Inspection on 16/10/07 for Overdene House Nursing Home

This inspection was carried out on 16th October 2007.

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

Overdene House Nursing Home 19/11/08

Overdene House Nursing Home 26/06/06

Overdene House Nursing Home 26/01/06

Overdene House Nursing Home 01/07/05

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 Unannounced Inspection 16 October 2007 10:00 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 Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Overdene House Nursing Home Address John Street Winsford Cheshire CW7 1HJ 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) 01606 861666 01606 861757 overdene@schealthcare.co.uk Modelfuture Limited, Mrs Susan Clacy Care Home 70 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (3), Old age, not falling within of places any other category (70), Physical disability (70) Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 70 service users to include: * A maximum of 70 service users aged 60 years and above, in the categories PD (Physical disability) or OP (Old age, not falling within any other category) * A maximum of 14 service users under the age of 60 in the category PD (Physical disability) * Within the number of 14 PD under the age of 60, 4 named service users in the category LD (Learning disability) may be accommodated * 3 named service users in the category of LD(E) (Learning disability over the age of 65) may be accommodated Only rooms 31, 36, 42, 43, 44, 45, 46, 47, and 48 may be used for intermediate care 26th June 2006 2 Date of last inspection 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. 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. The current charges for the home are £353:91 to £624:62 per week. This information has been provided by the home manager. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit, part of the key unannounced inspection of the home, took place over 7 hours. It was carried out on 16 October 2007 by two inspectors. The findings were discussed with the manager on the day of the visit. Before the site visit the manager was asked to complete a questionnaire to provide information about the home as part of the inspection. The views of the people who live at the home and their relatives were also sought; their comments are incorporated into this report. During the site visit the inspector spoke to the manager, some staff members and people who live at the home. Six people’s records were looked at to check the care they receive. Policies, procedures and records of medication, care plans, staffing rotas and training records were also checked. What the service does well: Residents are fully assessed before they are admitted to the home so they know that their needs can be met at the home. All residents have a care plan in place which contains adequate information so that staff know how to meet their needs. Medication management at the home is good so that residents receive their prescribed medications. Residents are offered choice in their daily lives and the standard of catering is good. Residents are treated as individuals and their privacy and dignity is respected. Recruitment procedures, staff training and staff supervision ensure that residents are protected from harm. Residents’ financial interests are also safeguarded. The home is clean and comfortable with a warm and welcoming atmosphere so people live in pleasant surroundings. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures used when people move into the home means they have their needs thoroughly assessed before they move in so they know their care needs can be met at the home. EVIDENCE: The care plans looked at for two residents on the first floor showed that their needs had been assessed before they moved in. The manager confirmed that she goes out to assess anyone interested in coming to live at Overdene, to find out whether their needs can be met at the home. The home does not provide intermediate care therefore standard 6 was not assessed. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans of care ensure that residents’ health and personal care needs are met and medicines are well managed at the home to make sure that the people who live there receive the correct prescribed medication at the right time. EVIDENCE: Care plans were looked at for six residents living at the home. These were comprehensive and contained health assessments, risk assessments, and records of visits by GP, physiotherapist and other health professionals. The care plans had been reviewed each month, but often no meaningful comment was made when the review took place to reflect the care that had been given and if any changes had been identified. Good daily entries were made to record care that had been given that day. Risk assessments were completed in relation to pressure areas, moving and handling, nutrition, continence and falls. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 10 There was evidence that the people who live at the home and their relatives had been involved developing their plans of care. Care plans looked at for residents that had a pressure sores contained good recording of wound care. The wounds had been measured and graded so that the staff could assess the progress following treatment. One person had a number of pressure sores when they moved into the home, one of which has now healed. Advice had been given by the tissue viability nurse specialist and this was recorded in the care notes. It is often helpful to include a photographic record of wounds and the manager should consider doing this. Following a meeting with CSCI and social services the home has now secured the services of a private chiropodist to ensure that residents are able to have foot care on a regular basis. Mouth care has improved in the home and care plans regarding this are