Inspection on 22/01/08 for Oak Lodge Nursing Home

This is the latest available inspection report for this service, carried out on 22nd January 2008.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oak Lodge Nursing Home 20/07/06

Oak Lodge Nursing Home 28/02/06

Oak Lodge Nursing Home 23/09/05

Oak Lodge Nursing Home 14/03/05

Oak Lodge Nursing Home 03/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Oak Lodge Nursing Home Lordsleaze Lane Chard Somerset TA20 2HN Lead Inspector Gail Richardson Unannounced Inspection 22nd January 2008 09:30 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 Oak Lodge Nursing Home DS0000003274.V356012.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. Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Lodge Nursing Home Address Lordsleaze Lane Chard Somerset TA20 2HN 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) 01460 67258 01460 68068 oaklodge@majesticare.co.uk Majestic Number One Ltd Caroline Orrell Care Home 47 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (39) of places Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Elderly persons of either sex, not less than 60 years, who require general nursing care No more than 39 persons requiring nursing care may be accommodated. Up to 10 places for elderly persons, of either sex, in the category OP, who require personal care only. Eight places exclusively in The Acorns for elderly persons of either sex, in the category DE(E) who require personal care only. There will be a named Care Co-ordinator and designated staff team for The Acorns. To provide care for one named person under the age of 60. Date of last inspection 16th July 2007 Brief Description of the Service: Oak Lodge was first registered in 1989 and is now owned by a growing care company. The home is situated in a private lane a short distance from the rural town of Chard. The home is partly converted house with a purpose built extension with accommodation provided on two floors. The home offers general nursing care for up to 39 older people. The home also has 8 beds registered to provide personal care for people with dementia care needs using a person-centred model of care. This provision is in a separate area of the home called The Acorns that is reached through the main reception area of the home and has a keypad secured entrance. The main area of the home has a pleasant outlook onto private gardens from two large downstairs communal rooms and a conservatory. The Acorns has been fully refurbished to provide domestic style accommodation including a kitchen/diner and lounge. The separate Acorns garden has been designed to be safe and secure with separate access for those people living there. Both these areas of the home have identified staff teams. Activities are provided during the week and include a weekly mini-bus trip. The fee range for personal care residents is £500.00 to £550.00 and the Nursing fee range is £504.00 to £700.00. These fees do not include items such as hairdressing and chiropody. Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. This was an unannounced inspection, which took place over 1 day (6.5 hours) on the 22nd January 2008 by Regulation Inspectors Gail Richardson and Shelagh Laver. For a period of 3.5 hours the inspectors were accompanied by an Expert by Experience who spent time talking to people using the service and observing social routines of the home. A tour of the home took place and a selection of the bedrooms and all communal areas were seen. There were 43 people currently residing at the home, this includes 33 nursing patients, 2 people receiving personal care only and 8 people residing in the Acorns Unit. The inspector spoke to 9 people using the service, 1 visitor, and 10 members of staff, the Registered Manager and Operations Manager were available throughout the inspection. The home has provided CSCI with a completed AQAA (Annual Quality Assurance Audit) which was completed by the Manager and gives details of aspects of the home. The inspectors spent time talking to people within the home and staff and observed that on the day of inspection, people appeared comfortable and that the people looked well cared for with an attention to detail of personal care. All people using the service spoken to, and who were able, stated they felt well cared for. Records relating to care including 5 care plans, 3 staff files, finances and health and safety records were examined The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Improvement in the content and instruction with the care plans was evident. Considerable work has been undertaken to ensure that care plans are updated regularly and contain sufficient detail to ensure that staff are supported to provide a good standard of care. The manager has implemented systems to ensure that all prescribed creams and supplements are recorded when given. The storage of oxygen is now secure and appropriate signage in place to ensure that staff are aware of any hazards. The upper floor window is now restricted to prevent the risk of injury to people using the service. The wardrobe and bookshelf previously identified as being unsecured have been addressed The home has an ongoing maintenance program. New carpets have been fitted to the upstairs corridor and refurbishments of some bedrooms and 2 bathrooms were evident. The home has replaced previously identified damaged sinks and has purchased ho/low beds for people using the service who have assessed nursing needs. One bathroom has been converted to a shower room and people using the service and visiting health professionals have converted office space to a small seating area for use. Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 7 The contact details of CSCI are now included in whistle blowing and complaints policies used by the home. Staff supervision is now undertaken with each staff receiving no less than 6 sessions per year. Topics covered are in line with the areas outlined in the National Minimum Standards. 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. Oak Lodge Nursing Home DS0000003274.V356012.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 Oak Lodge Nursing Home DS0000003274.V356012.