Inspection on 27/02/06 for Overton House

This inspection was carried out on 27th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Overton House 13/02/07

Overton House 10/10/05

Overton House 02/03/05

Overton House 20/09/04

Overton House 10/02/04

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

CARE HOME ADULTS 18-65 Overton House Overton Road Cheltenham Glos GL50 6BL Lead Inspector Mrs Caroline Jones Unannounced Inspection 27th February 2006 02:00 27/02/06 14:00 Overton House DS0000016529.V285090.R01.S.doc Version 5.1 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 Overton House DS0000016529.V285090.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 Adults 18-65. 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. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Overton House Address Overton Road Cheltenham Glos GL50 6BL 01242 234635 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) National Star College Mr Gareth Jones Care Home 31 Category(ies) of Physical disability (31) registration, with number of places Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th October 2005 Brief Description of the Service: Overton House is one of two homes providing off site accommodation for students attending the National Star College. The building is owned by Barnwood Trust and is leased to the college. Overton House is a large Georgian property, which has been adapted and extended to provide residential accommodation for up to 31 students who have physical disabilities. The house is situated in a residential area very close to the centre of Cheltenham. Student accommodation is provided on three floors, accessed by shaft lifts. This consists of a mixture of single and double rooms and a flat. A recent garage conversion creates an additional two independent living flats. Overseas volunteers who work at Overton are housed on the top floor. Students have access to a range of communal spaces, including a large recreation room, a quiet lounge and a dining room. A domestic size kitchen is also provided in addition to the main kitchen. An enclosed inner garden is accessible to all students. During the day time, parts of the building such as the computer room and recreation room are used by local people with disabilities for adult education courses. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place during the afternoon and early evening. The inspection focused on the three key inspection standards not inspected at the announced inspection, following up recommendations made at the last inspection and meeting students to get their comments and views. What the service does well: What has improved since the last inspection? There were no requirements made at the last inspection, however most of the recommendations have been taken note of, although few have been fully implemented. There have been two new staff recruited for Overton House and another member of staff transferring from the main site, meaning that fewer agency staff are needed. Records suggest that staffing at the weekends has improved and there were no comments from students to say that weekend activities were stopped because of staffing shortages. A system for recording homely remedies kept at the home has been set up, although keeping a running total is recommended. Work has started to see how the care and nursing records can be integrated, which may result in an electronic recording system. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 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. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected on this occasion N/a EVIDENCE: N/a Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 The college is exploring ways to better use existing records - and to share information and recording between care, nursing and main campus - to benefit students’ continuity of care. EVIDENCE: The senior nurse reported that the means of co-ordinating and sharing information between nursing and care records is being investigated, following the recommendation at the last inspection. Examination of nursing records identified a need for information to be shared from the main campus, where students are spending large amounts of time and may be receiving help with personal care tasks. The Residential Services Manager identified that electronic recording could resolve this. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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, 17 Students living at Overton House are supported to be responsible for their daily routines. Mealtimes at Overton House are pleasant, sociable occasions with choices of food routinely available, although it was not possible to judge the variety and nutritional quality of meals without food records being available. EVIDENCE: Students spoken to confirmed that they are encouraged to be independent and to organise their own lives and routines. Minutes of a recent house meeting show how students have challenged current practice in relation to weekly action plans; as a result this is being reviewed. Following comments from the last inspection, the house meeting minutes were used to remind students of their right to a key to their room and locker. However, a student who did not attend the meeting, or read the minutes, was not aware of his right to a room key. Students were observed to be able to choose to spend time alone or with a group and have free access around the building. Staff were observed to Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 11 interact with students, and students themselves confirmed that staff are approachable and easy to talk to. Students commented that the food at Overton House was good, stating that there is always a vegetarian choice or an alternative would be made for them if they asked. The evening meal was observed to be a sociable occasion with sufficient staff available to help those students who required it. The menu for the day is written up, but details of menus planned are not available to students. Records of the meals provided or planned were not available to judge variety, nutrition or quality. Students were aware of the two student representatives who meet the cook weekly to discuss the menu and pass on commendations or concerns. Nursing staff were seen to be aware of students eating habits and the need to monitor and review students and encourage their healthy eating. It was reported that on weekday evenings the cook prepares the food for the evening meal and the care staff takes responsibility for cooking and serving it. Whilst it is positive that both staff and students are free to come into the kitchen, the college must be mindful of the health and safety implications. A group of students described how they work with the cook to plan, shop for and prepare a group meal as part of their college independence programme. There is a student kitchen on the lower ground floor, suitably equipped and adapted to be assessable to many students. