Care Home: Olive House

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What the care home does well Prospective residents have their needs fully assessed before moving into Olive House. Visits are made to prospective residents and detailed pre-admission assessments are carried out to establish whether Olive House is able to meet the person`s needs and help them to make an informed choice about moving into the Home. Each resident has a detailed care plan which describes their health, personal and social care needs. Access is available to healthcare professionals and people are protected by the Home`s medication policies and procedures. The people living at Olive House have the opportunity to take part in a number of activities, hobbies and pastimes and are supported to maintain contact with family, friends and the local community, according to their wishes. The meals and mealtimes are of a very high standard, the food is wholesome and nutritious and additional food and drinks are available outside standard mealtimes. There is a very relaxed but jovial atmosphere and staff are very friendly and cheerful and continually chat and engage with residents. Residents, their families and friends know their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. Olive House provides a clean, safe and well-maintained environment for the people living there and the indoor and outdoor communal facilities are safe and comfortable. Healthcare Homes have robust recruitment policies and practices for Olive House, the existing staff team is stable and they have a good mix of skills and are trained and competent. A high number of care staff have also completed NVQ 2, 3 or 4 in Care. Olive House continues to be a well run home and the new proprietors, together with the acting manager, are working hard to ensure a smooth transition and continued feeling of security for residents and staff. What has improved since the last inspection? Since Healthcare Homes Ltd acquired the entire issued share capital of Olive House CRH Ltd in December 2009, a number of improvements have been confirmed as being implemented by the Group Director of Quality. Some of the specific areas highlighted have included the management of medicines, documentation to evidence that care needs are being fully met, staff training and staff supervision. Physical improvements to the environment have also been carried out, some of which were observed during this key inspection, such as substantial refurbishment to the laundry room, plus the fact that each person now has their own individually named laundry basket. The dining room has recently been redecorated and tables were seen to be very nicely laid with good quality cutlery and crockery. What the care home could do better: Updated/reviewed information should be dated in the General Guidance section of the care plans, to make it easier to audit and monitor the timing or patterns in respect of possible changes in people`s health or behaviour. Apart from this recommendation, Olive House is currently meeting and in some cases exceeding the outcome areas inspected and some excellent practices were observed during the inspection. Key inspection report Care homes for older people Name: Address: Olive House 7-17 Olive Avenue Newton Flotman Norwich Norfolk NR15 1PF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Debby Ames     Date: 0 7 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 34 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 34 Information about the care home Name of care home: Address: Olive House 7-17 Olive Avenue Newton Flotman Norwich Norfolk NR15 1PF 01508471718 01508471718 admin@olivehouse.healthcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Olive House RCH Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 35. The registered person may provide the following categories of service: Care Home only - Code PC. To service users of the following gender: Both. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. Date of last inspection Brief description of the care home Olive House was erected in 1996 and Healthcare Homes Ltd acquired the entire issued share capital of Olive House CRH Ltd in December 2009. Olive House is a purpose built residential home, designed to provide accommodation to Care Homes for Older People Page 4 of 34 Over 65 35 0 Brief description of the care home 35 older people. Accommodation is on the ground floor and all rooms are single, with en-suite facilities. The communal areas are generous and comprise a large lounge, small/quiet lounge, small lounge/games room and dining room. Olive House is situated in the South Norfolk village of Newton Flotman in a quiet residential street and stands in its own grounds with a landscaped garden to the rear and a large car park to the front. The acting manager confirmed that the current fees range between £520 and £550 per week, with additional costs for personal items such as toiletries, outings, newspapers, magazines, hairdressing and chiropody. Care Homes for Older People Page 5 of 34 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: three star excellent 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: Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. The fieldwork of this inspection was carried out over a period of six hours and included a tour of the premises, inspection of staff and residents records and the homes records relating to health and safety. Discussions also took place with the director of operations, the acting manager, some of the staff and brief conversations were had with some of the residents. Six questionnaires were completed and