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): 1 2 3 4 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to be able to provide prospective residents and relatives with sufficient information in the format of brochures, the Service User Guide and Statement of Purpose for them to make an informed decision about the home. All prospective residents receive a pre admission assessment by the registered manager to ensure the home can meet the assessed needs identified. EVIDENCE: The homes AQAA (Annual Quality Assurance Assessment) states; There has been developed a service user guide and statement of purpose to reflect the needs of the service user. A comprehensive information pack has been developed and is given to all prospective service users and their families Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 10 to enable them to make an informed choice as to whether admission to the home will be suitable for the service user. These documents have remained unchanged since the previous inspection. Prior to admission the people using the service and their representatives have the opportunity to visit the home to view prospective rooms and communal areas. One relative and 2 people using the service confirmed to the inspectors that this had been their experience at the home. Five people who use the service’s records were examined. Each person had received a pre-admission visit by the manager from the home. Their needs were assessed and documented and this forms the basis of the care plan. The registered manager had also received where available the SAP (Single Assessment Process) document to support the person admitted to the home. Contracts for each of the 5 people using the service were examined and were seen to contain the room to be used, terms and conditions of residency and fee rate. Oak Lodge Nursing Home DS0000003274.V356012.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 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has a care plan, the assessed areas of need were reflected in this plan of care and the detail recorded ensures that staff can provide a good standard of care. The management of medications systems meets the required standard in most areas. Staff were observed to treat service users with dignity and respect at all times and residents feel well cared for. EVIDENCE: Inspecors examined 5 care plans for people using the service and found that since the previous inspection the home has undertaken considerable work to improve care plans to include each identified area of need and an appropriate Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 12 plan of care for that need. This is required to ensure that staff is able to access the information needed to support that person. There was evidence of assessment of needs with clearly written, detailed care plans which included the input of other health professionals and which were reviewed regularly and updated as required. As people’s needs changed the care plan was updated and there was evidence of care planning for short term needs. Some care plans were particularly detailed to support staff in areas of nutrition and diabetes care. There was evidence within the detailed content of the care plans that the staff were developing a person centred approach to care planning. There was evidence of some recorded input by relatives/representatives and one visitor confirmed that they are involved in discussion about changes in care needs. Risk assessments were in place to support the people using the service to maintain independence with help as required. The registered manager explained the systems which would trigger further monitoring of areas including nutrition, pressure area care and challenging behaviour and monitoring records and daily records were available to evidence that action was being taken. It was noted that a person admitted 8 days previously had an incomplete care plan. The registered manager is recommended to ensure that all care plans are completed within a reasonable timescale to support staff to give the care needed. Some social care plans were not fully completed and lacked documentation of social choices and preferences.The recording of social activities is under development but is recommended to be improved to record all social interaction and the participation and level of enjoyment. This information could then be used to develop a more person centred approach to social activity. The inspectors spent time observing the care given and the interaction between people using the service and the staff. Staff appeared to treat people with dignity and respect. They were observed to have a good understanding of peoples care needs and interacted in a pleasant way. People using the service comments included “Staff are very kind” and “They (Staff) all look after us very well and are very nice”. One visitor commented that “They keep on top of the care”. As part of the inspection an Expert by Experience spent time talking with people using the service and looked at activities within the home. The Expert by Experience report stated that I observed the interaction between staff and residents during my visit. Staff treated their charges in a friendly and caring manner, with the right level of humour and respect. I did notice however that during the mid-morning coffee session in the lounge there did seem to be a shortage of staff to help Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 13 residents, and that the activities organiser was doing a lot of the serving of drinks and biscuits. Also, the buzzer seemed to be ringing almost continually between 1130 and 1200. All residents are registered with G.P. Regular appointments are upheld for visual, dental, chiropody, speech and specialist care requirements. The medication systems were assessed to be mostly satisfactory. There were no gaps evident in the Medication Administration Records, which indicates that all prescribed medications have been administered. There was evidence of variable doses being recorded. Hand transcribed entries were noted on 4 occasions to be either not dated or dated but not signed by 2 staff. This is required to enable a clear audit trail of the date of medication commencement and also to ensure that staff is checking for correct transcribing of medicines. This requirement was raised at the previous inspection and is unmet. The registered manager has implemented a system to record the administration of all prescribed creams and dietary supplements on the Medication Administration Records and this was seen to be followed. The manager has addressed the storage of oxygen within the home and all cylinders observed were stored upright and secured. Correct signage displaying the hazards of Oxygen was seen on the appropriate bedroom doors however a further correct sign is needed for the treatment room door. A homely remedy policy is in place with signed consent on agreed protocols by the relevant GP’s. All medications were stored safely and securely with systems in place for ordering and disposal. Oak Lodge Nursing Home DS0000003274.V356012.