Olive House Home for Older People

Olive House Home for Older People is a care home providing accommodation for persons who require personal care for up to 44 people. The service provides support to older people and younger adults who are living with physical disabilities, dementia, or mental health. At the time of our inspection there were 29 people using the service. The home accommodates people across 2 floors in one building.

People’s experience of using this service and what we found

Risks were not always managed safely. Infection control practices were not always safe. Medicines storage needed assessing. We made a recommendation about this. People were safeguarded from risk of abuse and people felt safe. Adequate staffing was in place, and although recruitment practices were safe, records relating to recruitment needed improving. We reviewed some examples of lessons learned, though work was needed to strengthen this.

Staff supervisions were not happening in line with the provider's policy, the provider had put a plan in place to address this over the next 3 months. Appropriate staff training was in place and people were supported with food and fluid intake, though records relating to this was not always completed. People’s needs were assessed, and people were supported with their health care needs. Although some adaptations had been made to the home to meet the needs of the people living there, further improvements were needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice, though we found that people who lacked capacity did not always have the appropriate paperwork in place to support restrictions in place. We made a recommendation about this.

Equality and diversity was respected and staff completed training in this area. People’s privacy and dignity was respected, and records were securely stored. Staff were kind and people were able to express their views.

Complaints were not always handled in line with the homes policy. Records were not always person centred. People told us they were involved in their care planning, and they were able to make everyday choices. Records relating to people’s communication needs required more detail. An activities coordinator supported people to take part in activities and people were supported to have visits from loved ones. The service was not supporting anyone who was end of life at the time of the inspection.

Shortfalls in governance were identified during the inspection. This included poor recording and ineffective audits. Necessary information was being sent to the local authority and CQC. The management team was aware of their responsibility under the duty of candour and spoke about being honest when things go wrong. People and staff spoke positively about the management and the service worked in partnership with the local authority and various health teams. Meetings with staff, people and their relatives were taking place and some surveys had been carried out.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (12 September 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service and concerns shared about a mental health unit that had opened since our last inspection, medicines management and general concerns over the management of the service. On arrival to the service, we were informed the mental health unit was in the process of closing.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Olive House Home for Older People on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk, infection control, staff supervisions, complaints and governance at this inspection. We have also made recommendations relating to medicines and depriving people of their liberty.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The registered manager had established robust infection prevention and control procedures which were understood and adhered to by the staff. Whilst the service was closed to all but essential visitors in accordance with Government guidelines, a visitors’ pod had been installed in front of the home. This will help facilitate safe visiting arrangements, when restrictions are eased. There was also clear signage for visitors and personal protective equipment (PPE) at the entrance to the home.

The registered manager was very aware of the emotional impact on people when they were not able to see their relatives. Considerable emphasis had been placed on finding different ways to enable people to maintain contact with their families which included video calls, telephone calls or written communication.

There were plentiful supplies of PPE and stocks were carefully monitored. Staff had been trained in infection control practices and posters were displayed throughout the home to reinforce procedures. We observed staff were using PPE appropriately and disposal arrangements were safe. There were sufficient staff to provide continuity of support should there be a staff shortage.

The layout of the service and the communal areas were suitable to support social distancing. The premises looked clean and hygienic throughout and there were enhanced cleaning schedules in place and adequate ventilation. The atmosphere of the home was calm and cheerful. People were occupied doing activities, spending time watching television and chatting to staff.

The provider’s infection prevention and control policies and procedures were up to date and audits had been carried out on a regular basis. The provider also had a business contingency plan and had developed guidance and risk assessments in relation to the current pandemic.

Olive House Home for Older People is a residential care home, providing personal care to 36 people at the time of the inspection. The service can support up to 44 people. The home was split into three areas known as Community Beds, Balmoral Manor and Kensington Manor. Balmoral Manor provided care for people living with dementia and the Community Beds area specialised in providing support for people receiving rehabilitative care.