returned to the Commission by residents, which contained mostly very positive comments and responses. Ten questionnaires were returned by staff members, which also contained Care Homes for Older People Page 6 of 34 mostly very positive responses. Some of the additional comments made by the residents who returned questionnaires included: ...Olive House does everything well... ...I am very happy living at Olive House, nothing is too much trouble... ...the staff are very friendly and caring... ...I was very sad when my [spouse] died but was very pleased to be sent to this lovely home by my family... ...our general care is done well. Friendly staff, helpful and mostly local which is very important... ...excellent, unobtrusive care. One feels safe but not imprisoned... ...there is a very happy atmosphere here, staff are always helpful and patient. One feels relaxed and happy with them and I do admire them all because they are the same to everybody... ...some nice short outings for the residents who can manage them... ...we enjoy the entertainment. Usually one most weeks (music)... ...the food is very suitable and we can ask for smaller portions from time to time... ...mealtimes could be more enjoyable if there was background music for part of the time. Conversation is limited because we are together so much... ...the staff here are lovely in that they organise and set up games and activities that us residents can do sitting down... ..they could vary the menu sometimes... ..I have some concern over that the new owners are looking to build 6 to 7 extra rooms and I think this would spoil the building and we would be over-crowded with 42 residents. There are 35 now. Plus all the noise and hassle of the building workers... Some of the additional comments made by the staff who returned questionnaires included: ...I have worked at Olive House since 1999 and am always gaining knowledge and learn something new every day... ...the home was sold in December 2009... as yet there have been no major changes but no doubt there will be a few... ...the home offers a clean, safe environment for the residents who live there... Care Homes for Older People Page 7 of 34 ...staffing levels and training could sometimes be better to meet the specific needs of the residents we care for... ...we provide a safe, happy and caring atmosphere for staff, residents and visitors, showing support and consideration to all... ...we could do with a few more staff meetings... ...give more support to staff, provide more staff and provide more regular ongoing training and training updates etc... ...some communication could be better between carers and kitchen staff... Care Homes for Older People Page 8 of 34 What the care home does well: What has improved since the last inspection? Since Healthcare Homes Ltd acquired the entire issued share capital of Olive House CRH Ltd in December 2009, a number of improvements have been confirmed as being implemented by the Group Director of Quality. Some of the specific areas highlighted have included the management of medicines, documentation to evidence that care needs are being fully met, staff training and staff supervision. Physical improvements to the environment have also been carried out, some of which were observed during this key inspection, such as substantial refurbishment to the laundry room, plus the fact that each person now has their own individually named laundry basket. The dining room has recently been redecorated and tables were seen to be very nicely laid with good quality cutlery and crockery. Care Homes for Older People Page 9 of 34 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 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 10 of 34 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 11 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have their needs fully assessed before moving into Olive House, which helps to ensure that they can be confident that their needs will be met. Evidence: Three care plans were looked at during this inspection; two of which were for people who had moved into the Home since the change of ownership to Healthcare Homes. All three care plans that were seen, plus a discussion with the acting manager, confirmed that visits are made to prospective residents and detailed pre-admission assessments are carried out to establish whether Olive House is able to meet the persons needs and help them to make an informed choice about moving into the Home. It was also evident from the care plans that prospective residents and their relatives, where applicable, are actively involved in the pre-admission assessment process and the information gathered was seen to form the basis of the persons care plan. Care Homes for Older People Page 12 of 34 Evidence: In respect of emergency admissions, it was stated in the Statement of Purpose that: When a resident is admitted in an emergency situation, it is the policy of the Home to work with the resident, their family and any outside agency to minimise the disruption to the resident. The key aspects of the Admission Procedure will be undertaken within 48 hours of admission. All other admission criteria will be met within 5 working days. All six questionnaires that were completed and returned by the residents, responded yes to the question: Did you receive enough information to help you decide if this home was the right place for you before you moved in? Meanwhile, it is stated in the Statement of Purpose that: Healthcare Homes offers a uniquely different choice for the elderly. Our objective is to create an environment where residents receive the highest standards of