Inspection on 25/03/09 for St Oggs

This inspection was carried out on 25th March 2009.

CSCI found this care home to be providing an Good service.

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

St Oggs 05/09/06

St Oggs 11/01/06

St Oggs 29/06/05

St Oggs 14/03/05

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Oggs 14 Front Street Morton Lincs DN21 3AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ken Hague     Date: 2 5 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: St Oggs 14 Front Street Morton Lincs DN21 3AA 01427617173 01427617171 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Prime Life Ltd care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 21. The registered person may provide the following category of service only:- Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disabilities or dementia - Code MD Date of last inspection Brief description of the care home The home is a detached adapted property providing care and accommodation for up to twenty residents with mental health needs. There is also a bungalow within the grounds, which can accommodate two residents. The home is situated in a residential area of Morton, once a village and now a suburb of the town of Gainsborough. There is a Church opposite the home and local shops and a post office are located on the corner of the road. Gainsborough town can be reached by using a bus service, which passes Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 3 19 Brief description of the care home the corner of the road. The home has a minibus, which also provides residents with transport for example to appointments, trips out and to attend day care services. This is shared with another home within the same group. The home was extensively refurbished when the current organisation took it over. There are three lounges, a games room and dining room. These are on the ground floor. Bedrooms are on both floors. The home does not have a lift. The front garden has flowerbeds, paved areas and seats. There is a driveway leading to the rear of the property, which has a decked patio/seating area and car parking. The home is part of Prime Life Limited. The home charges, £321 to £448 per week. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was unannounced any previous information held by the Commission for Social Care Inspection about the home was taken into account. The Commission for Social Care Inspection was replaced from 1st of April 2009 by the Care Quality Commission who has published this report and are now responsible for the inspection of this home. Throughout this report the terms we and us therefore refer to the Care Quality Commission. Before the visit the provider had returned an Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans for improvement over the next 12 months. We sent out surveys to residents staff and relatives of which 8 were returned. There were three relatives surveys returned and two staff and three from residents. The information from these surveys are summarised within this inspection report. Care Homes for Adults (18-65 years) Page 6 of 27 The main method inspection used was called case tracking. This involves selecting a proportion of the residents and tracking the care they received through the checking of records, discussions with them and the staff who care for them, and observations of care practice. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New residents receive a full comprehensive assessment before being admitted to the care home. Evidence: The care files for three residents were seen. The registered manager stated that care records were being updated to improve the quality of recording. We studied the initial assessment for the three residents being case tracked. Assessments were structured and identified the needs of each resident. They had all been completed prior to the resident being admitted to the home. A detailed risk assessment was not completed for each resident. The registered manager stated that detailed risk assessments were carried out but no detailed recordings to evidence this was found on the residents file. Where a risk had been identified the management of that risk was found on both the assessment and the initial care plan. Residents needs when identified were recorded in detail. This included input from family and the resident. Information obtained from the community health care services and local social services teams were included in assessments. Assessments described the residents wishes regarding the manner in Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: which they wished care to be provided. Assessments were signed and dated by the assessor and the individual resident or a member of their family. The following information was seen to be included in assessments, family history, education, medical history communication difficulties if any and the mobility of each resident. Risk assessments for medication administration had been completed after consultation with the general practitioner. There was evidence of residents consenting to medication being administered by staff where self-medication was unsafe. Residents had signed to say that they consented to having their photograph taken and included in their personal file. Residents medical history was recorded. The information recorded for each resident was personalised and described the difficulties they experienced in socialisation and work/training experiences in the community. Details of any legal action taken under the Mental Health Act were recorded in detail included the type of section used at the time. Those with drug misuse problems had their individual problems outlined in detail in care records. The registered manager stated that all residents were now in the possession of a contract in terms of their stay and the residential home. This had been a requirement at the last inspection. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The failure to provide detailed care plans for all residents could result in a residents needs not being met. The updated medication procedure of the home is being followed which ensures the safe Administration and storage of medication. Evidence: The care plans for three residents were sampled. Two individual residents files contained a current care plan which had been reviewed every four weeks. The file of one resident contained no current care plan. Staff, were using the information gathered at the initial assessment to provide care. There was no current risk assessment in place for this resident. There was Information on this residents file supplied by the National Health Service but no recorded evidence that the registered manager had checked the accuracy of this information as part of her initial assessment. The registered manager stated that the resident and only been in the home for a week and a care plan have not been written as they were still getting to know the needs of this resident. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: There were care plans in place for the other two residents being case tracked. Their care plans did contain the social need, personal care needs of each resident, and included their wishes in respect of social activities. Care plans instructed staff how to meet safely the needs of these two residents. They gave guidance how each task should be carried out and included instructions how staff should ensure that the safety dignity and privacy of the residents was maintained. The registered manager stated that risk assessments had been carried out for these two residents. Risk assessments can be improved however they lacked detail. The care home has a medication procedure for the safe administration and storage of medication. The registered manager and staff stated that only trained members of staff give out medication. Training records provided evidence that staff have received training in the administration of medication. The last pharmacy report was a positive one and contained no recommendations. Staff, were observed to make sure that the privacy and dignity of residents is maintained. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a diet, and a range of activities that suit their needs and wishes. They benefit from being able to maintain links with the local community. Evidence: Care plans guide staff how they can ensure that social stimulation is provided to all residents. Work training and social activities take place within the care home and in the community. All residents go out into the community for organised social outings. Residents obtain skill training within the home and at local training centres in Gainsborough and Lincoln. Staff, were able to explain the choices and wishes of the residents being case tracked and how these are being met by the resources of the care home. Residents use the community facilities on a daily basis. Residents go out to local shops, restaurant, and the leisure centre. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: The menu offers choices to residents while meeting their individual dietary needs. The likes and dislikes of residents are recorded on care plans. Staff were able to discuss the dietary needs of the residents being case tracked. A resident stated the food here is fine, we are given choices and I feel my dietary needs are being met. The registered manager and staff stated that visitors are free to visit at any reasonable time. Staff stated that residents are encouraged to maintain links with their own family and the community. Surveys completed by relatives provided evidence that residents are encouraged to maintain family links. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have care plans which identify their health care and social needs and instruct staff how these are to be met. Medication is administered and stored safely. Evidence: The registered manager stated in the majority of cases personal care needs are being met by providing advice and support rather than physical care. Residents are encouraged to self -medicate where their personal goal is to work towards independence and a risk assessment confirms that this would be safe practice. The individual care needs and social needs of each resident are recorded in their care plans. Residents who see a consultant on the regular basis have these appointments recorded in their care records. Staff stated that they support residents to ensure they can keep appointments with consultants and GPs. Community nurses visit the care home and these visits were seen to be recorded. Residents visit the local opticians, dentists and where appropriate receive chiropody. Residents stated that their health care needs are being met. Residents surveys provided evidence that in the opinion of the residents all of their health needs are Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: being met. Residents stated staff, ensure all hospital and GP appointments are kept. A resident stated sometimes I dont feel well the staff always help me to see my doctor if Im concerned about my health. Any allergies or special dietary needs were recorded in care records. The home has an updated medication procedure. Staff confirmed that they had been trained in the administration and storage of medication. The registered manager stated this ensures that medication is given out safely. There have been no notifications in respect of the maladministration of medication. The last pharmacy report was a positive one and contained no recommendations. Staff stated only qualified competent members of staff are allowed to give out medication. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to protect residents. Staff, are trained to protect residents from potential abuse. Evidence: The home has an updated complaints procedure which is displayed in the care home. The registered manager stated that an individual copy is given to all residents. All of the surveys completed by residents, relatives and staff confirmed that they were able to access the complaints procedure. A resident stated that they felt confident in being able to raise concerns. A resident stated if I am worried staff, help me to solve my problems and any concerns or complaints that I have. Staff confirmed that they have received training in protecting residents from potential abuse. Training records supported this statement. The staff interviewed stated that they are able to use the company whistle blowing procedure if they had any concerns about care practice at the home. Staff stated that they felt the home was a safe place in which to work and could not identify any health and safety issues which would affect the safety of residents. Staff stated they were confident in being able to protect residents from any potential abuse. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean care home. Ongoing maintenance has not been provided resulting in a deterioration of the fabric of the home. The up-to-date infection control procedure is followed and a safe environment is therefore maintained. Evidence: The home looked worn and tired. It was clean and smelt fresh but no evidence of ongoing maintenance was seen. A dining room had been modernised and restyled. This was the only physical improvement seen during the site visit. Resident stated in the have your say documents that the home is always clean and smells fresh. Residents and staff stated that they felt the environment needed to be improved. Three bedrooms were viewed they had been personalised by individual residents. Some Social areas within the home show signs of needing repairs to furniture and the fabric of the room. Two rooms used at the front of the house as smoking rooms. Staff stated that it was unpleasant to enter them to due to the smoke fumes and lack of ventilation. A step on the stairs was found to be broken and the carpet was hanging off this was repaired during the site visit. The registered manager stated that there was a need for ongoing maintenance. She stated a property audit was to be carried out in the following week on the 5th of Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: March. Prime Life supplied a copy of their audit to the Commission. It details areas to be decorated, floors to be repaired and new equipment is to be purchased. Prime life identified 28 additional jobs required to be carried out within the care home. The time scales for this work is said to be four to six weeks. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff, are recruited safely using the updated recruitment procedure of the care home. They are trained to meet the needs of residents. Evidence: The personal file for a new member of staff was seen. It contained all the documentation required to ensure that the member of staff was safe to work in the home which included a criminal record bureau check, two written references and proof of identity. Evidence was found within the personal file of an induction been carried out. The registered manager stated that supervision and appraisals are being provided to staff. Staff confirmed appraisals and supervisions have been provided. They confirmed that staff meetings and residents meetings do take place. Staff, were able to discuss in detail the needs of the individual residents being case tracked. Staff stated that residents are encouraged to maintain their personal social life. Staff stated that they do not work any additional hours except by choice. Staff said that they feel that they are well supported by the registered manager and work well as a team. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: There were three surveys returned by staff. The surveys were completed in 2008 and views within the surveys differed from comments made by staff on the day the site visit. These three areas raised were discussed with current staff and did not produce any issues. There was a common theme however from both the surveys and the site visit discussions. Staff stated that care plans have not always been written in detail. Staff stated that communications are sometimes a problem with verbal information being shared between staff members rather than the using the recording process. Residents and relatives spoke highly of the commitment and professionalism of staff in the surveys. A relative commented Care staff have the right skills and experience and patients to look after my relative. A resident stated if I have problems and are unsure of anything the staff will always advise me and help me A second resident stated all staff treat me nice, staff treat me with respect. Staff stated that in their opinion there was always sufficient staff on duty. The Inspector found no evidence to contradict the statements of current staff which conflicted with the past comments made in surveys. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well run, with good leadership. The Health and Safety and the well-fare of residents is promoted. Mangement hours are not being taken by the registered manager which will reflelt on the monitoring of staff and the qauilty of records. Evidence: The registered manager produced any record requested. She was able to describe the needs and care plans for any resident in detail. Supervision and appraisals were seen staff confirmed that they had taken place. Care records were found to be recorded in two different styles. Care plans were being reviewed. Staff training is being provided which includes specialised training in addition to essential core training. The AQAA states that Staff training has been organised to inform staff of the new Mental Capacity Act. Policy and procedures are being reviewed to update them in line with current legislation. Staff meetings are held. The registered manager has kept the Commission for Social Care Inspection informed Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: of all events which had a potential impact on the safety of residents. No complaints have been received by the home since the last key inspection or by the Commission for Social Care Inspection. No health and safety issues or infection control issues were identified during this inspection. Staff stated that they found the manager supportive and approachable. A member of staff stated the management are very supportive and patient and explain things very clearly to me. Residents consistently stated their satisfaction with the care home. Action had been taken to ensure that the requirements identified at the last key inspection would be met at this current key inspection. The registered manger stated that for the last few weeks she had used all working hours for providviding care to residents and had used none for mangement tasks at the home. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 All residents should have a written care plan To ensure residents needs are identified and can be met by the resources of the home. 26/06/2009 2 24 23 An ongoing maintenace plan should be in place to preserve the qaulity of the building 26/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The registered manager should ensure that the home complies with The smoke free ( premises and enforcement regulations) The registered manager should be given management time. Not work all of her hours provideing care 2 43 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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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