Care Home: Osborne Court

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What the care home does well Osborne Court provides a reliable and flexible respite service for younger adults with a learning disability. There is a stable team of staff, who are trained to meet the needs of the individuals using the service. Service users choose Osborne Court to go to for their respite care throughout the year. Relatives of service users say they appreciate how Osborne court tries to accomodate service users to stay on the dates they request, and that their loved ones are well cared for. Service users say they are usually asked about what they would like to do each day. What has improved since the last inspection? The manager produced a development plan for improvements needed in the physical environment, and has sent regular updates to the Commission of the homes progress. Some bedrooms have been redecorated, all have had new curtains. Staff have received training updates and have been put forward for additional training in areas that interest them provided it also meets the needs of the home and service users. All staff have received adult protection training, and understand their role in relation to any allegation of abuse. Staff are also receiving regular supervision. What the care home could do better: Service users bedrooms do not contain all the items of furniture indicated in the national minimum standards, as many do not have a bedside table or bedside lighting, risk assessments or documentation should be put in place to address this. The quality assurance systems could be improved by incorporating audits of documentation, and compiling a report using all the information from surveys, meetings, complaints, audits, etc. The staff must ensure that the home complies with the data protection act, currently a hand over book is used and sensitive confidential information is recorded on a shared record. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Osborne Court Lower Road Faversham Kent ME13 7NT     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: Justine Williams     Date: 2 0 0 5 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 22 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 Adults (18-65 years) Page 3 of 22 Information about the care home Name of care home: Address: Osborne Court Lower Road Faversham Kent ME13 7NT 01795533352 01795533352 wendy.hughesman@kent.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kent County Council care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is: 13. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) Date of last inspection Brief description of the care home Osborne Court is a two storey detached property set in the grounds of Faversham Day Centre. It is located on the outskirts of Faversham close to the village of Ospringe. There is a large garden with ample parking spaces available. The nearest shops and other public amenities are easily accessible by bus, taxi or the homes own transport. There is a shop within walking distance. The home offers single room accommodation on both floors. Seven rooms on the ground floor can accommodate people with multiple disabilities. The home provides short-term care for people with learning Care Homes for Adults (18-65 years) Page 4 of 22 Over 65 0 13 Brief description of the care home disabilities. Service users can stay from one night to a few weeks. The home aims to provide 24-hour care for adults between the ages of 18-65. The fees for this service is £546.24 for medium dependency. Care Homes for Adults (18-65 years) Page 5 of 22 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: An unannounced inspection was carried out on 20th May 2009 between 10:25 am and 2.30 pm by regulatory inspector Justine Williams. During that time the inspector spoke with residents, staff members, and the registered manager. Feedback was given during and at the end of the inspection. This report contains assessments made from observation, conversation and records, as well as case tracking. The manager returned the Annual Quality Assurance Assessment (AQAA) on time, and the information provided has been used in the report. As part of the inspection process surveys were sent to service users and to GPs, health care professionals, care managers and relatives of residents, information from the surveys was also used in the report. Care Homes for Adults (18-65 years) Page 6 of 22 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 Adults (18-65 years) Page 7 of 22 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 22 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. A full assessment of needs is carried out for prospective service users. Service users who have stayed at Osborne Court before have the existing assessment reviewed by staff each time they stay. Evidence: The majority of service users attend Osbourne court regularly for respite care, and as such have the assessment of their needs updated each time they stay. Staff sign a checklist to confirm the assessment is still valid. New service users are assessed by care management and the manager or senior staff from Osborne Court. Osborne court offers respite care for service users with a range of needs and staff receive regular training to ensure they can continue to meet the complex needs of the service users. Relatives said they appreciated Osborne Courts attempts to give them the dates for respite that they request. Care Homes for Adults (18-65 years) Page 9 of 22 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Service users individual needs and choices are respected and recorded in the support plans. Evidence: Each service user has a support plan developed with the service user where appropriate. Support plans are reviewed at each admission and staff sign a checklist to confirm the support plan is still valid. Staff must ensure that they sign for each respite period, as not all had been signed. The support plans have recently been developed further by the staff and the daily record in particular, this now gives a very detailed account of how each service user spent their day. The support plans include information on any behavioral issues and form the basis for risk assessments. The home has one long term resident, the support plan for this individual is reviewed every 12 weeks. Service users right to make decisions is respected, this is well documented in the support plans and daily records. Staff enable service users to take risks within a managed framework. Staff record risk assessments for each service user, and these are regularly reviewed. Care Homes for Adults (18-65 years) Page 10 of 22 Evidence: Relatives said they take good care of my daughter and listen to her needs. Care Homes for Adults (18-65 years) Page 11 of 22 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Service users have a range of activities to take part in, which are arranged flexibly. Service users have a varied and nutritious diet. Evidence: Service users and staff view the period of respite as a holiday for service users, therefore service users may continue with their usual routines such as visiting a day centre, attending usual activities etc, however if they do not wish to and their care manager is in agreement, they may participate in other activities organised by the staff. If service users do not wish to participate in cooking or cleaning or other daily routines they do not have to. The home does have a small training kitchen to promote independence for some service users. The home has an activities room with computers, games and a pool table as well as arts and crafts equipment. The home