Care Home: Ocean Hill Lodge

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What the care home does well During the course of the inspection considerable care and kindness was noted from the staff to the service users in the delivery of care. The registered provider employs the staff on a contract basis with hours that suit them, consequently there are a number of different shift hours being worked. The staff appreciate this and the registered provider stated that it helped retain the staff. This in turn is appreciated by the service users who all spoke enthusiastically about the wonderful staff at Ocean Hill Lodge. Daily recording records kept at the home are of a generally good standard. What has improved since the last inspection? Management have worked hard to comply with the Statutory Requirements listed in the last report. Good progress has been made to improve and keep up to date with care planning information. Policies and procedures have been revised and updated. The new system for care planning is now fully operational and is working well. Evidence is available to indicate that these plans of care are being regularly reviewed, dated and signed. Training profiles for staff are now more orderly and priority is given to ensure staff receive relevant training to enable them to keep up to date and enhance their competence. The majority of staff have attained an NVQ qualification. Overall progress has been made. What the care home could do better: Supervision records still need to be more consistently maintained. From a health and safety point of view, the building presents as being rather untidy and cluttered. Improvement will benefit residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ocean Hill Lodge 4/6 Trelawney Road Newquay Cornwall TR7 2DW     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: Michael Dennis     Date: 0 1 0 6 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 Older People 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 Older People Page 2 of 25 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: Ocean Hill Lodge 4/6 Trelawney Road Newquay Cornwall TR7 2DW 01637874595 01637874595 oceanhilllodge@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Sandra Dunn,John Howard Dunn care home 18 Number of places (if applicable): Under 65 Over 65 18 18 18 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 To admit one named service user under the age of 65yrs with dementia Date of last inspection Brief description of the care home Ocean Hill Lodge is a care home registered to offer personal care and accommodation to a maximum of eighteen residents over the age of sixty-five, who may also have a mental disorder. The home is situated in the seaside town of Newquay, within walking distance of the shopping centre and Trenance gardens. The boating lake is near and residents are assisted to enjoy the walks and coffee shop. For residents who are unable to get to town, services such as hairdressing and chiropody are arranged at the home. On the ground floor there is a lounge, lounge/dining room and patio garden area. There is a chair lift to the first floor. All rooms are singles, with the exception of two Care Homes for Older People Page 4 of 25 Brief description of the care home rooms, which have been combined for a couple. There is limited parking to the rear of the home and on street parking to the front of the premises. The residents are encouraged to take their meals in the dining room, although this is flexible depending on their wishes. Family and friends are welcomed to the home. Care Homes for Older People Page 5 of 25 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The key unannounced inspection at Ocean Hill Lodge took place over two days amounting to a period of approximately six hours. During the course of the inspection the registered provider was on duty. During the course of the inspection residents were met and spoken to, case tracking took place for four residents. We also spoke with some of the staff on duty. The premises were inspected and records were inspected relating to the welfare of the service users. The home is able to offer short term stays, when there is a bed available, as well as longer term care. Care Homes for Older People Page 6 of 25 Progress has been made to address the Statutory requirements listed in the last report and it is recognised that management have worked hard to improve the record keeping within the home. Feedback from residents and staff was positive. All comments received were positive. We determine that the actual delivery of care is good. 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 Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Residents needs are assessed so that they can be assured that the home can provide the care required. Evidence: Prospective residents are provided with the information they require to enable them to make an informed decision about the home. The Statement of Purpose and service user guide provides this information. The manager visits prospective residents and completes a needs assessment. A standard format for assessment and care planning is used. When completed in sufficient detail, this record covers the assessment issues specified in the standard and the diverse needs of prospective residents. The residents records case tracked contained completed and comprehensive needs assessments. The homes staff carry out an assessment for both private purchasers and those commissioned by the local Care Homes for Older People Page 10 of 25 Evidence: authority. The pre admission assessments stated who was present and signatures are obtained for evidence. Assessments were also available from the commissioning authorities. Written contracts of care and statements of terms and conditions with the home were present on peoples files. We were informed that people may visit the home before making a decision to move and this was evidenced from the recording systems. Care Homes for Older People Page 11 of 25 