Care Home: Overcliff House

What the care home does well Overcliff House provides a clean and well-maintained home where the personal, health and social care needs of residents are met. Residents and their relatives describe the home as a very relaxed and friendly place to live where the staff are helpful, cheerful and supportive. Mrs Cooper always visits prospective residents or invites them to the home, prior to making a decision as to whether Overcliff House is suitable to meet their needs. Relatives are encouraged to contribute to the development of care plans by providing important background information, social history etc. Care plans are regularly reviewed and relatives are encouraged to participatein this review process. The home sends relatives a copy every month and welcomes any additional comments they may wish to make. The staff treat residents with respect and provide encouragement for them to pursue their own lifestyles, wherever possible, and to make choices about their daily lives. Activities are available for those residents who wish to participate, but many of these tend to be spontaneous, rather than planned. Residents are supported to maintain contact with family and friends, enabling people living in the home to continue to enjoy relationships that are meaningful to them. Relatives say they are made to feel welcome. "I visit regularly and am always made to feel welcome. I am always kept informed." "Overcliff House is always friendly and relaxed. I am made to feel really welcome. I can go to the kitchen and make myself a drink and have a mince pie, just as I would in my own home." Residents are able to choose where to take their meals, but most prefer to eat together in the dining room. All residents spoken with were very positive about the quality of the meals provided. Residents commented, "I had a lovely dinner. This is the best bit of the day." "The food is very tasty." "They make very nice cakes here." Relatives commented, "The food is delicious. I have a meal with my relative and it is of excellent quality." "The food is very good. They eat better here than I do." The home is clean and free from unpleasant odours and has a happy, relaxed and welcoming atmosphere, which is beneficial to everyone. Residents say that Overcliff House is a good place in which to live with comments including "This is a nice place to be" and "I like it here". Relatives also commented very favourably, "You couldn`t hope for a better place. I looked at a dozen other care homes before I found this one and I am very pleased with the standards here." "It is like home from home here. I feel like I`m a member of the extended family." "I am not bothered about posh surroundings. I want the best possible care and I feel this is what the home offers." "The care is fantastic. I couldn`t do better myself." What has improved since the last inspection? Since the last inspection a new fire control console has been fitted. A new freezer and mixer have been provided in the kitchen and the rolling programme of redecoration is continuing, with four bedrooms being refurbished. External storage areas have been extended and level walkways have been provided in the rear garden to permit wheelchair access to the summerhouse. Plans are in hand to fully enclose the front garden before the end of March 2008, to create safer access for residents. The one requirement made at the last inspection regarding the recruitment procedure has been met. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Overcliff House 2 Cellars Farm Road Southbourne Bournemouth Dorset BH6 4DL Lead Inspector Marjorie Richards Key Unannounced Inspection 12th December 2007 10:45 X10015.doc Version 1.40 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 Overcliff House DS0000003967.V356389.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 Older People. 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. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Overcliff House Address 2 Cellars Farm Road Southbourne Bournemouth Dorset BH6 4DL 01202 424929 01202 426523 overcliffhouse@hotmail.com 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) Mrs Marilyn Cooper Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (18) Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2007 Brief Description of the Service: Overcliff House is a care home providing personal care and accommodation for 18 older people who have mental disorders or dementia. The home is owned and personally managed by Mrs Marilyn Cooper. It is situated in a pleasant residential area of Southbourne, Bournemouth, in an elevated position (sloping walk up to front entrance,) offering views of the sea. Local amenities, e.g., shops, post office, churches, doctors surgeries and cliff top walks are all within easy reach. Car parking is provided for visitors to the home and further parking is available on nearby roads. A bus stop is situated close to the home with buses from Southbourne into Bournemouth, Christchurch and beyond. Overcliff House is a large detached property that has been adapted to provide residential care. Accommodation for residents is provided on the ground and first floors, with a stairlift to assist access between floors. All residents have single bedrooms, seven of which have en-suite facilities. The home also has a dining room and a separate lounge that overlooks the sea. There are sufficient baths, a shower and WCs to meet the needs of residents. The home has very attractive gardens to the front and rear of the property, which are well maintained, easily accessible and well used by residents. Overcliff House is also home to two pet cats, two cockatiels, a tortoise and two ducks. Twenty-four hour care is provided. Laundering of personal