People’s experience of using this service and what we found

People were provided with a person-centred service, which was responsive to their needs and wishes. People continued to be safe and protected from the risk of abuse and avoidable harm. Staff were observed to be kind and caring. There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. The provider followed an appropriate recruitment procedure to ensure prospective staff were suitable to work for the service. Risks to people’s health and safety had been assessed, recorded and reviewed at regular intervals. All areas of the home had a good standard of cleanliness. The provider had established arrangements for the maintenance of the building and the shared areas had recently been refurbished. However, we found the electrical safety certificate was two years out of date. We received confirmation following the inspection the electrical check had been commenced. People received their medicines safely and were supported to eat and drink in accordance with their support plan.

The provider had appropriate arrangements to ensure all staff received training relevant to their role. New staff completed an induction training programme. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, not all documentation associated with the Mental Capacity Act was available on people’s files. We received assurances this issue would be addressed. People’s needs were assessed prior to them using the service.

People and their relatives consistently told us staff were caring and showed kindness and compassion. People and where appropriate their relatives had been consulted about their care needs and had been involved in the support planning process. Staff worked in respectful ways to maintain people's privacy and dignity. Staff were motivated and demonstrated a clear commitment to providing dignified and compassionate support. People were supported and encouraged to participate in a range of activities. People and their relatives had access to clear complaints procedure.

The registered manager had a strong and supportive leadership style. Staff felt valued and were proud to work for the service. The management team carried out a number of audits to check the quality of the service. However, we noted the audit forms did not always include important elements of the operation of the home. The senior operations manager either addressed the issues during the visit or in an action plan sent following the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Olive House Home for Older People is registered to provide accommodation and personal care for up to 44 older people. Accommodation is divided into three areas: Balmoral Manor which provides care for people living with a dementia, Kensington Manor which provides people with personal care and Sandringham Manor which provides rehabilitative care to help people learn or relearn skills necessary for daily living. There were 39 people accommodated in the home at the time of the visit.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 5 and 6 November 2014 we asked the provider to make improvements to the management of medicines, the maintenance of records and the quality assurance systems. Following the inspection, the provider sent us an action plan which set out what action they intended to take to improve the service.

During this inspection, we found improvements had been made in order to meet the regulations.

People living in the home said they felt safe and staff treated them well. There were sufficient staff deployed in the home to meet people's care and support needs. Safeguarding adults’ procedures were in place and staff understood their responsibilities to safeguard people from abuse. Risks associated with people’s care were identified and assessed. There was a whistle-blowing procedure available and staff said they would use it if they needed to. People's medicines were managed appropriately and according to the records seen people received their medicines as prescribed by health care professionals.

Staff had completed an induction programme when they started work and they were up to date with the provider's mandatory training. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. There were appropriate arrangements in place to support people to have a varied and healthy diet. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and people's privacy was respected. People living in the home had been consulted about their care needs and had been involved in the care planning process. We observed people were happy, comfortable and relaxed with staff. Care plans and risk assessments provided guidance for staff on how to meet people’s needs and were reviewed regularly. People were encouraged to remain as independent as possible and supported to participate in a variety of daily activities.

Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care.

People's care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments. People told us they had discussed their needs with staff and had been involved in the reviews of their care. We saw people had signed their care plans wherever possible to indicate their participation and agreement.

We found staff had received training on safeguarding vulnerable adults and had access to appropriate policies and procedures. Staff had an understanding of the safeguarding processes and knew how to raise an alert.

We noted appropriate checks were made during the recruitment of new staff.

There were effective systems in place to monitor and assess the quality of the service. People were asked their opinion of the service on a regular basis and were given the opportunity to complete a customer satisfaction questionnaire. This meant people were able to have input into the development of the service.

People spoken with told us they were satisfied with the service provided, one person commented, 'It's been very good, I've been quite happy with everything'. People told us their rights to privacy, dignity and independence were upheld and respected and they had a good relationship with the staff.

People's care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments and daily care records. This meant people's care could be readily monitored and evaluated.

People were generally satisfied with the food provided. There was a choice of meals and people confirmed the food was of a good quality and there was always plenty to eat. Drinks and snacks were served throughout the day or on request.

Suitable arrangements were in place to manage medication.

Appropriate systems were in place to ensure appropriate records were maintained and kept up to date.