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Inspection on 26/06/06 for Overdene House Nursing Home

Also see our care home review for Overdene House Nursing Home for more information

This inspection was carried out on 26th June 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Good information is provided to prospective residents and they are actively encouraged to visit the home and stay on a trial basis prior to making a permanent choice. Full and comprehensive assessments are carried out and care plans are in place to ensure the home will be able to meet the residents` needs. Medicines are well managed, ensuring that residents receive their prescribed medication. There is a good, friendly relationship between staff and residents and staff are mindful of service users` privacy and dignity. Residents and staff said that the management of the home is open and positive. The home is very well maintained and clean. It provides a comfortable and welcoming environment. Visitors are warmly welcomed into the home. Residents are consulted about their hobbies and interests and a varied programme of activities is available, which includes activities outside the home. Residents receive good and varied food. Staff recruitment, training and supervision ensure that resident`s interests are promoted and protected.

What has improved since the last inspection?

The manager has been in post since September 2005 and has quickly developed her knowledge of the home, the staff and residents. New trained staff have been recruited and the home has a team of staff that are positive. Care plans and recording has been improved. Residents have been asked about the suitability of activities provided and these have been improved. Exercise is now offered on a regular basis and residents are satisfied with the range of activities on offer. Formal supervision for staff is regularly being provided. The interior environment has been improved, with replacement of some carpets and the decoration of a number of bedrooms. The gardens have been improved with a new water feature and more garden furniture has been provided. Residents` and relatives views are now actively sought in order to measure the home`s success in meeting residents` expectations. Staff meetings are taking place on a regular basis and staff feel they are part of the team.

What the care home could do better:

Care plans have improved since the last site visit however, some aspects of recording the actions taken by staff could be improved. Risk assessments should be in place for all identified risks for residents. A gas safety certificate must be obtained and a copy sent to CSCI.