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The system for recording homely medicines could be improved further with a more accountable system. EVIDENCE: Following the recommendation from the last inspection, the nurses have set up a chart to record the details of any homely remedies purchased for use by students. This system only identifies the items purchased as the individual student medicine charts are used to record when a student is given these. This system still does not make it easy to check the exact amount held at any time and a more accountable system should be established. It was reported that copies of existing Risk Assessments for students self medicating have been requested from main campus, but had not been received. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected on this occasion N/a EVIDENCE: N/a Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Overton House provides students with adequate accommodation; which could be improved by tighter maintenance systems, décor in corridors and upgrading the sluice. EVIDENCE: As noted under Standard 6, following comments at the last inspection students were reminded in the house meeting that they are able to have a key to their room or lockable storage. It was reported that repairs and improvements to bathrooms have been undertaken, following recommendations from the last inspection, although this was not checked. There was evidence that maintenance issues are reported to the Star College maintenance team, although keeping track of outstanding maintenance issues can be time consuming. A faulty toilet flush needed attention and possibly an alternative mechanism. The Residential Service Manager recognised that an electronic system of notification and recording could improve maintenance management. It was noted that the main corridors in the building are very bare and institutional in comparison with students’ own rooms, which are decorated with posters of the students own choice and personalised with their own possessions. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 15 There are no reported actions following the recommendation in the last report about the home’s sluicing arrangements. Items such as urine bottles are not used exclusively by one student, the thoroughness of cleaning can vary between staff and there is a potential for error when changing the sterilising solution. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected on this occasion N/a EVIDENCE: N/a Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The safety of students is compromised by shortcomings in the Fire Safety arrangements. EVIDENCE: The Fire Safety arrangements at Overton were examined. It was not clear at the home what actions had been taken following the ten point report from a Fire Safety Officer’s visit in October 2005. There was no evidence of a comprehensive Fire Safety Risk Assessment, with associated policies and procedures. The Fire Safety Log showed that tests of the alarm system have not been undertaken weekly in the last four months. A Fire drill had taken place in the home in November 2005, however this had not included all the students. Records of evacuation practise and Fire training sessions suggested that only one member of night staff had attended recent training. Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 x 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 2 X X X X X 1 x Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 19 N/a 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 YA42 Regulation 23.4 Requirement The College must • Make Fire Safety Risk Assessments and associated Policies and procedures available to staff • Take action within an acceptable time scale to meet the Fire Safety Officers’ requirements • Ensure that the fire alarm system is tested weekly • Ensure that all staff, and most urgently night staff, have regular fire safety training and drills • Ensure that students are aware of procedures to follow in the event of a fire The College must make sure that the record of food is properly maintained and available at all times for inspection. Timescale for action 15/03/06 2. YA17 17 (Sch 4.13) 01/04/06 Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 20 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. 4. 5. 6. 7. 8. Refer to Standard YA2 YA6 YA20 YA20 YA24 YA24 YA30 YA34 Good Practice Recommendations It is recommended that greater use be made of existing assessments and goal setting when students move in to Overton House to avoid unnecessary duplications Greater co-ordination and sharing of information is recommended between care and nursing records. It is recommended that copies of existing Risk Assessments for students self medicating are transferred to their current files. It is recommended that an auditable system is established for supplies of homely medicines held and administered. It is recommended that all students are reminded of the arrangements for their having keys to their rooms or lockable storage boxes. It is recommended that attention is paid to the ongoing maintenance of the building, in particular the standards of bathrooms. It is recommended that the sluice facilities are upgraded in line with Health Protection Agency guidance. It is recommended that the recruitment system is tightened to ensure that references are on file prior to a persons appointment being confirmed, and there is evidence that any gaps in employment have been explored. It is recommended that the décor of the corridors is given some attention. 9. YA24 Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Overton House DS0000016529.V285090.R01.S.doc Version 5.1 Page 22 - 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!