care, where dignity is respected, where talents and interests are encouraged and where life is lived to its fullest potential. Care Homes for Older People Page 13 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each resident has a detailed care plan which describes their health, personal and social care needs. Access is available to healthcare professionals and people are protected by the Homes medication policies and procedures. Evidence: Three care plans were looked at in detail and the main sections were seen as follows:1. Pre-admission Assessment This section was seen to include the reason for admission, such as no longer able to cope alone at home, any special needs in respect of diet or weight etc, physical health summary, mental health summary, medication summary, mobility/handling/lifting assessment (including the use of aids), general comments/summary regarding personal health and hygiene care needs, personal safety and risk assessments, history of falls, interests (including hobbies, religion and cultural needs), family/carer involvement (including social contacts and relationships) and any other relevant information. Care Homes for Older People Page 14 of 34 Evidence: 2. Residents Personal Profile This section was seen to include information such as the residents personal details including full name and what they like to be known as, next of kin, religion, financial representative (if applicable), previous/current doctor, funeral directors and wishes in respect of burial or cremation. 3. General Guidance Form A brief summary was seen to be recorded here such as: ...[name] has been living alone for a number of years, therefore it may take some time to get used to living at Olive House and having other people around. [name] will need assistance with getting up, washed and dressed in the mornings and vice versa at bed time... This section also included information in respect of allergies and non prescription (PRN) medication. It was noted in this section that, although reviews and updates are completed quite frequently, the updated/reviewed information isnt always dated, which makes it difficult to audit and monitor the timing or patterns in respect of possible changes in peoples health or behaviour. A recommendation has therefore been made to this effect. 4. Residents Health Profile This section was seen to include more detailed information in respect of the persons medical history and any significant illnesses, ability to self medicate, mobility/dependency, eye sight, hearing, teeth and prosthetic devices, plus details of the last tests/reviews and any aids required. Additional information included continence management, memory/orientation/confusion, depression, behaviour, personality, sleep pattern, special dietary requirements, weight on admission and any therapies required. 5. Residents Social Profile A brief personal history was seen to be recorded in this section such as where the person was born, places they have lived during their lives, what they did as a job, Care Homes for Older People Page 15 of 34 Evidence: what family they have/had and what interests and hobbies they have or had. Other information included current community/social activities and interests the person would like to pursue and any personal/emotional support they might require. 6. Preferred Daily Routine This section was seen to be very specific to peoples individual choices from whether they would like a wake up call in the mornings and, if so, what time, whether they would like a drink at that point and, if so, what and how they like it, through to whether people wanted assistance with any aspect of getting up or going to bed and what level of night checks they would like. One person, for example, had confirmed that they would like a wake up call at 07:30, a cup of tea in their room (without sugar) and that they would like some assistance with getting washed and dressed. They also confirmed that they would like night staff to enter their room during the night to check on them. Daily notes were seen to support these wishes. 7. Residents Social Profile The information in this section was seen to provide more detail in respect of peoples individual choices of regular activities, hobbies and interests they wished to participate in such as bowls, dominoes, reminiscence, exercises, music and outings etc. 8. Preliminary Care Plan This area was seen to include the wishes, needs and goals identified by the resident such as being able to continue doing as much for myself as possible, take part in the activities, make friends and socialise with other residents and get outside in the nice weather. 9. Residents Progressive Care Plan This section was seen to record details of what action was needed by which person to help each resident achieve and maintain the wishes, needs and goals they had identified, such as care staff to remind, encourage or assist. 10. Moving and Handling Assessment and Guidance Form Information recorded here, explained what moving and handling procedures were Care Homes for Older People Page 16 of 34 Evidence: required for the person and what limitations or issues there may be, such as two staff needed, hoisting procedures, or areas of concern in respect of physical health conditions. 