clothing is carried out on the premises. All meals are prepared and cooked within the home and a variety of alternatives are always available to suit individual taste and preference at mealtimes. Special diets can be catered for. Social activities are arranged to provide stimulation and interest for residents. The fees for the home, as confirmed to us at the time of inspection, range from £410 - £575 per week. Additional charges include hairdressing, chiropody, dry cleaning, toiletries and newspapers. The Office of Fair Trading has published a report highlighting important issues for many older people when choosing a care home, e.g., contracts and information about fees and services. The CSCI has responded to this report and further information can be obtained from the following website: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choosing a care home .aspx Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 9.25 hours on the 12th December 2007. The main purpose of this inspection was to review the key National Minimum Standards, check that the residents living in the home were safe and properly cared for and to look at progress in meeting the one requirement from the previous inspection. The Annual Quality Assurance Assessment (AQAA) form had been completed by Mrs Cooper and provided to the Commission for Social Care Inspection in advance of the inspection. Recent legislation has made it a legal requirement for all registered services for adults to complete an AQAA every year. The completed assessment is one of the ways in which the Commission for Social Care Inspection will assess how well the service is delivering good outcomes for the people using it. On the day of inspection, 18 residents were accommodated. A tour of the premises took place and records and related documentation were examined, including the care records for three residents. Time was spent observing the interaction between residents and staff, as well as talking with seven residents and three visitors to the home. The daily routine was also observed during the inspection. Discussion took place with Mrs Marilyn Cooper, the registered provider and with members of staff on duty, including senior staff. For the purposes of this report, people who live at Overcliff House are referred to as residents as this is the term generally used within the care home. The Inspector was made to feel very welcome in the home throughout the visit. What the service does well: Overcliff House provides a clean and well-maintained home where the personal, health and social care needs of residents are met. Residents and their relatives describe the home as a very relaxed and friendly place to live where the staff are helpful, cheerful and supportive. Mrs Cooper always visits prospective residents or invites them to the home, prior to making a decision as to whether Overcliff House is suitable to meet their needs. Relatives are encouraged to contribute to the development of care plans by providing important background information, social history etc. Care plans are regularly reviewed and relatives are encouraged to participate Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 6 in this review process. The home sends relatives a copy every month and welcomes any additional comments they may wish to make. The staff treat residents with respect and provide encouragement for them to pursue their own lifestyles, wherever possible, and to make choices about their daily lives. Activities are available for those residents who wish to participate, but many of these tend to be spontaneous, rather than planned. Residents are supported to maintain contact with family and friends, enabling people living in the home to continue to enjoy relationships that are meaningful to them. Relatives say they are made to feel welcome. I visit regularly and am always made to feel welcome. I am always kept informed. Overcliff House is always friendly and relaxed. I am made to feel really welcome. I can go to the kitchen and make myself a drink and have a mince pie, just as I would in my own home. Residents are able to choose where to take their meals, but most prefer to eat together in the dining room. All residents spoken with were very positive about the quality of the meals provided. Residents commented, I had a lovely dinner. This is the best bit of the day. The food is very tasty. They make very nice cakes here. Relatives commented, The food is delicious. I have a meal with my relative and it is of excellent quality. The food is very good. They eat better here than I do. The home is clean and free from unpleasant odours and has a happy, relaxed and welcoming atmosphere, which is beneficial to everyone. Residents say that Overcliff House is a good place in which to live with comments including This is a nice place to be and I like it here. Relatives also commented very favourably, You couldnt hope for a better place. I looked at a dozen other care homes before I found this one and I am very pleased with the standards here. It is like home from home here. I feel like Im a member of the extended family. I am not bothered about posh surroundings. I want the best possible care and I feel this is what the home offers. The care is fantastic. I couldnt do better myself. What has improved since the last inspection? Since the last inspection a new fire control console has been fitted. A new freezer and mixer have been provided in the kitchen and the rolling programme of redecoration is continuing, with four bedrooms being refurbished. External storage areas have been extended and level walkways have been provided in the rear garden to permit wheelchair access to the summerhouse. Plans are in hand to fully enclose the front garden before the end of March 2008, to create safer access for residents. The one requirement made at the last inspection regarding the recruitment procedure has been met. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 7 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. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable at Overcliff House.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Overcliff House. Admissions only take place when the home is confident that they are able to meet the assessed needs of the prospective resident. EVIDENCE: Individual care records are kept for each resident and three of these were examined for recently admitted residents. They showed that, prior to moving to the home, care needs had been assessed by Mrs Cooper. Mrs Cooper says that she always visits prospective residents or invites them to the home, prior to making a decision as to whether Overcliff House is suitable to meet their needs. An assessment form has been developed for this purpose. This is in addition to information supplied by any funding authorities. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 10 A letter of confirmation is then written to the prospective resident so that they may feel assured their care needs can be met. When talking to residents and relatives, they confirmed that they had been provided with the opportunity to visit the home before making the decision to move there. Staff also confirmed that they were aware of the resident’s needs at the time of their admission. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Overcliff House. Residents are treated with respect and their personal care needs are met, with the home ensuring they have access to a range of healthcare services to meet all assessed needs. EVIDENCE: Following admission to the home, further assessments are carried out and a care plan is drawn up, identifying the needs of each resident and how staff are to meet these needs. To aid correct identification, each record contains a recent photograph of the resident. Relatives are encouraged to contribute to the development of care plans by providing important background information, social history etc. Evidence was seen to show that at least once a month, care plans are reviewed. Relatives are encouraged to participate in and contribute to this review process and the home sends them a copy every month. Relatives (or representatives) are Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 12 asked to sign the review and send it back, making additional comments if they wish. Care plans give personalised information to assist staff in ensuring good quality care. For example, identifying certain behaviour, which means the resident requires assistance to use the toilet, or highlighting favourite foods. Daily records are written by staff to evidence the care being provided. In discussion, members of staff are able to demonstrate a good knowledge of residents’ individual care needs. Care plans show that where care needs change, appropriate professionals have been consulted to carry out further assessments etc. Records demonstrate that residents have access to GPs, district nurses, chiropodists, opticians, etc and attend for hospital appointments, etc. Risk assessments are in place, including wandering, ability to use a call bell to summon assistance, agitation and anxiety and self-neglect. Appropriate steps are taken to minimise any of the identified risks. A considerable amount of information is available about each resident, but much of this is documented in separate records, rather than as part of one care plan. This means that it is not always easy to find the information required and makes it possible to misfile documentation and notes in the wrong record. This was discussed with Mrs Cooper who says it is her intention to bring all of the available information together, clearly setting out each care need, the desired outcome and how this is to be achieved. The home has systems in place for managing medicines. Only senior staff deal with medication and they first have to undertake a Safe Handling of Medicines course at Bournemouth and Poole College, so they know how to recognise and deal with any problems in use. Medicines are stored securely, to ensure the protection of residents. A new Monitored Dosage System is in use. Those Medicine Administration Records (MAR) charts examined were well maintained. Staff record all medicines received in the home and a system is in place for providing an audit trail, e.g. dating eye drops and creams when started. Information is available on all of the medicines used within the home for staff reference. The temperature of the medicines refrigerator is monitored daily and recorded. The recommended use of a maximum/minimum thermometer was discussed with Mrs. Cooper. (Mrs. Cooper has since advised us that this has been purchased and is now in use.) Staff induction includes respecting residents’ privacy and dignity. This was confirmed when speaking with staff. Staff interact with residents in a friendly and caring manner and were observed throughout the inspection to be treating residents with courtesy, kindness and respect. Staff were seen to knock at bedroom doors and to offer personal care discreetly. Residents appear comfortable and at ease with staff, benefiting from the relaxed atmosphere of the home. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 13 Toileting activities are carried out with discretion and continence products are stored out of sight in bedrooms so that visitors cannot see them. Residents have their own single bedrooms, thereby offering an opportunity to be on their own if they wish, or allowing privacy for any visitors or personal care needs. One resident commented, I like to go to my room sometimes. I have such a lovely room. I can recommend this place. It is very good here. I have everything I could possibly need. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to Overcliff House. The home is flexible in its approach to the provision of activities and meals, enabling residents to retain control over their lives wherever possible. EVIDENCE: The staff endeavour to seek to find out as much information as possible about the social history of residents. Where residents are unable to provide such details, this is sought from relatives, friends or representatives. This helps to inform the home about hobbies and interests and assists in the planning of activities. The social history on some files is limited, as relatives have not responded to the homes request for information. Information about activities is available from NAPA (National Organisation for Providers of Activities for Older People), to help and advise staff. An activities organiser provides activities for two hours on two days a week. The Extend coordinator visits the home every week to provide gentle exercise to music and entertainers and musicians visit monthly. The local library visits every six to eight weeks. Some activities arise spontaneously, such as Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 15 reminiscence or “sing-a-longs” but care staff also organise quizzes, manicures, Memory Lane Bingo, colouring and jigsaw puzzles. For those residents unable to participate in group activities, some one-to-one support is provided. Mrs Cooper is currently planning to introduce individual activities diaries to ensure that each resident receives sufficient opportunities for social activity and stimulation on a regular basis. The home provides a daily newspaper and three residents also have their own newspapers delivered every day. Residents are assisted to attend church if required and arrangements are made for clergy to visit individual residents upon request. Residents enjoy watching the church services on television as well as Songs of Praise on Sundays. Mrs Cooper says that she and her staff take a flexible approach to the running of the home to fit in with residents needs and wishes. Some residents like to help with small tasks in the home, such as laying tables in preparation for meals and this is encouraged. Important dates and events are celebrated, such as birthdays, Valentines Day, Easter, Halloween and Christmas. Several residents mentioned the Christmas preparations taking place within the home. Residents are encouraged to take part wherever possible, for instance with decorating the Christmas tree. During the evening of the inspection, a group of carol singers from a local church entertained the residents. Residents clearly enjoyed this opportunity to sing carols and join in with the festive spirit. During the day, staff reminisced with residents about writing, sending, receiving and opening Christmas cards. Residents commented, It is Christmas and I helped to decorate the tree. We had mince pies today, so it must be Christmas. I like singing Silent Night and Away in a Manger, they are my favourites. The trimmings look so pretty, I like Christmas time. The home has a number of pets. At present, Overcliff House is also home to two cats, two Cockatiels, a tortoise and two ducks. Mrs Cooper says that visitors are encouraged to visit the home at any time. Residents are able to choose where they see their visitors, including in the privacy of their own rooms. Members of staff and visitors confirm that visiting times at Overcliff House are unrestricted. Residents records and the visitors book demonstrate contact with family and friends as well as visits by professionals. A telephone is always available to residents so they may make or receive calls from family and friends. Monthly reviews are sent to relatives, which is particularly helpful for those unable to visit very often. Relatives commented, I visit regularly and am always made to feel welcome. I am always kept informed. Overcliff House is always friendly and relaxed. I am made to feel really welcome. I can go to the kitchen and make myself a drink and have a mince pie, just as I would in my own home. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 16 Residents are encouraged to choose their own lifestyle within the home and make choices wherever possible. These include choosing when to get up or go to bed, what to wear, what to eat or drink and freedom to come and go as they please within the home. They are able to bring their own possessions into the home to personalise their bedrooms. Observation confirms that staff respect the individual preferences and routines of residents. Lunch on the day of inspection was chicken and gammon pie, with sauté or mashed potatoes, diced mixed vegetables, runner beans and gravy. This was followed by hot raspberry blancmange with ice cream and fruit sauce. A wide range of alternatives is always available, such as omelettes, jacket potatoes with assorted fillings, a variety of soups and salads and this list of items is displayed in the dining room, next to the daily menu. The menu shows that residents receive a varied and nutritious diet. Mrs Cooper says that she tries to ensure that all residents eat at least five portions of fruit and vegetables a day. A choice of fruit juices or squash is always offered with lunch and fresh fruit salad is popular with residents. Fresh fruit is liquidised to provide fruit sauces for ice cream. The home has a good supply of foodstocks, all appropriately stored. Christmas preparations are well in hand and large quantities of mince pies and two Christmas cakes have already been baked. Meals are seen as social occasions and the lunchtime meal took place in a relaxed, unhurried and congenial atmosphere with discreet staff assistance provided wherever necessary. Residents may choose where in the home they eat their meals. Residents were observed making choices about what they wished to eat during the day. Residents commented, I had a lovely dinner. This is the best bit of the day. The food is very tasty. They make very nice cakes here. Relatives commented, The food is delicious. I have a meal with my relative and it is of excellent quality. The food is very good. They eat better here than I do. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Overcliff House. The systems in place provide residents with the confidence that their complaints will be listened to and acted upon and they are protected from possible abuse. EVIDENCE: The home has a complaints policy and procedure that is included in the information provided to residents, their relatives or their representatives. The complaints procedure is also displayed on the notice board in the hallway, in the staff room and in the Service Users Guide. A complaints record is maintained, but since the last inspection, no complaints have been received. Most residents are not able to comment about the complaints procedure, but one said, I have nothing to complain about, it is very nice here. A relative commented, The staff and management are very approachable and always willing to discuss any concerns. Overcliff House has an Adult Protection policy in place to protect residents from possible abuse. This makes reference to the Department of Health No Secrets guidance, which is available to staff. All staff have received Adult Protection training to ensure that they remain vigilant in protecting vulnerable Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 18 residents from risks of abuse and know how to properly manage any allegation or suspicion of abuse. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Overcliff House. Environmental standards are generally good, providing residents with comfortable, clean and well-maintained surroundings in which to live. EVIDENCE: Overcliff House is well maintained to ensure resident safety. Radiators are guarded to ensure residents cannot hurt themselves by coming into contact with hot surfaces. (Because of the position of one radiator, it is not possible to fit any kind of cover, so the temperature is regulated to ensure it does not get too hot.) Windows have only limited openings, to prevent any risk to residents. Maintenance records show that work is continually carried out to keep the home and gardens in good condition. Care staff confirm that prompt attention is paid to any defects. However, it was noted that there is virtually no hot Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 20 water supply to the wash hand basin in the ground floor bathroom (nearest kitchen) and in one bedroom, the carpet at the side of the bed is soiled. Two fire doors also need slight adjustment to ensure they always close fully to latch. Mrs Cooper agreed to remedy these matters as soon as possible. Since the last inspection a new fire control console has been fitted. A new freezer and mixer have been provided in the kitchen and the rolling programme of redecoration is continuing, with four bedrooms being refurbished. External storage areas have been extended to reduce the amount of storage needed inside the home. Level walkways have been provided in the rear garden to permit wheelchair access to the summerhouse. Plans are in hand to fully enclose the front garden before the end of March 2008, to create safer access for residents. A tour of the building shows that the home is clean and there are no unpleasant smells, making life within the home more pleasurable. Suitable facilities and procedures are in place in respect of laundry and the disposal of clinical waste. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Overcliff House. Overcliff House has systems in place to ensure that staff are only recruited after a rigorous screening process and then receive suitable training to make sure they are able to meet the needs of the residents. EVIDENCE: Talking to residents, relatives, staff and viewing staff rosters confirms that the number of staff on duty meets the present care needs of the residents in the home. A relative commented, “Staff are always caring and gentle.” Residents used words such as “kind” and “helpful” when talking about staff. During the inspection a resident fell whilst going into the dining room at lunchtime. Mrs Cooper and her staff handled the situation calmly and efficiently whilst waiting for the paramedics to arrive. The staff worked well together as a team, comforting and supporting the resident who had fallen, calming and reassuring other residents and continuing with the lunchtime preparations. After the paramedics had departed having found no serious injuries, the resident continued to be well supported by staff and assisted to eat lunch. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 22 Two staff are currently undertaking National Vocational Qualification (NVQ) level 2 training. All other care staff have achieved NVQ level 3 or equivalent and two staff have NVQ level 4, which far exceeds the required standard that 50 of staff achieve NVQ level 2. Induction training for two recently employed staff is in progress. The home has a thorough recruitment procedure in place, based on equal opportunities and ensuring the protection of residents. The two staff files examined demonstrate that documentation is in place to ensure the protection of residents, e.g., Application form with employment history, proof of identity and two written references. Mrs Cooper was advised to follow up one work permit application because of a delay in response from the Home Office following correspondence with them. A range of policies and procedures is in place to assist staff and they sign to show they have read and understood these. Mrs Cooper then tests their knowledge to ensure staff have a full understanding of what is required. Staff undertake a range of training, such as dementia care, moving and handling, first aid, health and safety, infection control, risk assessment and basic food hygiene. This is provided through a mixture of external and inhouse courses, as well as distance learning. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Overcliff House. The management arrangements at Overcliff House and the quality assurance systems in place, ensure that the residents live in a home that is well managed and the service provided meets their needs. EVIDENCE: Overcliff House is a well established home and Mrs Cooper has considerable management experience. She has successfully completed her National Vocational Qualification (NVQ) level 4 in management and care and is also an NVQ assessor and mentor. She is closely involved in the management of the home on a daily basis. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 24 Management of Overcliff House is a team effort, with senior staff encouraged to take responsibility for different aspects of the running of the home, such as medication, training and health and safety. These senior staff have also achieved NVQ level 4. The home has a happy, relaxed and welcoming atmosphere, which is beneficial to residents. Residents say that Overcliff House is a good place in which to live with comments including This is a nice place to be and I like it here. Relatives commented, You couldnt hope for a better place. I looked at a dozen other care homes before I found this one and I am very pleased with the standards here. It is like home from home here. I feel like Im a member of the extended family. I am not bothered about posh surroundings. I want the best possible care and I feel this is what the home offers. The care is fantastic. I couldnt do better myself. A full range of policies and procedures is in place to offer advice and guidance to staff and these are regularly reviewed and updated as necessary. Discussions with staff show that they are clear about roles and responsibilities within the home. Staff meetings are held so that staff have the opportunity to voice their opinions and make suggestions about the running of the home. Staff commented, All the staff are very helpful. They say ask any questions that you need to know. The managers are very supportive. Mrs Cooper is very fair towards her staff. I think we have a really good team of staff here, we all get on well together and support each other. It is a pleasure to work here. We work hard but we enjoy our jobs, so it is not like work at all. Mrs Cooper and her staff frequently spend time talking with residents informally to obtain their views. Quality Assurance questionnaires are sent quarterly to residents’ relatives or representatives and any comments or suggestions are discussed and actioned wherever possible. The results are collated annually and any outstanding matters are given a timescale for implementation. Mrs Cooper completed and returned the Annual Quality Assurance Assessment (AQAA) to us and says she will continue to use this document as part of the home’s quality monitoring programme. Mrs Cooper confirms that, in order to protect residents it is the policy of the home not to have any involvement in their personal finances. Therefore those residents who are unable to handle their own affairs, or choose not to, have a relative or other representative to deal with their finances etc. The home pays for services such as chiropody and hairdressing and this amount is then invoiced to residents, relatives or representatives for payment each month. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 25 The premises are well maintained and there are regular checks and tests of all equipment. Details of equipment servicing and maintenance were previously provided to the Commission in the Annual Quality Assurance Assessment. A sample of records was checked to verify this information. All substances that could be potentially hazardous to health are handled and stored safely. Keypad locks are provided on some doors, for example the laundry, to prevent entry to unauthorised persons and help to ensure resident safety. Fire records show regular maintenance of the fire warning system, emergency lighting and fire fighting equipment and checks being carried out at satisfactory intervals. Each member of staff has an individual record of fire training and fire drills are held to ensure all staff know the action to take in case of fire. A fire risk assessment is in place and this was reviewed in June 2007. A letter from Dorset Fire and Rescue Service dated June 2007 confirms that fire precautions are being satisfactorily maintained. Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 27 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 OP19 Regulation 23(2)(d) (j) and 23(4)(c) Requirement It is a requirement that issues identified in this report regarding the soiling on one bedroom carpet and the lack of hot water supply at one wash hand basin be rectified. Fire doors must be regularly monitored to ensure they always close fully to latch. Timescale for action 29/02/08 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 Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Overcliff House DS0000003967.V356389.R01.S.doc Version 5.2 Page 29 - 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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