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 health, personal and social care needs are set out in individual plans of care. Medication procedures are appropriately followed. Residents are treated with respect and dignity. Evidence: The previous two reports have required that improvements be made to the process of maintaining care plans. The provider has introduced a new care planning system which is now in place and up and running. We case tracked four residents care plans. In all cases information has been recording in detail and the content directs the care required by each individual. In particular the records pertaining to the latest admission were completed to a good standard. The plans of care have been dated and signed and evidence provided of regular review. Care Homes for Older People Page 12 of 25 Evidence: Daily records are completed by the care staff. These records clearly evidence that the staff provide a good standard of care to residents. Particular credit is given to the staff for the regular amount of bathing that is taking place at the home. The residents are able to make a complete choice as to how many baths they would like in a week and this choice is then met by the care staff. The daily records are full, comprehensive and informative and include information as to daily activities, interests and numbers of visitors received. If and when an incident occurs, full and comprehensive recording prevails. Residents are registered with local surgeries and receive appropriate health care support services as required. This includes for example support from community nurses. Records indicate that the home has good working relationships with health care professionals and that they are working in a preventative way by making referrals very early when there are problems. The local pharmacy provides support and training to the home and the care staff on an annual basis. On the day of the inspection medication administration records for the main medication were found to be completed appropriately. Improvement is noted in recording practices for the Controlled Drugs. A new register has been purchased and is being used correctly. We conducted a short audit of controlled drugs against the register and all was found to be satisfactory. During the course of the inspection all the residents spoken to expressed very positive comments on the kindness of the staff. A number of them said nothing is too much trouble for them. Observations of staff and resident interaction confirmed that the staff at the home are very kind and that they treated each resident as an individual with respect and consideration. Care Homes for Older People Page 13 of 25 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Residents are supported to follow a lifestyle, which accords as far as possible with their own choices and preferences. The diet provided is varied and nutritious with attention to individual preferences. Evidence: Residents were observed to exercise choice to enjoy the privacy of their own rooms or join other service users in communal areas for company or meals. Residents confirmed that they access community facilities and services with support. Most afternoons the registered providers and or staff are involved in an activity and or outing with the service users. The home has its own transport to facilitate this. During the course of the day relatives and friends visited the home and were observed to be made to feel very welcomed. Visiting is open, and encouraged. All visitors are asked to sign the visitors book for the fire regulations. The home will organise occasional visiting entertainers, group activities and church services at the home. A chiropodist, hairdresser and mobile library also regularly visit Care Homes for Older People Page 14 of 25 Evidence: the home. External activities in the specialist vehicle include trips to the coastal areas, garden centres and the local boating lake and cafe. The home utilises the services of an activities co-ordinator. The meals provided in the home are good with special diets and choice catered for. All records of meals provided are in place at the home, as required by legislation and the cooks know the service users well. Each resident spoken with expressed very positive comments on the standard of the meals at the home. The main meal of the day is served at lunch time with at least two choices available. In the afternoon a carer spends time with each service user asking them what they would like for tea. The home works with the District Council Environmental Health Department on keeping records in place for Safer food and better business good practice. Care Homes for Older People Page 15 of 25 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 has a satisfactory complaints procedure that would ensure that complaints are listened to and acted upon. There are arrangements to protect service users from abuse. Evidence: The home has in place a clear and simple complaints policy and procedure that includes the address and telephone number of the CQC and the timescales for complaint investigation. The home maintains a complaints log that includes the action taken to resolve the complaint. A further record is held on the individual file of the service user. The registered provider and all but the newest of staff have attended Adult Protection training run by Cornwall County Council. Further training is booked for all staff to ultimately receive this training. A new adult protection policy and procedure has been developed and expanded to include clear procedures for informing agencies with an alert. The policy now describes the steps to be taken when an allegation of Care Homes for Older People Page 16 of 25 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, 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. 