11. Daily Record Sheet The notes recorded on these sheets were seen to be written in a respectful and informative manner, although brief but factual. From the notes seen, together with observations and discussions, it was evident that the care plans looked at during the inspection were being followed in accordance with peoples individual requirements and wishes. Other information seen in the care plans included regular weight records, blood sugar levels (where applicable) and prescribed/regular medication (including details of any changes). A record of medical appointments/visits was also seen and included health professionals such as district nurse, optician, dentist, audiologist, chiropodist and general practitioner. In addition to the paper copies, care plan details are currently stored on the computer, using the Care Docs system, which enables staff to be reminded of residents appointments/reviews etc in good time and keep the care plans up to date. At the time of this inspection, it was confirmed that no residents were self medicating although policies and procedures are in place to support people to do this where they are able. Part of the lunchtime medication round was observed being carried out by the carer in charge, whose practice was seen to be professional, caring and cheerful and residents were treated with respect dignity. Olive House uses a Monitored Dosage System (MDS), medication is stored in a lockable medication trolley and all staff, who administer medication have received appropriate training. Observations, discussions and records seen during the inspection confirmed that the people living at Olive House are treated with respect and genuinely valued as people. Meanwhile, some of the additional comments included in the surveys that were completed and returned by residents included: Care Homes for Older People Page 17 of 34 Evidence: ...Olive House does everything well... ...I am very happy living at Olive House, nothing is too much trouble... ...the staff are very friendly and caring... ...I was very sad when my [spouse] died but was very pleased to be sent to this lovely home by my family... ...our general care is done well. Friendly staff, helpful and mostly local which is very important... ...excellent, unobtrusive care. One feels safe but not imprisoned... ...there is a very happy atmosphere here, staff are always helpful and patient. One feels relaxed and happy with them and I do admire them all because they are the same to everybody... Care Homes for Older People Page 18 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Olive House have the opportunity to take part in a number of activities, hobbies and pastimes and are supported to maintain contact with family, friends and the local community, according to their wishes. The meals and mealtimes are of a very high standard, the food is wholesome and nutritious and additional food and drinks are available outside standard mealtimes. Evidence: Observations during the inspection showed residents interacting socially with each other and a number of visitors were seen with their family or friends. A number of very positive comments were heard to be made by visitors and interaction from the staff was seen and heard to be cheerful, welcoming and courteous. During the afternoon of the inspection, a number of residents were seen joining in with the entertainment and daily notes confirmed that people regularly engaged in a variety of group activities or personal interests such as mime, food tasting, cheese and wine afternoon, current affairs discussions, word games, relaxation with music, exercises, target games, skittles, bowls, scrabble, board games, dominoes, bingo, quizzes, arts and crafts and snooker. Care Homes for Older People Page 19 of 34 Evidence: Outside entertainers were also noted to visit on a regular basis and included a singing and dancing duet, Elvis impersonator and line dancing. A hairdresser also visits regularly and the records seen confirmed that people looked forward to her visits and disappointment was noted from the few occasions she was unable to come. Regular church services are available and communion is delivered in the quiet lounge for people who wish to receive it. Some of the general observations throughout the inspection included: * A very relaxed but jovial atmosphere. * Residents chatting to each other and to staff. * Residents sitting in various areas of the Home, according to their choice. * Pleasant music playing in areas such as the reception and front hallway - at an appropriate volume. * Staff appeared to be very friendly and cheerful, continually chatting with residents. In respect of meals and mealtimes; Healthcare Homes have recently employed a catering manager at Olive House and a number of changes were noted to have been made to the dining room, menus and food/produce purchased. It was noted that there is a seating plan for people but it was confirmed through discussions with staff that it is changeable, in accordance with residents wishes and not set in stone. Observations during the lunch period indicated that people were comfortable and appeared happy with the current arrangements. It was also noted that the tables were laid with good quality cloths, table mats, cutlery and crockery, which gave the room a very pleasant restaurant atmosphere. It was also noted through observations, that people requiring assistance with their meals, received this in a dignified manner. A discussion with the catering manager confirmed that new options are gradually being introduced to the menus but residents feedback is taken very seriously and the Care Homes for Older People Page 20 of 34 Evidence: review of menus is ongoing. It was also confirmed that fresh produce, rather than frozen, is being used now as much as possible and all dietary requirements are catered for. The extensive breakfast menu was seen to be available on a daily basis and included options such as full English, Eggs (cooked to your liking), smoked