also has a living room with wide screen TV, and a Nintendo Wii. There is a day centre attached to the home and many service users use the centre during their stay. The Care Homes for Adults (18-65 years) Page 12 of 22 Evidence: home also has a sensory room. Due to the nature of the home activities are not planned far in advance but are more flexible and arranged with each individuals personal preferences, the day prior to the inspection 2 service users were taken to an aircraft museum, which they thoroughly enjoyed. Service users surveyed said they would like more activities planned, and the manager agreed to review activities. The manager said that trips out had been an issue due to to staffs reluctance to drive the large minibus, however a new people carrier has been purchased recently and staff are more confident driving it. One relative said It would be good if more staff were available so more outings could be arranged The home has its own garden within the extensive grounds belonging to the day centre, but service users can use all of the grounds if they wish. The garden is well maintained and accessible. The homes cooks keep a record of service users likes and dislikes and a rolling menu is followed but with a great deal of flexibility, service users are asked each morning what they would like for lunch and currently the main meal is served at lunch time. Care Homes for Adults (18-65 years) Page 13 of 22 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. The health and personal care needs of service users are well managed. Evidence: The support plans clearly indicate service users preferences about how they are helped and guided, times for rising and retiring, and their preferences about the gender of staff helping them. The health care needs of service users are also well documented, and staff either assist in arranging or arrange for service users to attend any health care appointments and check ups, which occur during their period of respite. The medication records and practices have recently been reviewed and improved, a clear audit trail is made of medicines entering and leaving the home as well as medication being administered, the staff member in charge must sign a document to ensure he or she has checked the medication and received the keys, at each shift change, this makes the it easier for staff to pick up on any errors. Medicines are stored according to best practice guidelines and legislation. Care Homes for Adults (18-65 years) Page 14 of 22 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Service users views are listened to and acted upon, and service users are protected from abuse, neglect and self harm. Evidence: Osborne Court has not received any complaints since the last inspection. Minor issues are recorded and dealt with effectively. Service users have a simple form they may use or they may complain verbally. Relatives and advocates of service users said through the surveys that they new how to complain should they need to, and that they were confident any complaint would be dealt with. One relative said it is easy to discuss concerns with staff members. Staff receive regular training updates in adult protection and staff understand their role in reporting safeguarding issues. Their are robust procedures in place for the protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 15 of 22 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Service users have a comfortable, clean and hygienic environment in which to live. Evidence: Some areas of the home have been refurbished recently, such as the lounge and some bathrooms. New pillows and bedding has been purchased recently, and all bedrooms have new curtains, and net curtains. The home now has a beauty room, which service users enjoy using, for hairdressing, nail painting etc. The home was clean and tidy. The corridor off the lounge leading to the beauty room and some bedrooms was dark despite the lights being on and could present difficulties for service users with visual impairment. Several bedrooms do not have bedside lighting or a bedside table, documentation to justify and, or, risk assess this must be put in place. The home has a self contained flat used for more independent service users or for those who may go on to supported living. There is a training kitchen where staff help service users practice making meals, drinks and snacks. The home has a large front and back garden accessible to service users with seating areas, service users also have access to extensive grounds owned by the attached day centre. The home was clean throughout, the laundry is in a separate room and staff are aware of infection control procedures. Washing machines have high temperature sluicing cycles for foul laundry. Care Homes for Adults (18-65 years) Page 16 of 22 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Service users are supported by competent staff who receive training relevant to their roles. Staff are safely recruited Evidence: Staff have regular training updates in core training such as moving and handling, fire, first aid, and additional training is arranged in subjects which staff express an interest in which is also beneficial to the home. The AQAA stated that 76 of staff have attained NVQ. The manager recruits staff in accordance with the homes policy. An application form is completed, candidates provide 2 written references, and staff are confirmed in post once a satisfactory CRB check is completed. Service users from the day centre are involved with the recruitment of staff, they are asked to interview prospective staff. There is a training and development programme in place for staff, and the manager keeps a matrix to ensure timely updates are organised for staff in core training. New staff receive a structured induction in line with Sector Skills Council specification. Care Homes for Adults (18-65 years) Page 17 of 22 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. Service users benefit from a well run home Evidence: The manager has been in post for 2 years, she managed another home for the local authority prior to this. The manager has NVQ 4, and undertakes regular training to update her skills. The manager began work on action plan following the last inspection to address the requirements made and other areas she felt needed improvement. All the requirements have been met. There is a quality assurance system in place, surveys are sent out annually, and the information from the surveys is collated into a report. Audits of documentation do not currently feed in to the quality assurance system. Regular meetings take place for the staff and for service users. The manager agreed to develop the quality assurance system further to ensure the home is constantly improving and acting on ideas and wishes of service users. Staff are recording confidential information about all the service users in residence in a hand over book, the manager agreed to review this urgently as records are not being held in accordance with the data protection act, and service users privacy is not Care Homes for Adults (18-65 years) Page 18 of 22 Evidence: being protected. Information supplied through the AQAA indicates that the manager is ensuring safe working practices. Care Homes for Adults (18-65 years) Page 19 of 22 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 Adults (18-65 years) Page 20 of 22 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 Care Homes for Adults (18-65 years) Page 21 of 22 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). 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. 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