Care Home: Mount Olivet Nursing Home

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What the care home does well The home is in a residential area with attractive views out over Torbay from many of the rooms; some rooms have access to an enclosed garden with patio doors; Comprehensive staff training is provided for all grades of staff; The home is involved in several initiatives to improve care practices, including infection control and end of life care; People we have spoken to previously told us that the home had developed good programmes of activities and developed weekly debating groups and a regular visitingservice. What the care home could do better: Medications must be administered safely and full records kept of all medications received, administered or destroyed at the home. Medications must be kept for 7 days after the death of the individual for whom they were prescribed. Care plans should be reviewed monthly at least and be an accurate reflection of the needs of the individual. When people regularly refuse medication this needs to be addressed via the prescriber and be seen in a conjunction with an assessment of the persons capacity to refuse this. The manager needs to ensure effective communication exists between shifts and that full audit trails are maintained for decision making in clinical issues. Random inspection report Care homes for older people Name: Address: Mount Olivet Nursing Home 2 Great Headland Road Paignton Devon TQ3 2DY three star excellent service 15/04/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Michelle Finniear Date: 1 8 0 6 2 0 1 0 Information about the care home Name of care home: Address: Mount Olivet Nursing Home 2 Great Headland Road Paignton Devon TQ3 2DY 01803522148 01803696573 monh@grayareas.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Alison Homer Type of registration: Number of places registered: Conditions of registration: Category(ies) : Robert Hugh Gray care home 30 Number of places (if applicable): Under 65 Over 65 30 0 old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 30 1 5 0 4 2 0 1 0 Mount Olivet is situated in the Preston area of Paignton and is easily accessible by public transport. It is set in private grounds with a pleasant sheltered garden. The home overlooks the sea at Paignton and is approached from a driveway, parking is available for several cars to the right of the building. The home occupies a position that overlooks Torbay with panoramic views across to Brixham. The home is registered to provide accommodation to a maximum of 30 people of either gender, over the age of 65 years requiring nursing andor personal care because of physical frailty, illness or disability. A registered nurse is on duty at all times supported by a team of Health Care Care Homes for Older People Page 2 of 9 Brief description of the care home Assistants. The home has a range of equipment and adaptations to cater for the needs of the residents. Information about the home and the latest inspection report was found in the entrance hall, people can also receive information by visiting their website. Information given to the Commission by the provider indicates the current range of fees is from GBP 558.70 to GBP 764.60 per week. Additional charges are made for podiatry, hairdressing, newspapersmagazines and aromatherapy. Care Homes for Older People Page 3 of 9 What we found: We visited the home to follow up some concerns raised in a safeguarding meeting about the care and medication offerred to an individual who had lived at Mount Olivet Nursing Home. On the visit we spoke to the manager and some of the staff on duty. We also looked at some of the records kept by the home, in particular the care plans, daily notes and medication records. The care plan we saw showed us that not all aspects of the persons care had been identified in the care plan and that the plan had not been reviewed regularly enough or in a timely way to reflect a deterioration in the persons condition. The medication records were not all signed properly, which meant we could not easily identify whether the person had been refusing medication or whether this had not been offered to them. In addition the medication had since been destroyed so it was not possible to conduct a full audit trail. Records from earlier interventions indicated that the person regularly refused medications and these refusals were fully recorded, but there was no clear assessment of their capacity to make these decisions or a record of any actions the home may have taken as a result. This could for example have included contacting the persons GP to discuss their repeated refusal or inability to take medication, offering the medication in another format or including a protocol for the refusal of medication. The manager agreed that following the identification of the concerns she woud conduct a full medications audit within 48 hours and ensure a review of all care plans is carried out to ensure needs are being fully addressed, with regular reviews. It was also agreed that the manager would hold a meeting without delay for the trained staff to look at the issues of concern and ensure they cannot be repeated. The manager agreed to conduct a review of the systems at the home, to include ways in which communication is managed between shifts and how an audit trail of decision making is maintained in each individuals records. Care plan reviews need to be carried out at least monthly and whenever a persons condition changes. What the care home does well: The home is in a residential area with attractive views out over Torbay from many of the rooms; some rooms have access to an enclosed garden with patio doors; Comprehensive staff training is provided for all grades of staff; The home is involved in several initiatives to improve care practices, including infection control and end of life care; People we have spoken to previously told us that the home had developed good programmes of activities and developed weekly debating groups and a regular visiting Care Homes for Older People Page 4 of 9 service. 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 2. Care Homes for Older People Page 5 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 9 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 1 7 15 A full audit of care plans is to 25/06/2010 be completed, to ensure they are reviewed and an accurate reflection of the individuals needs and how they are to be met. This is to ensure peoples needs can be met safely and consistently. 2 9 13 A full audit of medication practice and recording must be carried out The home is required to ensure medication is received, administered, recorded and used or disposed of safely. We identified some concerns over the way the home has been administering, recording and disposing of medication. We also have concerns over the way the home has not identified and raised with the prescriber that medication is being regularly refused. 20/06/2010 3 36 12 The manager agreed to hold 21/06/2010 a staff meeting without delay to look at communication, care planning and medication issues. This is to ensure safe and best practise for all people receiving care at the home. Care Homes for Older People Page 7 of 9 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 7 15 Care plans must contain a full audit trail of decision making for clinical practice. This is to ensure it is clearly evident why decisions have been made to alter care practices. 16/07/2010 2 7 15 Care plans must be maintained and updated to reflect changes in need. This is to ensure peoples needs can be met consistently and safely. 16/07/2010 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 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - 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. 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