonstrated that she is now fully aware of the correct procedure and will ensure this is followed when employing any new staff in future. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 19 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): 35 (Standards 31, 32, 33, 36 & 38 were met at the previous inspection) Residents are assured of sound management of their financial interests. EVIDENCE: Mrs Cooper says that, in order to protect residents, it is the policy of the home not to have any involvement in their personal finances. Therefore, all residents who are unable or do not wish to handle their own affairs, have a relative or other representative to deal with their finances etc. The home never handles residents monies, but pays for services such as newspapers, chiropody and hairdressing and this amount is then invoiced to residents, relatives or representatives for payment each month. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X 3 2 X X X X STAFFING Standard No Score 27 X 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 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 Standard OP29 Regulation 19(1) Schedule 2 Requirement The registered person must operate a thorough recruitment procedure to ensure the protection of residents. All staff must be properly checked before being employed. Timescale for action 30/04/06 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. Refer to Standard OP22 Good Practice Recommendations It is recommended that the Overcliff house premises be assessed by a suitably qualified person to ensure that the homes adaptations and equipment are suitable to meet the needs of residents. Overcliff House DS0000003967.V284538.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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