CARE HOMES FOR OLDER PEOPLE Overdene House Nursing Home John Street Winsford Cheshire CW7 1HJ Lead Inspector Joan Adam Key Unannounced Inspection 26th June 2006 09:30 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.V292190.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. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 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 Modelfuture Limited, Ms 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.V292190.R01.S.doc Version 5.1 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 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 2 Date of last inspection 26th January 2006 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. The current charges for the home are £343.34 to £500 per week. This information has been provided by the home manager. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One regulatory inspector undertook this unannounced site visit over two and a half days. The Key inspection was arranged as part of the Commission for Social Care Inspection’s (CSCI) regulatory programme under Inspecting for Better Lives. The site visit took place over 15 hours. Feedback was given to the manager on the 3rd July . Records were inspected and staff practice was observed. Discussion took place with the registered manager, residents and staff. A tour of the premises was undertaken. Information was also provided by the home before the site visit. The service history of the home was also considered. What the service does well: Good information is provided to prospective residents and they are actively encouraged to visit the home and stay on a trial basis prior to making a permanent choice. Full and comprehensive assessments are carried out and care plans are in place to ensure the home will be able to meet the residents’ needs. Medicines are well managed, ensuring that residents receive their prescribed medication. There is a good, friendly relationship between staff and residents and staff are mindful of service users’ privacy and dignity. Residents and staff said that the management of the home is open and positive. The home is very well maintained and clean. It provides a comfortable and welcoming environment. Visitors are warmly welcomed into the home. Residents are consulted about their hobbies and interests and a varied programme of activities is available, which includes activities outside the home. Residents receive good and varied food. Staff recruitment, training and supervision ensure that resident’s interests are promoted and protected. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Care plans have improved since the last site visit however, some aspects of recording the actions taken by staff could be improved. Risk assessments should be in place for all identified risks for residents. A gas safety certificate must be obtained and a copy sent to CSCI. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 7 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 DS0000018730.V292190.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 Overdene House Nursing Home DS0000018730.V292190.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): 3 and 6 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Assessments of people’s care needs are carried out before they move into the home so there is information to show that their needs can be met. EVIDENCE: The pre-admission documentation of two residents who had moved into the home in recent weeks was looked at. It contained assessments of dependency levels and likes and dislikes of the resident. Discussion with the residents confirmed that they had moved into the home in the knowledge that is suitable to meet their identified needs. However, one of the assessments had not been signed or dated by the member of staff who had completed the form. See requirement 1 The home did not have any residents who had been identified as having intermediate care needs. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 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): 7,8,9and 10 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ health, personal and social care needs are met by staff who enable them to maintain their privacy and dignity. EVIDENCE: Five care plans were seen. Care plans identified areas of need such as pressure area care, mobility, continence, nutrition and general dependency. They contained sufficient information to provide staff members with the necessary information for them to look after a person’s needs. There was written evidence to confirm that care plans were being reviewed and where necessary re-written on a regular basis. The care plans seen showed that there had been consultation with residents or their families/advocates. However, one care plan for a resident with a small pressure sore that had been redressed had not had the appropriate wound record chart completed. See requirement 2 Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 11 Risk assessments were completed in relation to pressure areas, moving and handling, nutrition, continence and falls. However, one resident that had been admitted for respite care had been identified as having a high risk of falls. A care plan was in place, which identified the area of need, but no risk assessment had been completed. See requirement 3 Care plans at the home have improved since the last inspection visit, however some of them had been altered but had not been signed or dated by staff. See requirement 4 Medications were managed separately for each unit and storage arrangements were satisfactory. The home used a monitored dosage system. Staff were seen administering medication to residents in an appropriate manner. Medication Administration Record Sheets were completed appropriately. Audits were carried out for medicines liable to abuse and were found to be in accordance with the records. During the inspection staff showed respect for the residents by the way they spoke to them. Staff acted in a friendly and warm manner towards residents. Personal care was conducted in the privacy of their own bedrooms. Residents spoken with said that “ All the staff are lovely, they are very willing” “The staff are always busy but are really nice” “ excellent place, staff are marvellous” “ nothing is too much trouble” Overdene House Nursing Home DS0000018730.V292190.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): 12,13,14 and 15 The quality rating for this outcome area is excellent . This judgement has been made using available evidence including a visit to the service. The routines of daily living and activities available are flexible and varied to suit residents’ expectations, preferences and capacities. EVIDENCE: The home employs two activity co-odinators. Activities at the home are much improved and are divided between group activities and individual sessions which are on a one to one basis for residents who prefer this or are unable to join in the group activity sessions. All activities attended are recorded. The activities co-ordinator was spoken with during the visit to the home. Activities provided are varied and include beetle drive, bingo, card games, darts, manicures, quizzes, baking sessions, crafts and flower arranging. A hairdresser visits the home twice weekly and entertainers are booked on a regular basis. The home has a new minibus and trips are arranged to local shops, theatres and garden centres. Tia chia sessions have recently been added to the list of the activities on offer and residents spoken with said they enjoyed this. Residents said that “the activities had improved and there was always something going on.” A notice board in the main entrance to the home has a programme of events displayed and photographs of events are posted on this board. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 13 The residents’ religious preferences were noted in the care plan. It was said that residents could see a minister of their choice. Staff said that residents could see visitors in private or in the shared areas. Residents spoken with confirmed this. There were no restrictions on visiting. Residents they said they were able to go out and about as they preferred and that they chose what they wanted to do. Some comments such as “ the things going on are really good” “ always plenty to do” were made by residents. During this visit a partial tour of the units was undertaken and bedrooms seen were personalised with mementoes, photographs of families and friends and small pieces of residents’ own furniture. Meals can be taken in the dining room or in the privacy of residents’ own rooms. The kitchen area was well managed and organised. There is a menu that has the flexibility to meet individual needs and choices. All of the residents that commented said that the food was good and that choices were available. Residents said” The food is lovely” “ if you don’t want something on the menu you can get something else” Special diets are prepared where necessary. Overdene House Nursing Home DS0000018730.V292190.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): 16 and 18 The quality rating for this outcome area is good . This judgement has been made using available evidence including a visit to the service. There is a complaints procedure in place and the residents are protected from abuse. EVIDENCE: The home’s complaints procedure provides appropriate guidance and information as to how to make a complaint. There have been no complaints made either to the home or to CSCI since the last inspection. This information was provided by the manager before the site visit and by looking at the complaints file. All of the residents spoken with said they knew the complaints process and would complain to staff if they needed to. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance “No Secrets”. The manager, deputy and all staff have received training in this area. Both staff members and the home’s training records confirmed this. Overdene House Nursing Home DS0000018730.V292190.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): 19 and 26 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Overdene provides a comfortable environment for those living there and visiting. EVIDENCE: A partial tour of the units was undertaken. All the shared areas and a selection of bedrooms were seen. The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats and hoists provided as necessary to meet the residents’ needs. A good standard of décor was evident. Decoration at the home is on going and a number of bedrooms have been decorated and some have had new carpets. The lounge/dining areas had a variety of seating affording choice of style of seating. Bedrooms were entered with the consent of the residents. They were all single and were personalised with residents’ own furniture and mementoes. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 16 All areas seen were clean and free from any unpleasant odours. The entrance hall has been reorganised and is warm and welcoming. The gardens have been much improved with a water feature and new garden furniture, making a very pleasant environment for residents to enjoy good weather. Overdene House Nursing Home DS0000018730.V292190.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): 27,28,29 and 30 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staffing levels and skill mix are sufficient to meet the needs of the residents, Residents are protected by the home’s recruitment practices and staff training. EVIDENCE: Rotas revealed that staff numbers complied with agreed minimum staffing levels and on some occasions this number was exceeded. Copies of courses undertaken were seen on the staff files. These included moving and handling, health and safety, fire awareness, pressure sores, drug administration, food hygiene and resident welfare which includes protection of vulnerable adults. Staff who are working on the younger persons unit had received some training by the company to assist the staff to look after these residents. This was a requirement at the last visit and has now been met. The company have recently reviewed training courses to enable staff to continue to undertake NVQ level 2 in care. Only eight of the thirty-six care staff have attained this qualification and it is an expectation that fifty per cent of all care staff should be qualified by 2006. This information was provided by Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 18 the manager before the site visit. See recommendation 1 Staff files were looked at for four newly employed staff members and all of these contained appropriate checks prior to commencement of employment. Overdene House Nursing Home DS0000018730.V292190.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): 31,33.35 and 38. The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to the service. The systems for resident and staff consultation are good and the health safety and welfare of residents is protected. EVIDENCE: The home has an experienced and competent manager who has recently been registered with the Commission for Social Care Inspection. She has completed the registered managers award. The residents and staff spoken with said that the home’s management team were approachable and supportive. The home had various quality assurance systems in place. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 20 Audits were carried out in relation to pressure sores, catering, monitoring of residents’ weights and accident analysis. All had action plans showing improvements to be made. A monthly medication audit was seen showing the receipt, administration and disposal of medication. The Operational Manager completes monthly unannounced visits and copies of these reports are kept in the home and sent to CSCI. Day to day supervision was good and staff said they were well supported. Formal supervision was given to staff and records showed that the supervisor and staff member signed these. A selection of staff and manager sessions records were seen. Policies and procedures seen were up to date and accurate. These were kept secure within the home. During discussions some residents confirmed that they had access to information kept about them. One resident that had been admitted for respite care had been identified as having a high risk of falls. A care plan was in place which identified the area of need but, no risk assessment had been completed. See requirement 3 The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place on a regular basis. The maintenance staff checked the hot water in the home and this was recorded. Certificates were seen for the passenger lift and the hoists, however, the home did not have an up to date gas safety certificate. See Requirement 5 Resident, relative and staff meetings were held on a regular basis and the minutes were recorded. Residents and staff said that these meetings were productive. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 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 2 X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 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 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 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 OP3 Regulation 15 Requirement Pre-admission assessments must be signed and dated by the member of staff completing the assessment. Care plans must be up-dated following each nursing intervention. All identified risks to residents must have a risk assessment completed. Alterations made to care plans must be signed and dated by the member of staff completing the documentation. The home must obtain an up to date Gas safety certificate and a copy must be sent to CSCI. Timescale for action 31/08/06 2. 3. 4. OP7 OP38 OP7 15 13 15 31/08/06 31/08/06 31/08/06 5. OP38 13 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 23 No. 1. Refer to Standard OP28 Good Practice Recommendations The home must have 50 of care staff qualified to NVQ level 2 or equivalent. Overdene House Nursing Home DS0000018730.V292190.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Northwich Local Office 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 DS0000018730.V292190.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!