Inspection on 01/07/05 for Overdene House Nursing Home

This inspection was carried out on 1st July 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Overdene House Nursing Home 19/11/08

Overdene House Nursing Home 16/10/07

Overdene House Nursing Home 26/06/06

Overdene House Nursing Home 26/01/06

Overdene House Nursing Home 25/11/04

Overdene House Nursing Home 22/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Overdene House Nursing Home John Street Winsford Cheshire CW7 1HJ Lead Inspector Joan Adam Unannounced 1 July 2005 09:00 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 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. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Overdene House Nursing Home Address John Street Winsford Cheshire CW7 1HJ 01606 861666 01606 861757 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) Modelfuture Limited Mrs Gillian Goodwin Care Home 70 Category(ies) of Physical disability (14) Both registration, with number Old age, not falling within any other category of places (70) Both Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Service Users aged 60 years and above 2 3 4 Within the maximum 70 beds, 14 PD are provided for nursing care aged 18 years and above Within the maximum 70 beds, 20 OP beds are provided for personal care and 1 PD bed for personal care Rooms 31,36,42,43,44,45,46,47,48 may be used for intermediate care Date of last inspection 25 November 2005 Brief Description of the Service: Overdene House Care Centre is a modern purpose built care home providing nursing care, located close to Winsford town centre. It is a two storey building and service users are accommodated on both floors. Access between floors is via a passenger lift or one of the staircases. Service users’ accommodation consists of 70 single bedrooms, 30 of which have en-suite facilities. The home provides nursing care for 50 people including 14 who are in the category of physical disability aged 18-65 years. 20 older persons requiring personal care are also accommodated at the care home. A choice of lounges and dining rooms are available on each of the three units. Nursing staff are on duty at the home twenty-four hours a day. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over six hours by two inspectors and was carried out as part of the yearly inspection process. A tour of the home was carried out, and care records, fire records, staff files and staff training files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. During the inspection six of the staff on duty, nine residents, and three relatives were spoken with. Feedback was given to the temporary manager who was present at Overdene in the absence of the registered manager. A second visit was made to the home on 7th July to complete the inspection. Medication issues were not looked at during this inspection as the Pharmacy inspector for CSCI has made a number of additional visits to the home following the last inspection where concerns were raised about the management of medication. At each of these visits, the inspector made a number of requirements for compliance with the Care Homes Regulations. What the service does well: What has improved since the last inspection? The redecoration of some bedrooms has taken place. Items previously stored in bathrooms have been removed leaving bathrooms clear for use by the residents. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 6 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. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 standard(s) 3,6 Although staff spoken with were aware of the needs of some residents there was no recorded evidence to support that the needs of the residents admitted to the home can be met. EVIDENCE: A sample of care plans were examined on three units. On the young physical disabled unit and the personal care unit the care plans contained pre-admission assessments covering all aspects of personal care and nursing care. On the frail elderly unit there were no pre-admission documents contained on the files of three newly admitted residents to guide staff on the actions to be taken to ensure that the needs of these residents are properly assessed and planned for. One resident spoken with said that he had visited the home prior to his admission but there was no documentary evidence to support this. (See requirement 1) Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 9 The staff members on duty were spoken with and they were aware of the needs of two residents that had been admitted but staff said that they were finding it difficult to fully address the needs of one resident due to inadequate information. This situation was also seen at the last inspection visit when a requirement was made for action to be taken to ensure that proper assessments were carried out before prospective residents entered the home. There was no evidence that this action had been taken. The home is registered to provide intermediate care for nine residents but there were no residents who had been admitted for intermediate care at the time of the inspection. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 standard(s) 7,8,10 Limited progress has been made on improving arrangements to ensure that the health care needs of the residents are identified and met on the frail elderly unit. These shortfalls have a potential to place residents at risk. Residents are treated with dignity and respect. EVIDENCE: Samples of care plans were looked at on the three units. Pre-admission assessments covering all aspects of personal care and nursing care were present on the residential care unit and the young physically disabled unit. Care plans were based on the identified needs of the resident following this assessment. Of the care files looked at on the young physically disabled unit, all had been completed appropriately and there was evidence that the care needs of the residents were being met. Individual choices were recorded in the care plans, such as what time they got up and went to bed and choices of food. Risk assessments were in place for lap straps on wheelchairs and use of bed rails. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 11 There was evidence that residents or their relatives had been involved in the drawing up and changes to the plan of care. Two residents spoken with said that they were happy with the care that they received and the choices they could make. Care plans of residents living on the residential care unit showed, that the care needs of the residents were met. These had been evaluated and reviewed monthly or as changes occurred. There was evidence of district nurse involvement. Risk assessments were in place and there was information regarding moving and handling needs of the individual resident. On the frail elderly unit residents files looked at did not contain plans of care to identify the on -going needs of the residents living at the home. Some individual plans of care are in place but little progress has been made on the requirement made at the last inspection visit to ensure that all aspects of health, personal, social and nursing care needs are identified and planned for. Some care plans had been commenced but the documentation had not been fully completed. Pre-admission assessments were not present on this unit making it difficult for staff to fully address the needs of residents due to inadequate information. Two residents that had been identified as having pressure sores had care plans in place however these had not been updated adequately and charts to measure the on going size and condition of the sore were not in place. Staff were therefore unable to assess the improvement or deterioration of the sore. Care plans of residents living at the home for some time had not been evaluated and reviewed. The trained staff on the unit said that they did not have time to up-date and review care plans due to staff shortages. There was little written evidence and a lack of clear plans and guidance for staff working at the home and residents are at risk of not having their health care needs met. (See requirements 2,3) Residents spoken with said that the staff treat them with dignity and their privacy is respected. Residents also said that the care and attention they receive from staff is good and that they are aware of their likes and dislikes. Some residents said that staff are too busy to talk to them and that it can take a long time for staff to answer the call bell. Good interaction was observed between residents and staff and the atmosphere in the home appeared warm and friendly. Staff spoken with were aware of the needs of the residents but felt that they did not have enough time to spend with residents. Medication issues were not looked at during this inspection as the Pharmacy inspector for CSCI has made a number of additional visits to the home following the last inspection. Concerns were raised about the management of medication at each of these visits, the inspector made a number of requirements for compliance with the Care Homes Regulations. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 standard(s) 12,14,15 Social activities are not well managed, there are days within each week where no structured activities take place. Residents are frequently left to sit in small groups without any distraction or stimulation from staff. The lack of detailed care plans on the frail elderly unit means that the home cannot demonstrate that residents can make choices regarding their daily life. The residents enjoy a good and varied choice of wholesome and well presented meals. EVIDENCE: An activities co-ordinator is employed at the home. There is a programme of activities on display within the home for the three units but residents and relatives spoken with said that the activities don’t always take place and that they felt the list is “ only to impress and these things didn’t happen.” Another relative spoken with said that they could visit the home at any time but that they had not seen any activities taking place on a regular basis. Visitors were seen during the afternoon, there were no restrictions on visiting and relatives were seen to be made welcome. The residents on the young physically disabled unit said the disco always takes place and they enjoyed going to that but nothing much happens. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 13 Staff spoken with said that there are not enough activities taking place at the home leaving residents sat with no one to talk to and they do not have the time to sit and talk. (See requirement 4) Menus on display at the home were for Saturday and Sunday of the previous week. (See recommendation 1) Lunch was observed to be sociable and relaxed. Staff helped those residents that required assistance with eating in a calm and dignified manner. There are two choices of food each day and staff ask the residents to make a choice the day before. Residents said that they were happy with the food but some residents on the young physically disabled unit felt the menus were more suitable for older people as there were no curries or pastas on offer. (See recommendation 2) Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 standard(s) 16,18 Complaints at the home are not being dealt with in accordance with the company’s policy, which could leave residents at risk. Residents are protected from abuse. EVIDENCE: A copy of the complaints procedure is available in the service users guide and displayed on the notice board in the main entrance. The home’s complaints logbook was checked. This contained details of a complaint received earlier in the year that had been investigated by the home The recording of the complaint had not been fully completed and action taken by the home was not recorded. One complaint made to CSCI, which was being investigated by the provider , had not been recorded within the home’s complaint logbook. (See requirement 5) The home has an adult protection procedure and a copy of the Department of Health’s document, ‘No Secrets’. Both documents advise staff on the forms abuse may take and how to report abuse if it is witnessed or suspected. Staff training records showed that they had received training on adult abuse in April 2005. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 standard(s) 19,21,22,23,26 Some areas of the home require attention to ensure that residents live in a safe and well-maintained environment. The home was clean and apart from the one area identified was free from unpleasant smells. EVIDENCE: The home has a programme of redecoration in place and appeared well maintained and was clean. Hoists, bath lifting aids and wheelchairs are provided for residents with mobility problems. Care call points are located in bedrooms, bathrooms toilets and communal areas. Residents rooms on the three units are well personalised with residents own furniture, photographs and ornaments. Residents said that they liked their bedrooms. There were no identified problems on the residential care unit. The young physically disabled unit had a worn and stained worktop in the kitchen area that requires replacing. (See requirement 6) Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 16 One bedroom on the frail elderly unit was identified as having an odour and a new carpet had been ordered for this room. On this unit a pressure relieving mattress had been left on the floor in one of the bedrooms. This is a risk of health and safety to the residents. (See requirement 6) Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 A review of the residents dependency levels is needed to ensure that there are enough members of staff on duty with the appropriate skills to meet the residents’ needs at all times. Adequate training needs to be available so that all staff have the knowledge, skills and competence to do their jobs effectively. All new staff working at the home must have induction training. EVIDENCE: A review of the staffing rotas showed that there were three trained staff on duty between eight am. and two pm and two trained staff on duty between two pm and eight pm. On most days there were seven care assistants working in the morning and seven during the afternoon/evening. Occasionally this number was exceeded. The staff members were divided between the young physically disabled unit and the frail elderly unit. Staffing for the residential care unit was separate to these staffing numbers. A review of the dependency levels of the residents on the two nursing units should be undertaken by the home to check that there are sufficient staff on duty, particularly around meal times. During the course of the inspection, staff were observed to be assisting a high number of residents with their lunch. (See requirement 7) A staff group spoken with raised some concerns to the inspector including shortage of staff due to frequent short notice sickness and absence. Staff are constantly moved from one unit to another to cover, leaving some units understaffed. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 18 Staff on the young physically disabled unit and the frail elderly unit are working their days off on a regular basis and feel worn out. Residents at the home appear more highly dependent than in the past, however staff felt that they received sufficient training to enable them to meet the needs of the residents. They displayed a good understanding of the importance of choice and dignity in resident’s lives and gave a number of good examples. A number had worked at the home for a long time providing continuity of care for the residents. Staff training records were looked at and the staff at the home have had training in moving and handling, health and safety, food hygiene and adult abuse. There was no specific training recorded for the staff working on the young physically disabled unit. (See requirement 8) A member of staff who had recently commenced at the home had received only a basic induction to the home environment and had been left in charge of the frail elderly unit. (See requirement 9) Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,36,38 The management of the home maintains the safety of residents living there. Staff must be formally supervised to ensure the safety of the residents at the home. EVIDENCE: There was recorded evidence that staff had been trained and up-dated in moving and handling, fire and evacuation, food hygiene and COSSH. Accidents are recorded and the forms state what action has been taken to ensure that the resident’s safety is maintained. Some staff members are trained in first aid. Certificates were available for servicing the passenger lift and hoists at the home. A senior manager visits the home on monthly basis, unannounced and areas checked are health and safety, property and equipment and staffing issues. Discussion with residents and staff also takes place. These visits and any resulting actions are recorded with a copy of the report sent to CSCI. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 20 There was evidence that fire training has taken place. Fire points and emergency lights are tested on a regular basis and are recorded in the appropriate file. Informal supervision of the staff takes place on a daily basis but formal supervision sessions have not been taking place. (See requirement 10) Some staff have had appraisals. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x 2 x x x x 3 Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 22 yes 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 op3 Regulation 14 Requirement Residents must not be admitted to the home without their needs being assessed and a copy of the pre-admission assessment documentation must be kept at the home (Timescale of 7th January 2005 not met) Suitable plans of care must be in place that address all of the identified needs/problems of the residents accommodated at the home( Timescale of 7th January 2005 not met). proper provision for the health and welfare of residents must be made at home( Timescale of 7th January 2005 not met) A wider variety of activities must be provided to enable residents to take part in activities having regard to their needs and preferences. all complaints received by the home must be recorded equipment must not be left on the floor to maintain a safe hygenic working enviroment. The worktop in the young physically disabled unit must be replaced. . Timescale for action 30th August 2005 2. op7 15 31st August 2005 3. op8 12 31st August 2005 31st August 2005 4. op12 16 5. 6. op16 op19 22 23 31st August 2005 30th September 2005 Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 23 7. op27 18 8. op30 18 9. 10. op36 op36 18 18 A review of the dependency levels of the residents should be carried out to ascertain whether their needs can be met by the number of staff on duty. Staff working on the young physically disabled unit receive training apropriate to the work they perform All new staff working at the home receive induction training. Staff working at the home receive formal supervision 30th September 2005 31st October 2005 31st august 2005 31st August 2005 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 15 15 Good Practice Recommendations Menus at the home are displayed are up to date Alternative menus should be provided for the young physically disabled unit. Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Overdene House Nursing Home F51 F01 S18730 Overdene V235328 010705 Stage 4.doc Version 1.40 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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