Care Home: Owston View

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What the care home does well The people have their needs assessed and a contract drawn to tell them about the service they will receive and the rights they have whilst they live in the home. The principles of respect, dignity and privacy are put into practice by the staff so that the people living at the home are comfortable and confident that they are correctly supported and cared for. People who use service are able to make choices about their life style, and are supported to develop their life skills. People at the home receive a good wholesome diet. People who use the service are able to express their concerns and have access to a complaints procedure. The physical design and layout of the home enables people who use the service to live in a safe and comfortable environment, which encourages independence. The home has extensive grounds, and there are facilities for residents and visitors to walk around and also to sit out, where a number of benches and garden furniture are available. What has improved since the last inspection? The prospective users now have an up-to-date statement of purpose setting out the aims and objectives of the home and a service user guide so that people are able to find out about the suitability of the service. People who live in the home are consulted; including those residing in the EMI unit (or their representatives) with regard to the activities programmes. The activities organised have regard to the needs of those who live at the home. The staff were attending formal training on Protection Of Vulnerable Adults and those who have attended training were familiar with the whistle blowing policy. An additional stand aid hoist had been purchased to meet the needs of the people who live at the home. The staff training records have been audited and the management have reviewed the training programmes. The induction programme has also been reviewed to reflect the present Skills for Care standards. A quality monitoring system has been introduced based on seeking the views of the people who use the service and those who work in the service. What the care home could do better: The registered manager must ensure that the recently admitted people have a careplan reflecting their needs within a set time scale so that the staff could be held responsible if not complied with. Some People usig the service and their relatives have informed us that due to staff shortage especially at the weekends, holidaytimes and in the evenings they were unable to receive baths when they wanted and in some cases support with personal care. We have informed the manager of these comments. The care staff need to receive formal training in end of life care so that they are able to make sure that the people receive appropriate care and the families get the attention and support they require. The staffing numbers must reflect the assessed needs of those who receive the service. This must include the day care users. Those staff who are allocated for 1:1 support for individuals must not be expected to help with care of other residents. To ensure that the management are able to operate a thorough recruitment procedure the staff recruitment files need to be accessible to the management at the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Owston View Lodge Road Carcroft Doncaster South Yorkshire DN6 8QA     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: Marina Warwicker     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Owston View Lodge Road Carcroft Doncaster South Yorkshire DN6 8QA 01302723368 01302729167 None Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Doncaster Metropolitan Borough Council Name of registered manager (if applicable) Mrs Susan McNair Turton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Owston View is a purpose built care home for older people situated on Lodge Road Carcroft, in a residential area close to many local facilities. It is also on the bus route to Doncaster. The home provides care for 24 older people in the main part of the home, and a further 12 people who have a mental infirmity in a specialist unit known as The Croft. The Home also provides a day care service for up to 8 people. Fees range from £330.00 - £490.00 per week, and additional charges apply to hairdressing, specialised toiletries, and magazines etc. There was a lack of information about the facilities to people living at the home and also to those who visit in the form of the Statement of Purpose and the Service User Guide. Care Homes for Older People Page 4 of 28 care home 36 Over 65 12 24 0 0 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. An unannounced inspection was carried out on Tuesday 11th November 2008 between 10 am and 3 pm. Seven people who use the service and four visiting relatives were Care Homes for Older People Page 6 of 28 consulted and six staff were spoken to. Time was spent observing and interacting with staff and the people using the service. The deputy manager was present during the inspection. The premise was inspected which included bedrooms of people using the service and the communal areas inside and the outdoors. Sample records such as the care plans, medication records, some service reports and staff recruitment and training files were checked. I would like to thank the people who live at Owston View, their relatives, the care staff and the managers for their contribution to wards this process. What the care home does well: What has improved since the last inspection? What they could do better: The registered manager must ensure that the recently admitted people have a care Care Homes for Older People Page 8 of 28 plan reflecting their needs within a set time scale so that the staff could be held responsible if not complied with. Some People usig the service and their relatives have informed us that due to staff shortage especially at the weekends, holidaytimes and in the evenings they were unable to receive baths when they wanted and in some cases support with personal care. We have informed the manager of these comments. The care staff need to receive formal training in end of life care so that they are able to make sure that the people receive appropriate care and the families get the attention and support they require. The staffing numbers must reflect the assessed needs of those who receive the service. This must include the day care users. Those staff who are allocated for 1:1 support for individuals must not be expected to help with care of other residents. To ensure that the management are able to operate a thorough recruitment procedure the staff recruitment files need to be accessible to the management at the home. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective people and their representatives who wish to use Owston View have access to information such as the statement of purpose and the service user guide so that they are able to make an informed decision. The people have their needs assessed, opportunities given to visit the home to sample the atmosphere and also assurance given to them by the management that their needs would be met. Evidence: The deputy manager gave us copies of the statement of purpose and the service user guide, which had been recently updated by them. We found information on the aims, objectives and the facilities for the people wishing to live at Owston View. Care plans belonging to three people living at the home were checked. All three people had copies of the needs assessments undertaken prior to them moving into the home. Care Homes for Older People Page 11 of 28 Evidence: The placing authorities had carried these out. Six people and five staff were consulted about the admission process. They confirmed that people had needs assessments and care staff were allocated to them as they arrived at the home. All six people had a good understanding of the key worker system and were satisfied with the arrangements. The feedback from two relatives, three residents and three staff confirmed that when people first move into the home they are encouraged to have trial periods before agreeing to settle permanently at the home. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive at Owston View is based on their identified needs. The present care plans are person centered and this helps the people and the staff to work in partnership and achieve the correct level of care. The principles of respect, dignity and privacy are put into practice by the staff so that the people living at the home feel safe, comfortable and confident that they are supported and cared for appropriately. Evidence: Three care plans were checked. Two of them had the required information including care plan reviews and evidence of relatives and or representative involvements. However one of the recently admitted resident s care plan was incomplete. During our interviews with the staff we checked whether the staff knew the needs of the person and how they were met. The comments from the staff and the individual assured us that the person was receiving the appropriate level of care although the paperwork had not been fully completed. The deputy manager was made aware of this. Care Homes for Older People Page 13 of 28 Evidence: Four staff and three people living at the home said that they had been involved in the planning and the reviewing of their care. Two more people said that the staff were good at looking after them and that they did not feel the need to get involved in the jobs of the staff. The manager and the care staff said that they sought professional advice with regards to continence and tissue viability from the community nurse specialists. All the people living at the home had access to their own general practitioner. There was evidence of people attending hospital appointments having visits from the general practitioners and the community nurses in their care plans. Designated staff were responsible for medication management at the home. These staff had received training and had been deemed competent by the manager. On the day of the site visit one person was administering medication to the people. We found a bottle of antibiotic suspension left on the drugs trolley after the medicine round. We were informed that due to the person being asleep the medication was delayed and to remind the staff they had left the medication on the trolley. We prompted the staff to return the bottle to the fridge as suggested by the pharmacists. This was corrected immediately. Three Medication Administration Sheets were checked and the medication storage and management processes were discussed with the deputy manager. The staff adhered to the home s medication policy. The supplying pharmacists too had an active role in the audits of the management of medication at the home. During the staff interview it was evident that the staff monitored the condition of the people and if concerned they sought help from the general practitioner or the district nurse. We observed the staff interacting with people in a friendly and respectful way. The people were appropriately dressed and they looked clean and comfortable. The feedback from the relatives and people using the service confirmed that the care staff gave them privacy and dignity at all times. Although the staff said that they had looked after people dying and supported the families the majority of staff need formal training in end of life care and bereavement counseling. We have been informed that the management have organised training to start early next year 2009 to adhere to the above. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are able to make choices about their lifestyle, and are supported to develop their life skills Social cultural and recreational activities are available on a regular basis therefore the home meets the individuals expectations and the people are occupied at the home People at the home receive a wholesome diet and there was a choice for those who preferred an alternative to what was offered There was food supplements available to those who needed it Evidence: On the day of the site visit we saw people seated around the communal areas and in their own rooms. Three people said that they had different activities on different days. Two of them said how much they enjoyed baking. One person said that during better weather they had outings, which they enjoyed very much. During the day we observed some families and friends who were visiting using the bedrooms or the quiet room to meet privately if they so wished. The deputy manager said that the people either managed their own finance or their families took over the responsibilities. The three people case tracked had their finance managed by their families. A further two people said that their families managed their monies and gave the home some money for Care Homes for Older People Page 15 of 28 Evidence: their personal use such as hairdressing, toiletries and daily paper. The dinnertime was observed. The people were given a choice of meals and the kitchen staff served the meals attractively. The care staff helped people who needed assistance in a discreet manner. The care staff sensitively handled those people who had difficulty having meals with the other people. These people were offered alternative areas to have their meals but they were not isolated. I had lunch with the people at the home. The lunch was tasty. The cooks and the kitchen assistants not only prepared the meals but also served the lunch and were involved at mealtimes. The people said that the meals were always good and the portions too were good. One person said that they could have seconds if they want. Another person jokingly said that it was easy to put on weight because the food was so good. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a complaints procedure. The home s policies and the staff training protect the people living at Owston View. Evidence: The home s complaints policy was accessible and two staff said that they had read the policy. A record was kept of the complaints received by the home. There had been one complaint since the last site visit. There was documentation showing that action had been taken to rectify it. The staff feedback stated that they have had training in Protection Of Vulnerable Adults and that they were aware of the whistle blowing policy and how it worked. The people living in the main house said that they have the freedom to vote and either they went to the local voting station or use the postal voting system. Three care staff said that they would use an advocacy service if they found out that a person living in the EMI unit needed independent support/advice. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe and comfortable environment, which encourages independence. The extensive grounds with seating areas enable residents and their visitors to take a walk around and enjoy the premise. Evidence: The premise was checked during the tour of the home with a senior officer. The grounds were kept tidy, accessible and attractive. There were pleasant sitting areas, lounges and a dining room for the people to use. These areas were well used by the people and their visitors. The bedrooms did not have ensuite toilet facilities. The majority of people had commodes in their bedrooms and the inspector was told that the commodes were used at nightime for the convenience of the people who live at the home. There were toilets near the bedrooms and the communal areas. There was a sluicing facility for cleaning the commodes. Toiletries belonging to different residents were left in the communal bathrooms in some cases with used face flannels. The senior officer took note of this and immediately instructed the staff to remove the items. Every room had a call system which was accessible to people occupying the room. The rooms were single occupancy. The individual bedrooms were personalised according to the occupants liking. Several bedrooms had personal belongings and the care staff Care Homes for Older People Page 18 of 28 Evidence: recorded these in the individuals care plans. Discussions took place about the bedroom doors having identifiable characters or nameplates to make the room look more like individual flats. Especially in the EMI unit this would be very helpful for the people in recognising their rooms. Rooms were individually ventilated and there was emergency lighting throughout the home. The premise was kept clean hygienic and free from offensive odours. The staff were familiar with the policies on control and the spread of infection. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management ensure that the care staff are trained and competent to deliver care. The staffing numbers to support the people who use the service, which also includes the people who access the day care service need to be monitored closely by the management so that the permanent residents at Owston View are able to receive the contracted hours of support. Evidence: On the day of our visit there was an adequate number of staff. However the care staff said that it was unusual to have two senior people on duty. Two people using the service said that the staff were very helpful but during some parts of the day they felt that there was a lack of staff on the floor. We also noted that the person allocated to give one to one support was also getting involved in the care of others due to the needs of others. We have requested the management to use the Residential Forum and calculate the care hours needed by the residents so that a safe number of staff would be allocated to each shift. Four staff said that they had completed NVQ level 2 in care and one was to commence Level 3. Four staff recruitment files were requested and they had to be collected from the head office. However, only three files were brought for checking since the fourth was misplaced. The three filed had all of the information needed to comply with the Care Homes Regulations 2002 and we were Care Homes for Older People Page 20 of 28 Evidence: unable to check the forth file. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and ensuring the home is run in the best interests of the people who occupy it. The quality assurance system helps the manager to monitor the quality of service provided. The care staff are able to fulfil their obligation to the people using the service since they are supervised regularly and feel supported by the management of the home. Evidence: The registered manager has several years of experience in the care sector. The management have had meetings with the staff and with the people who use the service. The deputy manager made available minutes of the residents, relatives and staff meetings. There had been regular meetings and the management had documented actions to be taken in the light of feedback from the meetings. The annual development plan was agreed with the council and repairs and replacement to the structure were being carried out. The staff said that the frequency and the quality of Care Homes for Older People Page 22 of 28 Evidence: supervision was dependent upon the supervisor and that they were happy and comfortable with the way they received supervision. The four staff files checked had copies of their supervision records. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 The registered person must 07/09/2007 ensure that all the people who are using the service have an appropriate and up to date care plan to suit their needs. Previous timescale.30/06/06 2 11 18 The care staff must receive 07/09/2007 formal training in end of life care so that they are able to make sure that the people receive appropriate care and the families get the attention and support they require. At least 50 of care staff to receive the training by the stated time scale and the rest by 11/12/07. The staffing numbers must 26/06/2007 reflect the assessed needs of those who receive the service. This must include the day care users. 3 27 18 4 29 19, Schedule2 The manager must operate a 26/06/2007 thorough recruitment procedure to safeguard the people who use the service. The manager must have all the information stated in regulation 19 and the schedule 2 of the Care Home Page 24 of 28 Care Homes for Older People Regulation 2002 on each staff employed by the home. Care Homes for Older People Page 25 of 28 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 1 7 15 Recently admitted people 12/12/2008 should have an individual care plan based on their care needs. assessments. The staff must be informed of the timescale to complete the admission records including the new care plan so that identified care is delivered . 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 1 11 15 The care staff must receive 20/02/2009 formal training in End of Life Care. So That staff are able to support people and their families. 2 27 18 The staffing numbers must 12/12/2008 reflect the assessed needs of those who receive the service. The management must ensure staffing levels are calculated using the dependency levels of the occupants, number of day care users and other specialist users. Care Homes for Older People Page 26 of 28 So that the idividuals receive their contracted hours of care. 3 29 19 All staff recruitment files must be kept safely and must be accessible by the management of the home. To enable home manager and the appropriate outside authorities are able to check the suitability of staff and the process used by the home when recruiting staff. 12/12/2008 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 Older People Page 27 of 28 Helpline: 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 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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