haddock, porridge, toast and preserves, cereals, fruit basket, grapefruit or prunes and a yoghurt pot selection. Some examples taken from the current main meal menu included fish pie or omelette, roast beef or cauliflower cheese, lemon chicken or cheesy potato pie and shepherds pie or cold meat and salad. A choice of desserts was confirmed to be available if people dont want the main option, other alternatives are also available if people would prefer something other than the two main meals stated on the daily menu. A notice for residents was also seen on display, which confirmed that: Throughout The Day there is A choice of... white or brown selection of freshly made sandwiches, daily selection of home baked cakes, assorted sweet biscuits, cheese and biscuit platter, fruit basket, yoghurt pot selection, fresh fruit salad, variety of flavoured ice creams, choice of fruit juices, variety of fruit squashes and a selection of hot beverages. Meanwhile, in the completed questionnaires, three residents responded always two responded usually and one responded sometimes to the question: Do you like the meals at the home? Five out of the six residents who completed the questionnaires responded always to the question: Does the Home arrange activities that you can take part in if you want? One person responded usually. Some of the additional comments made by residents in the questionnaires included: ...some nice short outings for the residents who can manage them... ...we enjoy the entertainment. Usually one most weeks (music)... ...the food is very suitable and we can ask for smaller portions from time to time... Care Homes for Older People Page 21 of 34 Evidence: ...mealtimes could be more enjoyable if there was background music for part of the time. Conversation is limited because we are together so much... ...the staff here are lovely in that they organise and set up games and activities that us residents can do sitting down... ..they could vary the menu sometimes... Care Homes for Older People Page 22 of 34 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. Residents, their families and friends know their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. Evidence: The acting manager confirmed that no formal complaints have been received since the last inspection and a large number of compliment cards and letters were seen, including a copy of a letter sent to the local paper by a relative, part of which read: ...TV or press only want to hear about bad care homes. What a pity, this one is just brilliant... Of the six questionnaires that were completed by residents, everyone responded yes that there is someone they can speak to if they are unhappy. Four people said yes they knew how to make a formal complaint but two people said no. It is confirmed in the Healthcare Homes Statement of Purpose that there is a formal process in place for managing and handling complaints, which is fully explained in the Residents Guide. It was also stated that: It is the policy of the Home to strive to ensure that compliments outweigh complaints. Meanwhile, Healthcare Homes have policies and procedures in place for Olive House, in respect of adult protection, prevention of abuse and whistle blowing and a discussion with the acting manager confirmed that all staff are well trained in these Care Homes for Older People Page 23 of 34 Evidence: areas. Care Homes for Older People Page 24 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Olive House provides a clean, safe and well-maintained environment for the people living there and the indoor and outdoor communal facilities are safe and comfortable. Evidence: A tour of Olive House showed the environment to be extremely clean, bright and airy, with no unpleasant odours. Very good quality decor and furnishings were also observed throughout and a display area near the front entrance and managers office presented a lovely Easter theme at the time of this inspection. Residents have a choice of communal areas to use as they wish, such as a large lounge, small lounge/games room and quiet lounge. There are numerous board games, puzzles and books available for residents use and the television/DVD player in the quiet lounge was confirmed as often being used by residents and their families to look at photographs stored on CDs. The laundry room was seen to be maintained to a high standard, with new washing machines recently having been purchased and each resident was noted to have an individually named laundry tray for their clothing. Care Homes for Older People Page 25 of 34 Evidence: Some peoples rooms were observed during the general tour and each one seen was clean, tidy and personal. All the bedrooms were noted to be en-suite and ample toilet, shower and bathing facilities were available throughout the Home. Observations confirmed that many people have specialist equipment such as wheelchairs and walking frames etc, which help them maintain their independence. From the six questionnaires returned by residents, five people responded always that the Home is fresh and clean, one person responded usually. One person made an additional comment in the questionnaire, which needs to be given some consideration by Healthcare Homes for reassurance: ..I have some concern over that the new owners are looking to build 6 to 7 extra rooms and I think this would spoil the building and we would be over-crowded with 42 residents. There are 35 now. Plus all the noise and hassle of the building workers... Care Homes for Older People Page 26 of 34 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. Healthcare Homes have robust recruitment policies