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 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are opportunities for social stimulation and people are supported to join in with organised activities or pursue their own interests. Recording and development of activities requires further attention. The meals in the home are of an adequate quality and a range of choice is available. EVIDENCE: The inspectors spent time talking with people using the service and observed people reading newspapers and chatting to staff and visitors. Monthly activity plans are available in each bedroom. The Expert by Experience noted that; On the morning that I visited there was an activities session going on in the lounge. The organiser was helping some of the residents to make Valentine cards, and also to do jigsaws. The organiser worked 18 hours a week, and a colleague worked another 18 hours a week. There was a weekly programme of activities for residents including exercise, music, bingo, painting, playing cards, and craft sessions. One of the residents told me Id never painted in Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 15 my life before coming here . She proudly showed me framed examples of her art, which now hung on the wall in the lounge. This kind of accomplishment is a tribute to the enthusiasm of the activities organiser. She was extremely proactive in her role, with a friendly and encouraging manner to the residents Also that morning the hairdresser was visiting Oak Lodge, and several residents were preparing for a visit to a local pantomime in Chard later that day. Apart from the weekly programme of activities there were regular events including fortnightly communion, trips out in the minibus, and musical entertainers visiting. The Acorns unit has access to an enclosed garden and on the day of inspection people using the service were enjoying coffee and chatting with staff. People were seen to move freely around the unit and one person was assisting with the washing up. The home is required to develop social care histories and ensure that the record of activities undertaken is accurately maintained. It was noted during case tracking that some people using the service had significant gaps of time with nothing recorded. In the case of 3 people, there were records of only 2 social interactions each month for the last 3 months. It was discussed with the manager that one to one sessions of activity/discussion should be planned and recorded for the people using the service who remain in their bedrooms. This record of participation and enjoyment for all activities and interaction could then be used to develop a more person centred approach to activity provision. People using the service’s rooms were decorated in a manner, which reflected their tastes and lifestyles. Evidence was seen in some cases of people’s own furniture in their bedrooms. People using the service who were able confirmed that within a reasonable timescale they could get up and return to bed when they wanted to. People were seen choosing to remain in their rooms. One person commented,” Its nice here, the food is good, you can get up when you want”. The Expert by Experience noted that; I visited several residents in their own rooms, all of which were bright and comfortable. Residents were able to add their own personal touches to furnishing their own room with pictures, small pieces of furniture etc. Staff helped residents both to get up and to go to bed at times that suited residents The rooms I saw were all en-suite. One resident remarked that the Home was the best there is and another told me she was very happy The Expert by Experience was able to confirm that visitors are always welcome. Relatives and friends were able to come in at any reasonable time to visit residents. I spoke to a son who was visiting his mother mid-morning in the lounge. He was well satisfied with the care that his mother received, telling me “ Although no-one really wants to be in a Home, this is as good as possible. She is very well looked after here . Another family were visiting their Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 16 relative in her room. The daughter told me Were very reassured to find a Home that looks after her so well. Staff are very approachable and always contact us if theres any change to routine or medication . The meal was served hot and appeared plentiful and appetising. Staff assisted with eating and drinking in an appropriate and discreet manner. Tables were laid with drinks and condiments. There is always a choice of meal at both lunch and teatime and several people explained that should you not like the choice there are always further options available. Special diets were available for high calorie and diabetic diets and pureed diets were served separately. Meals were served both in the dining room and in people’s bedrooms if preferred. Breakfast is served in people’s bedrooms and a cooked breakfast is available 2 days per week or on request. On the day of inspection lunch consisted of: Gammon, mashed potato, swede and carrots Or Cheese and potato pie Desert was fruit flan or ginger sponge and custard. The evening meal was mushroom soup and a selection of sandwiches including salmon, ham and cheese and pickle. Fish fingers and chips, followed by