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 design, layout and facilities provided at Ocean Lodge, enables residents to live in a reasonably safe and comfortable environment Evidence: Ocean Hill Lodge is positioned in a very accessible position and convenient location to access all the facilities of Newquay. A limited amount of car parking is available in the rear grounds of the home with additional parking on the road. Communal space within the home includes a large combined lounge with dining room and a separate television lounge. Bedrooms are available on the ground and first floor of the home. All bedrooms are individually furnished and decorated. Access to the first floor of the home is by stair lift if required. The home is generally well maintained, and homely. Storage space is at a premium, the result being that various areas of the home appear cluttered and in places untidy. The providers must ensure that health and safety aspects are minimised and if necessary risk assessed with particular emphasis on fire safety. The home provides appropriate equipment to support service users (where required) in their day to day living. Safety measures are in place to protect those service uses with a dementia. Care Homes for Older People Page 17 of 25 Evidence: The home was found to be very clean on the day of the inspection. The laundry is small, with one industrial washing machine and one domestic tumble drier. Improvements to the building have been completed with the installation of a new wet room shower and toilet. A new mobile hoist has been purchased. Care Homes for Older People Page 18 of 25 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Evidence is in place that staff are recruited correctly, staffing levels are satisfactory and training is on going and planned. The staff were noted to be very capable, kind and caring during the course of the inspection. The staff are appreciated by the residents. Evidence: On arrival at the home there were appropriate staff numbers and skills mix available to provide for the residents welfare. The rota showed that four carers are on duty during the morning and this reduces to three for the afternoon and early evening. One waking and sleeping carer are provided for residents that may require attention at night. A cook, domestic and maintenance staff support these arrangements. The staff presented very well during the course of the inspection with appropriate skills and good, positive and kind attitudes during their interactions with service users. The home maintains a good communication system at handover meetings where senior carers delegate daily tasks and responsibilities to carers. Evidence is in place that satisfactory recruitment procedures are being followed for the Care Homes for Older People Page 19 of 25 Evidence: employment of new staff. There is a large amount of training for staff booked and ongoing and planned to take place. The statutory requirement for ensuring that a staff member who has a first aid qualification is on duty at all times has been met. Fire drill training for all staff is up to date as is moving and handling training. A rolling programme for staff to attend adult protection training, dementia, mental capacity act training Equality and Diversity training is being implemented. There are currently 16 care staff employed. Twelve of these have attained an NVQ qualification, 3 will be enrolled shortly to start the course. Care Homes for Older People Page 20 of 25 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 registered provider and staff are providing a good standard of care. Considerable improvement has been made by management to comply with the Statutory Requirements listed in previous reports. Evidence: The registered provider manages the home on a day to day basis. The registered provider has completed the NVQ level 4 in care and the Registered Managers Award. She is now commencing a management diploma course. Policies and procedures have been revised and updated during the past twelve months. Staff told us that they had seen these policies but not all had signed to confirm this. Previous inspection reports have suggested that the registered provider would benefit from additional support to undertake and complete the administrative role. This Care Homes for Older People Page 21 of 25 Evidence: recommendation is included in this inspection report. It is however acknowledged that the Registered Provider has made considerable progress in bringing records up to date. The homes internal Quality Assurance survey of the care provided is currently underway. This exercise is conducted annually and previous results have proved most positive. All the service users are encouraged to hold their own finances or if this is not possible a family member/representative is asked to have these responsibilities. Consequently, there is no money being held on the premises on behalf of the service users. We were told that supervision and support of staff is regularly undertaken as and when required. All staff must have a formal supervision at least six times per year. A record of the content of supervision has been devised and is now being used. It is important that these documents are kept up to date. Health and Safety training has taken place and the majority of staff have attended courses. There is now, as required, a staff member on duty at all times with a first aid qualification. As mentioned in the environment section, it is important to reduce the level of unnecessary clutter lying about the home. Care Homes for Older People Page 22 of 25 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 Older People Page 23 of 25 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 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 2 25 36 The use of communal areas for storage should, as far as is practicable, cease, and at the very least be risk assessed. Evidence obtained would suggest that staff are being supervised at regular intervals. It is still important that consistent recorded evidence supports this statement. Care Homes for Older People Page 24 of 25 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). 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