Inspection on 23/07/08 for The Ormsby Centre

This inspection was carried out on 23rd July 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Southfields

Thorndene

Insight - Eastchurch

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

1 Marten Road

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE The Ormsby Centre 59 East Street Littlehampton West Sussex BN17 6AU Lead Inspector Sheila Gawley Unannounced Inspection 23rd July 2008 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 The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Ormsby Centre Address 59 East Street Littlehampton West Sussex BN17 6AU 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) 01903 713815 01903 731331 registeredmanager@ormsbycentre.com Lifetime Care UK Ltd Mrs Lynne Smith Care Home 60 Category(ies) of Dementia (0), Learning disability (0), Mental registration, with number disorder, excluding learning disability or of places dementia (0) The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Learning disability (LD) 2. Mental disorder, excluding learning disability or dementia (MD). The maximum number of service users to be accommodated is 60. Date of last inspection Brief Description of the Service: The Ormsby Centre is a care home that provides nursing, registered to accommodate up to sixty residents in the category of older people with dementia or mental health needs. It is located in the coastal town of Littlehampton West Sussex, close to the shops and the sea. Recent building work, which extended the building, provided new kitchen facilities and administration facilities and additional day space is near completion. There are well-maintained patio areas and safe grounds surrounding the premises with private parking to the rear. Facilities include a spacious lounge, dining room and smoking room. The service is now owned by Lifetime Care Uk Limited and the appointed responsible individual is Mr. Wootton. The Registered Manager in post is Lynne Smith. The current basic fee is £713 per week rising to over £1000 depending on need. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This site visit as part of the inspection process was carried out on 23/07/08. This was the first inspection visit since the former partnership formed the new limited company. Prior to the visit the service file was reviewed as were any comments or complaints received by the Commission for Social Care Inspection. Six people who use the service were case tracked during the inspection. Five people who use the service were spoken to. A total of five relatives and visitors were spoken to on the day, as were three members of staff. We were in receipt of ten surveys we had sent to people who use the service, the comments were positive. “Staff work hard to do their jobs”. “Care is 100 here”. The Health and Safety Executive contacted us in relation to the bathing policy, which they find inadequate and they are writing to the proprietors in relation to this. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. Staff and people who use the service spoken to on the day stated that they were happy in the home and that it was well managed. The premises were toured. The registered manager and two of the proprietors facilitated the inspection and any documents required on the day were made available. What the service does well: Needs are assessed prior to admission and the required information is given to prospective admissions. Care needs are met with respect, equality and diversity is addressed. There is a key worker system in place. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 6 There is good activities provision and nutritious meals are served in a pleasant and unhurried manner. Complaints and protection issues are addressed. Following the building of an extension the bedrooms are clean bright and well decorated. Visitors speak highly of the staff and management. What has improved since the last inspection? What they could do better: Amend the bathing policy in line with the guidelines of the Health and Safety Executive. This is a requirement of this inspection report. Complete the renewal of furnishings, which may make the sitting room more homely in appearance. Ensure people assessed as needing footplates on wheelchairs are not moved without them. Please contact the provider for advice of actions taken in response to this The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 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 The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, Standard 6 is not applicable People who use the service experience good quality in this outcome area because needs are assessed and information needed to make an informed choice is available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service have their needs assessed prior to admission. In the care plans inspected these assessments were seen and were comprehensive with evidence of medical, mental health, social, nursing and personal care needs. Relatives spoken to confirmed that this had this assessment took place. Care management plans were also seen in care plans in which social services detailed the care needs they wished to see being met. New documentation has The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 10 been put in place to further improve the recording of the various aspects of the needs of people who use the service. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-9,10 People who use the service experience good quality all needs are assessed and met, set out in a plan and residents are treated with respect. Medicines are handled safely This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents had a plan of care. New documentation has been put in place to improve recording of all assessed need The care plans were drawn up following an assessment of medical, mental health, nursing, social and personal care needs. This also included nutritional assessments, mobility, hygiene, continence, pressure areas, and risk assessments. The risk assessments covered, moving and handling, nutrition and pressure area risk, smoking, use of wheelchair footplates and choking. There were daily records and evidence of monthly review and weight is monitored. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 12 Access to specialist health support is available as required including general practitioner and community mental health team, hospital appointments, chiropody and dental and optician services. Relatives spoken to stated that need is met as assessed and that the home is good at communicating any changes. There is a key worker system in place; evidence of the key worker input was seen in the care plans inspected. Medicines are received and stored correctly. Medicine Administration Charts inspected were up to date. There are not any people who use the service selfmedicating at present. Controlled drugs are appropriately stored. The home is supported by a local pharmacy. The registered manager stated that should it become apparent on pre admission assessment that a prospective person who would use the service wished and had the capacity to self administer medicines, then the correct self administration risk assessment would be purchased from the company supplying all the care plan documentation. Staff were observed offering care in a respectful and encouraging manner. The relatives spoken to stated that people who use the service are treated with respect and that when they visit the home they are made welcome. One relative stated that “the care was 100 here and she could not be happier” The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use the service experience good quality in this outcome area because the lifestyle in the home meets their expectations. Activities and events provided satisfy social, cultural and recreational needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are activities every day and these are listed on a white board. This includes music, exercises, crafts, singing and an accordion player. A mini bus is hired for day trips out fortnightly and also for theatre trips in the evening. Sometimes it is hired at short notice, for example on a sunny day for a picnic. Some individuals are facilitated to have whole days out such as a trip to Brighton. Some of the entertainment is provided by external people, some by the carers who take a flexible approach, offering what the people who use the service want on any given day. Two people spoken to on the patio expresses satisfaction with life in the home. One person who uses the service was heard The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 14 playing his own harmonica. People who use the service can be involved in the local community; some are accompanied into town for walks as one did during the inspection. There is a monthly church service and one person who uses the service regularly attends a local church on Sundays. The AQAA stated that daily routines are flexible and that people who use the service are encouraged to have choice and control in their lives. There is a rolling menu in place offering a choice of nutritious food. People who use the service are asked daily which choice of food they wish to have. During the morning one person asked for a bacon sandwich and this was supplied. The kitchen areas were neat and clean and there were ample fresh and dried food stores. People requiring assistance were helped with their meal in a quiet and respectful manner. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,19 People who use the service experience good quality in this outcome area because complaints are listened to, the home learns and adapts when they receive complaints and people are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home has a complaints procedure. This was seen on display in the hallway and it is also made available in the Statement of Purpose and Service User Guide. The AQAA stated that the home that a pictorial procedure was also in place, however this was not seen on the day. Three people who use the service spoken to in the smoking room all stated that they had no reason to complain but would be able to talk to the registered manager if they had a problem. All of the visitors spoken to stated they were very happy with the home and that any comments or concerns are dealt with satisfactorily. There are safeguarding procedures in place and staff spoken to are aware of the processes to follow. Staff files contained evidence of safeguarding training. The home communicates well with the Commission and all incidents are notified according to the regulations. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20, 22, 24,26 People who use the service experience good quality in this outcome area because they live in a well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home externally and internally is decorated to a good standard. There is a large lounge, a dining room, a visitors room and a smoking room. It was neat, clean and free from offensive odours. It has comfortable furnishings. The communal area is very large and as such represents a challenge in creating a homely atmosphere. This was discussed with the registered manager and deputy manager who pointed out the hazards of ornaments due to the mental health needs of the people who use the service. New furniture is to be The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 17 provided when all building work is completed. There is a well-maintained garden with seating which people who use the service were seen to enjoy. The AQAA states there are further plans to redesign the garden area. The specialist equipment required to meet the needs of people who use the service is in place. There are sufficient wheelchairs, hoists and assisted baths. People who use the service are risk assessed on the use of footplates as some people can injure themselves on these. However one person assessed as requiring footplates was seen being moved without them. This was discussed with the registered manager. A beanbag is being purchased for the comfort of one person who uses the service who will not sit in a chair but likes to be on the floor. Sensory lights are provided for another. Bedrooms are comfortable with contemporary furnishings. The bedrooms are personalised where possible according to the wishes of people who use the service. Nearly all rooms now have ensuite facilities. Radiators are covered and there are water temperature control valves in place. There are suitable laundry facilities in place. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People who use the service experience good quality in this outcome area because needs are met by suitably qualified staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rota showed staffing levels were sufficient to meet the needs of residents. There is domestic support, a chef and a maintenance man. There are robust recruitment procedures in place and staff files inspected contained all the documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history. Criminal Records Bureau Clearance and POVA check, two references, identity documentation and photograph were all in place. The comments received on surveys received were positive indicating that people find the staff helpful. One person who uses the service commented, “Every member of staff works hard to do their respective jobs”. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 19 There is a staff-training programme in place which staff spoken to confirmed they attend. Training records were seen in staff files. The training provided includes food hygiene, moving and handling, fire, infection control, first aid and health and safety. There is also ongoing training on dementia and other mental health issues. There has been training in nutrition, wound care and HIV. Staff undergo a Skills for Care Induction, these workbooks were seen. Nine care staff have National Vocational Qualification Level 2 in care and one has level 3. This is less than the recommended 50 but the home has recently takes on eight new carers due to the increase in numbers of people who use the service. They will commence on the NVQ programme when eligible to do so. Staff whose first language is not English have had English lessons at a nearby school. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 People who use the service experience good quality in this outcome area because the home is run in the best interests of people who use the service, however, people who use the service are not protected by the bathing policy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager holds the Registered Managers Award and is registered with the Commission since August 2007. She is not a registered nurse but there is a care manager in place who is. There have been positive changes in the running of the home in the past year. A key worker system has been put in place; there are meetings for people who use the service monthly, The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 21 and staff meetings two monthly. Surveys are sent to relatives and professionals six monthly. One General Practitioner commented, “The staff provide consistent high quality care in a challenging circumstances and are well managed”. The financial interests of people who use the service are safeguarded. The proprietors have worked hard to ensure the finances for people who use the service are held in their own named accounts. For some this has proved difficult due to banking procedures around identity and capacity and in some peoples situations there is not anyone willing to take power of attorney. Many of the people who use the service now have their finances held in a residents account where they are individually identified by their national insurance number and their balances listed separately. The proprietors are working towards achieving this for all residents. The home does not normally hold cash allowances for people who use the service, however on the day were holding £50.00 brought in by relatives of a new admission. Any expenditure will be recorded and receipted. Staff are supervised six times a year and evidence of this was seen on files. Staff spoken to feel well supported within the organisation and feel training needs are met. The Health and Safety of people who use the service and staff are protected by the provision of mandatory training, electrical and boiler systems are maintained and temperatures are recorded. The home has recently had a full fire and fire equipment assessment. The home has a bathing policy in place; they have had a recent inspection by the Health and Safety Executive who have concerns that the home still uses a variety of methods to check the bath water temperature, which may cause margin for error. The Health and Safety Executive are writing to the home to request that they rectify this matter. This was discussed with the registered manager on the telephone. The registered manager notifies the Commission of all accidents and incidents in relation to people who use the service. The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 22 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 23 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 OP38 Regulation 13 (4) (c) Requirement The registered persons must act on the guidance of the Health and Safety Executive in the drawing up and implementation of a bathing policy. Timescale for action 19/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Ormsby Centre DS0000071798.V367767.R02.S.doc Version 5.2 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. 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