CARE HOMES FOR OLDER PEOPLE
Overleat Derby Road Kingsbridge Devon TQ7 1JL Lead Inspector
Judy Cooper Unannounced Inspection 11:45 7 October 2005
th 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 Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Overleat Address Derby Road Kingsbridge Devon TQ7 1JL 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) 01548 852603 01548 852603 Mrs Sharon Angela Hard Mr Richard Hard Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (10), of places Physical disability over 65 years of age (10) Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 06/05/2005 Brief Description of the Service: Overleat is a small family run home situated near the centre of Kingsbridge.The home is a period property, and is set next to a small park on the level to the Quayside walk and the town centre.The home provides accommodation on two storeys, serviced by a chair lift, for up to 10 older residents with or without physical disabilities and/or with or without mild confusion. Accommodation is in single rooms, which vary in size, and some have en suite facilities. The home also has level easily accessible gardens and plenty of parking facilities. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on a Thursday late morning and into the afternoon finishing at 4.00p.m. Opportunity was taken to tour the premises, examine some records and policies and talk with the home’s deputy manager, residents and staff, as well as some visitors to the home. Staff on duty were also observed, whilst in the course of undertaking their daily duties. All required core standards were inspected at the last inspection in May 2005 and many were concluded as met at that time. Those inspected on this occasion concentrated on resident welfare on a day to day basis, and on the few standards that had not been met at the previous inspection. What the service does well: What has improved since the last inspection?
Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 6 The owner has felt confident in allowing the staff to take extra responsibility for the day to day decision making within the home and has now begun to use the home’s deputy manager to full effect. Further additional water regulation, to allow hot water to be run at a safe temperature, has been provided to some more residents’ wash hand basins. Also additional protection of hot surfaces, to which residents have access, has been provided with, all but one, residents’ bedroom radiators now protected. This further reduces the risk of a resident sustaining a burn. Some additional upgrading has occurred within the home, including the provision of some new carpeting to the home’s landing, downstairs corridors and lounge, as well as redecoration of some areas of the home. 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.
Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The admission process continues to be well managed and residents are given clear information regarding the service prior to admission so that they, and their relatives, can make an informed decision regarding coming to live at Overleat. EVIDENCE: Since the last inspection the home has admitted one new resident and it was noted, by observing records, that a full and detailed admission procedure was undertaken, which ensured that Overleat was considered an appropriate home. The resident confirmed that they had been made to feel welcome, and had been given clear information about the home prior to admission, having been able to have a short stay at the home to see if it what was what they wanted before they took up permanent residency. The resident is now very happy living at Overleat. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,10 Residents’ needs are well documented and well known. Residents are treated with dignity and respect and their individuality and independence maintained. EVIDENCE: During this inspection the care plan was seen for the resident who had recently moved into the home and this clearly documented all care that the resident needed. The resident had been fully involved in this care planning process. The plan was also regularly reviewed. The resident was able to state that they had been able to have a short stay prior to choosing to live at the home and that all support had been made available at all times by the owner and staff. They also confirmed that they felt happy and well settled. Other residents spoken to confirmed that they were always treated with respect by the owner and staff and felt confident that both would help them with any area of their life that they needed assistance with. Staff were noted as treating residents with kindness and sensitivity whilst, at the same time, respecting their individuality and dignity.
Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 10 Overleat DS0000003768.V251454.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15 Residents continue to enjoy a peaceful, pleasant yet varied life at the home and excellent meals continue to be provided. EVIDENCE: Residents were noted as choosing how they spent their time with some spending time in their own rooms or others in the welcoming communal areas of the home. One resident was out to lunch with their family who were visiting. The atmosphere was relaxed, warm and welcoming and some residents stated that they enjoyed the fact that Overleat felt just like their own home. Meals continue to be provided to a very high standard with residents stating that they very much enjoyed all meals provided. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 12 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 Residents know how to complain and would be confident to do so if necessary. EVIDENCE: Residents confirmed that they would be confident in speaking to the home’s staff about any concern they may have. The home’s complaint procedure was prominently displayed and included this Commission’s local contact details. There have been no complaints received by this Commission, or the home itself, within the past twelve months. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 13 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 Recent upgrading measures have helped ensure that Overleat provides a very comfortable, clean well maintained and warm environment. The registered provider is compromising residents’ safety, by not fully maintaining all fire prevention measures within the home as required. EVIDENCE: Overall the home presented as very comfortable, clean and welcoming. The tour of the building evidenced that the owner further continues to undertake required upgrading within the home to ensure a good standard of accommodation is provided throughout. Bedrooms have been personalised as desired and residents can bring in personal items with them if they wish to. The management of the home maintains the day to day home’s fire precautions in line with the requirements of the local fire department, however it was also noted that the home’s laundry room door and one bedroom door were being wedged open during the inspection. An immediate requirement notice was issued in respect of this as resident safety was being compromised
Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 14 by the use of such, and the deputy manager did take immediate remedial action before the inspection ended by removing the door wedges. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 15 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 Staff at the home continue to be well trained and employed in sufficient numbers to meet the residents’ needs. EVIDENCE: Staffing levels continue to be in sufficient numbers to ensure that residents’ needs can be met at all times of the day and night. Mr and Mrs Hard no longer routinely provide the “sleep-in” cover at night, but existing staff have now taken this on, which ensures residents continue to be cared for at night by staff that they are familiar with. Training continues to be very well planned and supports the staff in providing for the varied needs of the residents Residents confirmed this to be the case by stating that they felt well looked after, staff were always available if needed and they were happy at Overleat and benefited from the care they received. Staff continue to feel supported in their caring role and have been kept informed of some current ownership changes, (i.e. Mrs Hard’s plans to take over sole ownership of Overleat).This means that there are little, if any, feelings of uncertainty amongst the staff group. This in turn allows the residents’ care to be maintained to the highest level by a confident and aware staff group. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 16 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): 38 The home is managed efficiently and well with residents best interests upheld. Although every day routine health and safety matters are in the main well managed, some environmental safety precautions have not been completed, which means that residents’ health and safety continues to be compromised. EVIDENCE: The home’s environment was seen to be mostly safe with routine health and safety measures in place and further upgrading noted as having taken place, since the last inspection, in the form of both additional hot water regulation and protection of hot surfaces within the home. The home’s hot water supply is now regulated where there are full bathing facilities however not all residents’ hand washbasins yet have a heat regulated water supply.
Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 17 All, but one, radiator sited within residents’ bedrooms, have been provided with a radiator cover, and the other non covered radiators within the home’s hallways etc are to be provided with low surface radiators within the near future. As the home is registered to be able to offer care for physically frail and mentally frail residents, as well as elderly only residents, the two former resident groups could be considered to be at risk of sustaining a scald/burn from non-regulated hot water or from an unprotected hot surface. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 18 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 STAFFING Standard No 27 28 29 30 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 9 10 11 2 x x x x x x x x x 4 x 3 x x 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 2 Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP25 Regulation 15 Requirement Timescale for action 06/05/06 2 OP19 23 The registered providers must continue to ensure that all pipe work and radiators to which service users have access must be risk assessed and guarded or have low temperature services. (Timescale given previously not yet expired). The registered provider must 06/10/05 ensure that the homes’ fire precautions are maintained in accordance with the requirements of the local fire and rescue service. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP24 Good Practice Recommendations The registered providers should continue to ensure that all other water outlets, to which residents have access, including residents hand wash basins are risk assessed and fitted with valves to provide hot water to 43 degrees
DS0000003768.V251454.R01.S.doc Version 5.0 Page 20 Overleat Centigrade as deemed necessary. Overleat DS0000003768.V251454.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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