and practices for Olive House, the existing staff have a good mix of skills and they are trained and competent, which ensures residents are in safe hands at all times. Evidence: Observations, discussions and the records looked at during the inspection confirmed that Olive House continues to have sufficient numbers of staff on duty at all times. The staffing summary, provided by the acting manager, confirmed that the majority of care staff have worked at Olive House in excess of five years, with only one new member employed within the last year. It is evident that the stability of the staff team has helped ensure consistency in care provision for people living at Olive House and a smooth transition with the recent change of ownership. Three personnel files were looked at in detail and these were seen to contain relevant records and information such references, identification, application and employment contracts. The staff files were also seen to contain evidence that appropriate checks from the safeguarding register and Enhanced Criminal Records Bureau (CRB) Disclosures have been obtained for staff prior to starting work at Olive House. Two written references Care Homes for Older People Page 27 of 34 Evidence: were also seen to have been requested and stored in the staff files. The acting manager provided an excellent summary of the training and qualifications for the current staff team. This confirmed that, of 24 care staff, 19 people have already completed NVQ 2, 3 or 4 in Care, one person is currently working towards their qualification and another is just awaiting their certificate. Two of the domestic staff have also completed NVQ 2 in Housekeeping. From the training summary it was confirmed that staff have received training in areas such as adult protection/abuse, PEG feeding, COSHH (Control of Substances Hazardous to Health), medication, dementia, MUST (Malnutrition Universal Screening Tool), food hygiene, infection control, fire safety, first aid, moving & handling and risk assessments. It was also confirmed that although some of the updates are overdue, arrangements for refresher courses are in the process of being arranged through the new organisation. Meanwhile, some of the additional comments made by staff in the completed questionnaires included: ...I have worked at Olive House since 1999 and am always gaining knowledge and learn something new every day... ...the home was sold in December 2009... as yet there have been no major changes but no doubt there will be a few... ...the home offers a clean, safe environment for the residents who live there... ...staffing levels and training could sometimes be better to meet the specific needs of the residents we care for... ...we provide a safe, happy and caring atmosphere for staff, residents and visitors, showing support and consideration to all... ...we could do with a few more staff meetings... ...give more support to staff, provide more staff and provide more regular ongoing training and training updates etc... Care Homes for Older People Page 28 of 34 Evidence: ...some communication could be better between carers and kitchen staff... Care Homes for Older People Page 29 of 34 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. Olive House continues to be a well run home and the new proprietors, together with the acting manager, are working hard to ensure a smooth transition and continued feeling of security for residents and staff. Evidence: The deputy manager has worked at Olive House for approximately ten years and has been temporarily appointed Acting Manager by Healthcare Homes until the end of April, when a permanent manager, with experience of the Healthcare Homes organisation, will take over the post. It was acknowledged that it has understandably been quite an unsettling time for the staff and residents with the recent change of ownership but the pre-existing staff and deputy were noted to have worked very hard together to ensure continuity of care for the residents, together with assurances of stability and security. Healthcare Homes also appear to have undertaken a smooth and gradual transition with relevant changes being carried out on a steady basis. Care Homes for Older People Page 30 of 34 Evidence: Meanwhile, safe procedures continue to be in place in respect of any money held on behalf of residents by the Home and a sample looked at was found to be correct. Healthcare Homes have confirmed that a formal Quality Assurance process is in place and feedback from residents, family and friends is actively sought and welcomed. However, due to the very recent change of ownership, the first quality audit has yet to be completed. It has also been confirmed that The Home has established procedures in respect of Health and Safety, which are stored in the Homes policy manual. It was also confirmed that the regulated checks for environmental health, fire, water and electrics continue to be undertaken on a regular basis. Cleaning materials and hazardous chemicals were seen to be stored appropriately and no obvious safety hazards were noted at the time of the inspection. Care Homes for Older People Page 31 of 34 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 32 of 34 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 7 Updated/reviewed information should be dated in the General Guidance section of the care plans, to make it easier to audit and monitor the timing or patterns in respect of possible changes in peoples health or behaviour. Care Homes for Older People Page 33 of 34 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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