Care Home: Orla House Care Home

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What the care home does well People who live at Orla House are encouraged in everything they do and have plenty of opportunities to take part in various appropriate activities. They have a healthy diet and choices at mealtimes. A daily diary was written by staff and detailed what everyone had done each day and there was a menu book to record what people had eaten. Staff responded to requests when people asked for help with personal care and gave support where it was needed. The Medication Administration Record sheets were all completed appropriately and there were clear records of health appointments. The home was very clean and fresh throughout. There was plenty of room for people in the areas they share and bedrooms were individual and comfortable. Staff had been trained in specific areas relating to the people they care for. They had good communication between them to ensure care needs were met. They were interacting fully and positively with each person who lives there. There were enough staff and the staff group has remained the same. Most have been working at the home for many years. The manager is one of the providers who own the home and has been known to most of the residents for many years. This has provided people who live there with stability and security. What has improved since the last inspection? The Commission did not make any requirements at the last inspection of this home, but staff reported that they had received refresher medication training. Also, there is a newly constructed accessible patio with plenty of space for tables and chairs. What the care home could do better: To ensure any new person`s needs in respect to health and welfare are met in full, an individual plan of care must be compiled as soon as a person moves into the home. CARE HOME ADULTS 18-65 Orla House Care Home 317 Mapperley Plains Mapperley Nottingham NG3 5RG Lead Inspector Meryl Bailey Unannounced Inspection 1st April 2008 09:30 Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 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 Orla House Care Home DS0000008730.V361558.R01.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 Adults 18-65. 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. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orla House Care Home Address 317 Mapperley Plains Mapperley Nottingham NG3 5RG 0115 920 3754 0115 9267325 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) Mr J & Mrs M Dobbin & Mr S & Ms S Dobbin Miss Sinead Maire Aine Dobbin Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd April 2007 Brief Description of the Service: Orla House is a care home registered to provide support and accommodation for up to thirteen adults with a learning disability. An application to raise the number of residents to fourteen is currently being processed. The home is a large detached property situated on a main road, north of Nottingham. The home has a separate lounge and dining room and an additional quiet room where residents can meet their family and friends in private. There is one bedroom that is shared by choice, but all others are single. There are well kept gardens both to the front and rear of the property and some parking to the front of the house. Fees: £368 - £835.25 per week Orla House Care Home DS0000008730.V361558.R01.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 took place on 1 April 2008 and was part of a key inspection. Inspections focus on outcomes for people that use the service. In order to do this the main method of inspection used was ‘case tracking’ which meant three residents were selected and their care was tracked through discussion with them and with staff, checking their care records and observing practice. Altogether, the manager, two staff members and four residents were spoken with during the course of the inspection. A sample of staff records were also looked at to make sure staff get the necessary training and that checks are carried out on staff before they start working at the home. Information about a home that is collected before the inspection is also used to make judgements about a service. Services are now required to fill in a document called an AQAA (Annual Quality Assurance Assessment) in which the registered manager identifies from their own quality monitoring what the service does well at and what they need to improve on. The AQAA was returned before the site visit and was used to plan the site visit and to support judgements made in this report. What the service does well: People who live at Orla House are encouraged in everything they do and have plenty of opportunities to take part in various appropriate activities. They have a healthy diet and choices at mealtimes. A daily diary was written by staff and detailed what everyone had done each day and there was a menu book to record what people had eaten. Staff responded to requests when people asked for help with personal care and gave support where it was needed. The Medication Administration Record sheets were all completed appropriately and there were clear records of health appointments. The home was very clean and fresh throughout. There was plenty of room for people in the areas they share and bedrooms were individual and comfortable. Staff had been trained in specific areas relating to the people they care for. They had good communication between them to ensure care needs were met. They were interacting fully and positively with each person who lives there. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 6 There were enough staff and the staff group has remained the same. Most have been working at the home for many years. The manager is one of the providers who own the home and has been known to most of the residents for many years. This has provided people who live there with stability and security. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this 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. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Any person intending to move into the home will have their needs appropriately assessed. EVIDENCE: The files of three people were inspected and one of these had been admitted to the home within the last three months. There was extensive assessment material and various pieces of information had been gathered to assist in planning how the care needs would be best met. There had been a gradual introduction to the home, other residents and staff. Staff spoken with were aware of how they should communicate and assist this person. However, the plans to meet assessed needs were not established and agreed in a written plan. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff make individual plans of care for each person that lives at Orla house, but these take time to establish. EVIDENCE: We looked at detail at the individual plans of three people. Two of these had lived in the home for several years. Their plans were well established and agreed with descriptive introductions followed by clear information and action plans for each area of need. Risk assessments were included in these individual plans. In the Annual Quality Assurance Assessment (AQAA) the manager stated that residents, their families, carers and advocates all contribute to the individual plans. There was evidence of reviews of the plans and adjustments in actions staff need to take. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 10 One person had moved into the home three months before this inspection, but the individual plan was not complete. There was plenty of assessment information, with contributions from various people, but no formalised risk assessments. There were some notes written by a key worker, but the whole plan needed to be formalised and agreed with the person it was for. Staff we spoke with said that they know what they need to do to meet needs from reading care plans, reading daily notes and from discussions with people they care for, with other staff, and with the manager on a daily basis and in staff meetings. There were aware of the needs of, and of how to respond to, the new person. We watched how staff interact with people living in the home and they showed us that they know how to communicate with each individual. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at Orla House are encouraged to take part in various appropriate activities and to continue to develop relationships. They have a healthy diet and choices at mealtimes. EVIDENCE: At the commencement of this inspection visit all the people that live at Orla House were out at day centre or college. There were records of communication between staff at the home and at day centres. Transport support was arranged individually. When people returned from to the home in the afternoon they reported some things they had been doing. A daily diary was written by staff and detailed what everyone had done each day. Staff told us about Saturday shopping trips and visits to Rufford Park, Clumber Park and Burnt Stump at weekends and people were also given the choice of going to a Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 12 local pub on Friday evenings. An 8-seater car and two other cars were available for use by staff with people they support. One car had been specifically adapted for use by a wheelchair user. Visitors were recorded in the daily diary. People could meet with their visitors in the small lounge or in their own bedrooms. There were records of people being supported to visit their families if they wished and one person spent every weekend with family. The manager told us that a balanced 4-week menu was planned, with individual choices and availability of fresh produce taken into account. We saw the menu book where actual meals taken were recorded and this showed a variety of food and a balanced diet. We heard staff discussing what food people wanted for the evening meal. Residents are encouraged to make their own drinks. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at Orla House can be assured their personal care and health needs are met. EVIDENCE: Staff described giving encouragement to those who are able to attend to their own personal care and supporting others where it is needed. They described responding to requests when people asked for help with showering, for example. Details of support needed were included in the individual plans. The residents we spoke with gave limited responses, but indicated through facial expression and eye gaze that they were happy with the way staff helped them. There were records of regular health appointments and of assistance being arranged in emergencies. Contact numbers were clear on each person’s file. There were monitors, pressure pads and alarms used to alert staff of health needs during the night. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 14 Medication was looked after for each person that needed it and was stored in a locked cupboard. The Medication Administration Record sheets were all completed appropriately and staff reported that they had received refresher medication training since the last inspection. The manager told us that updated information on new medication and possible side effects are discussed at staff meetings. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at the home are safeguarded from abuse. EVIDENCE: Since the last inspection there have been no complaints, but some positive comments received from relatives. The complaints procedure was displayed within Orla House, and forms part of the Service User Guide. Staff were asked about their awareness of safeguarding adults, and issues relating to abuse. They told us of previous training and were able to answer questions, which showed they had an understanding and knowledge of the issues involved. The manager described the procedure she would follow and was aware of the need to discuss any concerns with the local authority Adult Social Care staff, but did not have a copy of the latest procedure and guidance. She contacted the local authority to order one during the inspection. Staffing records showed that recruitment procedures protect people by obtaining references and checks on any new staff before they start work at the home. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents at Orla House live in a safe, homely, clean and comfortable environment. EVIDENCE: We made a full tour of the premises during this inspection and saw that the home was very clean and fresh throughout. The main lounge and separate dining room were both spacious and homely in décor and furnishings. Outside, there was a freshly cut lawn, some flowerbeds and a newly constructed accessible patio with plenty of space for tables and chairs. All bedrooms were seen, and these were decorated and personalised by residents to their own tastes and requirements. One bedroom was shared by choice, but the twelve others were single. Seven of the bedrooms had ensuite facilities and separate showers/bath and toilets were close to bedrooms. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at the home are supported and protected by competent staff. EVIDENCE: There were two staff on the premises in addition to the manager throughout the day involved in support and domestic tasks whilst the people who live there were out at day activities. Further staff arrived during the afternoon to support people on their return home. The rota showed there were always a minimum of four staff when all 13 people were at home during the day. From 10pm until 7am there were two staff available – one awake and the other sleeping and on call. There have been no new staff within the last twelve months. Most have been working at the home for many years. The sample of staffing records seen were well maintained with up to date supervision meetings recorded. Staff on duty confirmed they have regular meetings with the manager. There were training records and certificates. In addition to safe working practices staff had also been trained in specific areas relating to the people they care for. This included epilepsy and learning disability and also Dementia Awareness. More than 50 care staff have achieved the National Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 18 Vocational Qualification at level two in Care Practice. Two of the staff are currently undertaking the level three course. Staff told us of regular staff meetings and good communication and support between them to share skills and knowledge and ensure care needs are met. They used specific communication sheets in addition to a general diary. Discussions with the staff confirmed their knowledge and awareness of individual needs and they were observed interacting fully and positively with each person returning from day services. Plans were being made for meals and appropriate activities. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at Orla House benefit from a well run home, where their health and safety are promoted. EVIDENCE: There have been no changes in the management of this home during the last twelve months. The manager is one of the providers who own the home and has been known to most of the residents for many years. She has a Certificate in Management Studies and is a registered nurse. Staff spoke positively of the support they receive from the manager and good leadership provided. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 20 The manager completed the Annual Quality Assurance Assessment (AQAA) and has stated that questionnaires are sent to relatives and advocates each year. Also, through individual communication with residents, their views and wishes have been sought on an individual level. Examples of listening to views of residents and their families are the changes in menus, purchase of specific car and holiday arrangements. Records were available that showed that all daily health and safety checks and tests had been carried out and recorded in an appropriate manner by staff. Checks of electrical circuits and equipment were completed in February 2008 and there were further records showing that the fire alarm system and fire extinguishers had been checked in December 2007. Staffing records showed that most staff had completed training in safe food handling and management of infection control. Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 22 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 YA6 Regulation 15 Timescale for action To ensure each person’s needs in 01/05/08 respect to health and welfare are met in full, an individual plan of care must be compiled as soon as a person moves into the home. Requirement 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 Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Orla House Care Home DS0000008730.V361558.R01.S.doc Version 5.2 Page 24 - 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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