mousse and homemade cake. People using the service said that the food was all right, one person commented that there was “plenty of food” and another stated that they “had never been hungry, sometimes it is not too exciting”. Mealtimes appeared to be a pleasant dining experience. The Expert by Experience observed that; The lunch menu contained a choice of 2 main courses and puddings. The food was hot and nutritious, and the cook told me that as much food as possible was locally sourced. Residents could decide whether to eat their meals in the communal dining room, or have it served in their own room. I observed that individual assistance was given to those residents who had difficulty in feeding themselves, and that staff were extremely patient and caring when giving this support. Talking to both residents and the catering staff it was obvious that meals were of a good standard and variety. One resident told me she was very happy with the meals, and another told me she had a cooked breakfast in her room every day. Oak Lodge Nursing Home DS0000003274.V356012.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 17 18Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and residents are confident that the homes management team would appropriately deal with any complaints or concerns. Policies, procedures and training are available to staff to ensure they have the knowledge to prevent service users from the risk of abuse EVIDENCE: The complaints records of the home were examined and confirmed that all complaints were investigated and outcomes reached within an agreed timescale. The policy has been amended to include the contact details of CSCI. The homes complaints record was examined and the home has received 3 complaints since the previous inspection, all have been addressed and responded to in writing. CSCI is involved in one ongoing concern raised. All people using the service are registered to vote and have access to an advocacy service if requested. The home has policies and procedures in respect of challenging behaviour, making a complaint and whistle blowing, staff training in the protection of vulnerable adults. Discussions with people using the service, staff and visitors confirmed that they knew how to make a complaint, raise a concern and are Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 18 confident that the management of the home would deal with it in an appropriate manner. All staff receives a POVA (Protection of Vulnerable Adults) check and a CRB (Criminal Record Bureau) check prior to commencing employment. Oak Lodge Nursing Home DS0000003274.V356012.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 20 21 22 23 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an ongoing maintenance program. Some refurbishment in some areas has made improvements to the décor and facilities and the home appears to be maintained to a good standard. The gardens are suitable for people using the service and the home appeared to have a good standard of hygiene. Suitable equipment is available where there is an assessed need. EVIDENCE: A tour of the home was made by the inspectors and a selection bedrooms and all communal areas were seen in both the main body of the home and the Acorns Unit. All the bedrooms seen were comfortable and people using the service had been supported to personalise their own rooms. Some rooms have been refurbished and all appeared by be clean and tidy. Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 20 One person commented that their bed was “Comfortable and the room was very nice”. An ongoing maintenance plan is underway and upstairs corridor carpets have been replaced. The areas identified at the previous inspection have all been rectified and the home has purchased the remaining hi/lo beds were there has been an assessed nursing need. Further audits of equipment are being undertaken to replace worn equipment. There are suitable and sufficient toilet and bathing facilities for all people using the service. The downstairs bathroom has been converted into a shower room and the other downstairs bathroom is being refurbished. The design of the Acorns supports people using the service to find their way around and be able to identify their own room easily. The unit was noted to be clean and comfortable. The unit has developed a comfortable homely atmosphere by creating a domestic style environment and people using the service appeared settled and happy. It was brought to the inspectors attention some wheelchairs did not have footplates. It is recommended that an audit of wheelchairs and associated equipment takes place to ensure that all wheelchairs are correctly maintained to ensure that people using the service are not placed at risk. The recent decommissioning of 2 stand aids was discussed and a replacement stand aid is to be purchased. Oak Lodge Nursing Home DS0000003274.V356012.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 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels at the home are adequate to meet the assessed needs of people using the service and staff training is organised to promote and support people using the service. The home has an induction program, which is in line with the Common Induction Standards. Recruitment practices are robust and protect people using the service. EVIDENCE: The home ensures that there is always qualified nursing staff available on duty over each 24-hour period. On the day of inspection there were 2 qualified staff on in the morning with 6 care staff in the main unit and 2 care staff in the Acorns. Also on duty were 1 activity staff, 3 domestic staff, 1 laundry staff and 2 kitchen staff. The maintenance man was also on duty. Staff confirmed to the inspectors that this is a sufficient staff number to provide the care required. Shortages of staff due to sickness have been experienced but the registered manager confirmed that levels are relatively well maintained and agency staff are used as required. Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 22 Staff rotas examined confirmed that levels of staff on duty are relatively consistent. People using the service and 1 visitor confirmed that staff are always available when you needed them. Comments received from people using the service included; “Certain staff are easy to talk too” “If you ring the bell they don’t come very quickly, they do come at night.” “They do look after us well- can be very short staffed, they can’t do justice to what they are capable of” One staff commented that “the lines of communication within the home are clear and staff meetings take place regularly” and another stated, “We work as a team”. People using the service who were able confirmed that staff are kind and caring and they felt well looked after. All staff receives an induction-training period. The induction follows the Skills for Care Common Induction Standards and covers areas including mandatory training and abuse awareness. Staff confirmed that training is provided regularly and is advertised on the staff notice board. Staff training records confirmed that this training is recorded and updated. The home actively promotes staff to undertake NVQ training, currently levels exceed 50 of staff have completed NVQ training. The recruitment process within the home is good; the 3 staff files examined contained sufficient detail to ensure that people using the service are protected from the risk of abuse. The inspector advised that all references, which have any adverse comments, are investigated, discussed and the outcome recorded. Oak Lodge Nursing Home DS0000003274.V356012.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 32 35 36 37 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being effectively managed and benefits from the proactive management style of the registered manager. People using the service best interest are safeguarded by robust financial arrangements and the correct storage of information. Systems are in place to ensure the health and safety of people using the service whilst encouraging and promoting independence. EVIDENCE: The Registered Manager of the home is Caroline Orrell who has managed the home for over one year. Discussions with the inspectors confirmed that she has a clear understanding of the needs of the people living at the home and strives to develop a team of staff to provide a high standard of care at all Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 24 times. People using the service confirmed that they could speak with the manager, one visitor confirmed that “Caroline is very approachable ”Staff stated that they felt supported by the manager. As required, the company in accordance with Regulation 26 of the Care Homes Regulations 2001, carries out monthly visits. The format for these visits has been improved and provides CSCI with a detailed reviewed each month. Records seen at this inspection were appropriately and securely stored and staff have access as required. Quality assurance records were not seen at inspection. There are established systems in place for dealing with people using the service’s finances. The inspector evidenced that each person’s personal monies were stored in individual envelopes with a running total of deposits and withdrawals. A random check of 3 people using the service’s finances and all were correct. Staff supervision is now underway, records were seen to cover topics outlined in the National minimum Standards and staff confirmed that supervision takes place regularly. The manager has a supervision matrix to ensure that supervision remains ongoing. Accident records were viewed and it noted that monthly audits of accidents take place. The registered manager has devised a graph representation showing incidences of place and time. As a result of this audit a plan to prevent accidents is implemented. This system of review is very good and the registered manager stated that the graph is used to further advise staff at meetings of areas for accident prevention. Maintenance records were well maintained and up to date these included; Fire extinguisher checks were undertaken annually 29/06/07;the fire safety system is checked annually 02/01/08. The fire alarm system is checked weekly by the maintenance staff and was last checked 18/01/08 when the staff undertook the weekly fire drill. Emergency lighting is checked monthly buy the maintenance staff 16/11/07 The lift is serviced annually 01/06/07 The hoists are services bi annually 05/12/07 Hard wiring is tested every 5 years 12/08/05 Gas safety is checked annually 21/01/08 certificate is pending. Hot water temperatures are checked at all outlets monthly and recorded. Last record December 2007 Call bells are checked and reviewed by computer for working status. All bedrails are checked monthly by maintenance staff 14/01/08 Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 25 Portable appliances are tested annually 28/08/07 Environmental health last visited the home 19/11/07 Oak Lodge Nursing Home DS0000003274.V356012.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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 4 3 Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? yes 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 OP9 Regulation 13(2) Requirement The manager must ensure that all hand transcribed entries on the Medication Administration Records are signed by 2 suitably qualified staff members to ensure that there is no risk of transcribing error. Previous timescale of 30/08/07 not met. 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. 1. Refer to Standard OP7 Good Practice Recommendations The registered manager is recommended to ensure that all care plans are completed within a reasonable timescale to support staff to give the care needed. The manager is recommended to ensure to ensure that all activities undertaken are recorded in the persons file, this is recommended to include all one to one activities undertaken. DS0000003274.V356012.R01.S.doc Version 5.2 Page 28 1. OP12 Oak Lodge Nursing Home 3. OP22 The registered manager is recommended to audit all wheelchairs used in the home to ensure that footplates are available. Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Oak Lodge Nursing Home DS0000003274.V356012.R01.S.doc Version 5.2 Page 30 - 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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