detailed. Medicines are well managed and very good records are kept. The medicine storage room on the first floor was clean, tidy and orderly. However the room temperature is consistently above the safe limit for the storage of medicines. Stocks are kept to a minimum. All medicines items are checked in and signed for and a stock balance is kept for any items carried forward from one month to the next. Eye drops and other items with a limited shelf life had been dated when they were opened. Controlled drugs were generally well managed although there were a small number of unused tablets awaiting destruction. With regard to staff in general, they friendly towards the residents. When beside people and encouraged them to knocking on the doors before entering a respectful manner. were seen to be kind, courteous and assisting with meals or drinks they sat take what was offered. Staff were seen residents’ rooms and talking to them in Residents spoken with said “the staff work hard”; “staff are kind and helpful”; “I sometimes have to wait for the buzzer to be answered but they always come”; “staff are always busy, sometimes I have to wait to go to the toilet” Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities available are flexible and varied so they suit the expectations, preferences and capacities of the people who live at the home. EVIDENCE: There are two activities co-ordinators employed at the home. Activities on offer are varied such as beetle drive, bingo, card games, darts, manicures, quizzes, baking sessions, crafts and flower arranging. A hairdresser visits the home twice weekly and entertainers visit the home regularly. The home has its own minibus which is used to take residents out in to the local community. A new plasma TV has been purchased and people living in the unit for younger people were looking forward to the rugby match at the weekend. A karaoke night has been planned and aromatherapy services are to be introduced. One to one sessions were available for residents that were unable to join in group sessions. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 12 Residents felt that their needs were being met with regard to activities. They said, “we can join in with lots of things if we want to”; “I like to sit and chat”; “staff ask me what I want to do”. Choice was recorded in the care plans and residents could sit in the lounges or stay in their bedrooms as they wished. Some residents on the ground floor said that they had to wait to go to bed most nights. The Menus seen are varied with a new menu for the younger residents to enable them to have more choice. Special dietary needs are catered for and the lunch on the day of the visit looked nutritious. Residents said, “the food is good”; “plenty to eat” Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are acted on to show they are taken seriously and the staff have received guidance to make sure they are able to protect the people who live at the home from possible abuse. EVIDENCE: The home has a satisfactory complaints procedure that was on display. There have been three recorded complaints received at the home since the last inspection. The complaints had been investigated appropriately and the response and action taken was recorded. There are policies and procedures to guide staff on how to make sure that the people who live at the home are protected from harm or abuse. There is also a whistle blowing policy that tells staff how they can make any concerns known. Most of the staff have attended training about abuse and the protection of vulnerable people, and the manager had dates planned for those who haven’t yet attended. Staff spoken with said that they had received the training and this was recorded in staff files. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 14 The manager of Overdene, nurse assessors and Leighton hospital had made several referrals to social services under the protection of vulnerable adults procedures. The home had co-operated with the social services and staff have been suspended. Following meetings held with social services, police, CSCI and the manager of the home, some of the concerns raised have been investigated by a manager from the company. Social services and the police are also conducting investigations and the residents and relatives concerned are aware of these investigations. Social services were satisfied with the investigations undertaken by the management at the home and no further action was taken. Examples of action taken following the completion of investigations were that some staff members were supervised for a period of three months and further staff training has taken place. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained so that the people who live there live in comfortable, safe surroundings that suit their needs. EVIDENCE: The bedrooms looked at during the visit were nicely decorated and adequately carpeted and furnished. All areas, including sluice rooms, were clean and tidy. Some communal areas were being re-decorated. A good range of equipment is provided including 15 specialist beds and a number of different types of hoists and slings. There are different types of armchairs to provide support for people with disabilities, including some armchairs with wheels. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 16 A new shower room on the ground floor is almost completed and a similar shower room is planned for the first floor. A shower trolley is available which means that people who are severely disabled and unable to sit up can have a shower. The manager said that a new bath has been ordered and will be installed within the next month. Murals have been painted on the bathroom walls by a local artist depicting a south sea island and views from Tatton Park gardens. Some plastic bath panels are cracked and damaged and have been repaired with tape, but a more permanent solution needs to be found. The home was clean and fresh on the day of the visit. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a good recruitment process in place to ensure that staff are suitable to work in the home but staffing levels should be reviewed and the staff training programme needs to be improved to make sure that the needs of people living at the home are always met. EVIDENCE: The duty rotas were looked at; for 63 residents there are 3 nurses and 10 carers on duty between 8am and 2pm, 2 nurses and 9 carers between 2 pm and 8 pm and 2 nurses and 5 carers between 8pm and 8am. Most of the people living at the home are heavily dependent and two staff members are required to give care and to move the residents using a hoist safely. Following discussion with the residents, manager and staff it was felt that the dependency levels of all residents should be reviewed and the staffing numbers assessed especially in the evening on the ground floor. A twilight shift was discussed to enable the residents on the ground floor to have more choice of when they wished to go to bed. Some residents on both floors said that the staff took a long time to answer the call bell and that they had to wait to go to bed. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 18 Staff training records were looked at. There is a summary sheet in the front of the file but this was quite difficult to read and not up to date. There was also a training plan for the year, which showed the home’s commitment to providing a range of both mandatory and other training. On the day of this visit, training about personal care was being provided by a nurse from the local Primary Care Trust. The records showed that all staff have attended moving and handling training this year. Most staff have attended fire safety training this year. Most have attended training about abuse and the protection of vulnerable people, and the manager had dates planned for those who haven’t yet attended. There are seven senior care staff who administer medicines but the training records showed that only two have received training about medicines. However, evidence was later provided to CSCI to show that staff had attended a training course on the safe handling of medication. Only eight of the care staff have achieved NVQ level 2 or above at present; however twenty-six of the forty-four staff care staff are at present working toward this award. This falls short of the national minimum standard of 50 . Seven staff personnel files were seen during the visit including three newly employed staff members. These showed that thorough recruitment procedures are in place including two references for each member of staff and a Criminal Record Bureau Check. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well managed home with safe financial procedures and equipment to meet their needs and effective quality assurance systems in place to make sure that the home is run in the best interests of the people who live there. EVIDENCE: The manager of the home is experienced and is a trained nurse. She has NVQ level 4 in management and a diploma in nursing. During the current round of reviews of residents by social services and nurse assessors support for the home manager is currently being provided from the area manager and a project manager. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 20 Records showed that staff receive regular supervision. A group supervision had taken place on 15th October 2007 for a group of 16 care staff. They had discussed issues about the personal care of residents. A relatives meeting had been held on 9th October 2007, with 26 people attending. They discussed current issues and relatives were able to put forward their views. There have also been recent meetings for all groups of staff. There were monthly audits completed by the manager that covered care plans, accidents, pressure ulcers and treatments, medication, the building including; kitchen, laundry and standard of cleanliness, and notifiable incidents. The area manager visits the home monthly, unannounced, and a report of this visit is compiled and a copy is sent to CSCI. No personal monies other than personal allowances were held on behalf of residents. Relatives were billed directly for additional services such as chiropody or hairdressing. Residents’ personal allowances were safely secured and records for credits and debits maintained. Records showed that fire detection equipment is tested by contractors regularly through the year and weekly alarm tests are carried out. There were good records of regular fire drills, including the names of the staff attending. Information provided to CSCI by the manager prior to the inspection in the Annual Quality Assurance Assessment stated that all the required maintenance and health and safety checks of the building and equipment had been completed. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 22 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 OP27 Regulation 18(1)(a) Requirement Staffing levels must be reviewed to ensure that people’s needs are met and that they are do not have to wait for long periods of time before getting the help they have called for. Timescale for action 30/11/07 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 OP7 OP19 OP28 Good Practice Recommendations Reviews of care plans should reflect the changes, if any had taken place. The plastic bath panels should be replaced with a more permanent fixture to ensure the risk of injury to residents and staff. The home should have 50 of care staff qualified to NVQ level 2 or equivalent. Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Overdene House Nursing Home DS0000018730.V348823.R01.S.doc Version 5.2 Page 24 - 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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