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Inspection on 18/01/10 for Oakhaven Residential Care Home

Also see our care home review for Oakhaven Residential Care Home for more information

This is the latest available inspection report for this service, carried out on 18th January 2010.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Each prospective resident is fully assessed before admission to Oakhaven, ensuring that the home is able to meet all his or her care needs. The staff team is well trained and supported and provides a good standard of personal care and support. Positive relations are maintained between the staff team and the people living in the home. The environment is maintained and decorated to a high standard providing comfortable and homely accommodation. Health and safety is managed well by the home. A good variety of activities are provided for people to participate in if they choose. The service is well managed and organised and committed to evaluating its performance and making improvements or changes when required. Medication administration is managed well.

What has improved since the last inspection?

The service has continued to maintain the high standard of service provision which was also reported at the previous inspection.

What the care home could do better:

No areas or issues requiring improvement were identified during this inspection.

Key inspection report Care homes for older people Name: Address: Oakhaven Residential Care Home 136-140 Hales Road Cheltenham Glos GL52 6TB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Simon Massey     Date: 1 8 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Oakhaven Residential Care Home 136-140 Hales Road Cheltenham Glos GL52 6TB 01242528377 01242262600 myra@oakhaven-rch.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Oakhaven Residential Care Home Limited care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Oakhaven is an adapted and extended three-storey Edwardian style house, situated on the main bus routes and within walking distance of local shops, near the centre of Cheltenham. The home provides accommodation for twenty-seven older people. There is a lounge and dining room on the ground floor with the service areas and staff office. Staff sleep-in facilities are located on the top floor of the home, which is not accessible to the residents. The bedrooms are situated on the ground and first floors and all have hand washbasins and, with the exception of one, which is used by a married couple, are single occupancy. The married couple use a second bedroom as a sitting room. Sixteen of the rooms have en-suite toilets.A shaft lift and stairs provide access to the first floor, although in some areas of the home residents are required to negotiate stairs to their rooms; these tend to be rooms for more able people. There is access to a level well-maintained garden to the front and side of the home, which can be used by residents and their visitors in good weather.The provider supplies information about Care Homes for Older People Page 4 of 24 Over 65 27 0 Brief description of the care home the home, including the most recent CSCI report to current and prospective residents on request. The fees range from GBP550 to GBP760. Hairdressing, chiropody and any personal items are charged extra. The costs of these services are readily available in the home, as required. Care Homes for Older People Page 5 of 24 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: three star excellent 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: This inspection was undertaken on 18th January 2010. The Inspector met with the registered managers, one of whom is also the registered Provider, several members of the care staff and also a number of people who live at the home. Two relatives who were visiting the home on the day of the inspection were also spoken with. An inspection of the environment was also carried out. Records relating to care planning, staff recruitment and training, health and safety, medication and quality assurance were also examined. Prior to the inspection a number of surveys were circulated to residents, staff and outside professionals involved with the home. The service has also recently completed and returned their Annual Quality Assurance Assessment (AQAA) to the Commission. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 24 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 8 of 24 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. A satisfactory assessment process plus the invitation to visit the home, enables prospective residents to make an informed decision regarding their admission and gives them assurance that their needs will be met. Evidence: Evidence from surveys and interviews confirmed that people are supplied with enough information about the home before they make a decision about moving in or not. Full assessments are completed prior to admission and the opportunity is there for prospective residents and their families to visit the service. Information is also collected on an ongoing basis to develop the care plans so that they are person centered and fully reflect the needs that are to be met. People spoken to were very positive about the admission process to the home. The Statement of Purpose is readily available within the home. Care Homes for Older People Page 9 of 24 Evidence: Intermediate care is not provided at the home. Care Homes for Older People Page 10 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel they are well cared for and are treated with respect by the staff. Their needs are met by a well trained staff team and a well developed care planning system. Medication systems are also managed very well, ensuring that residents should not be put at any risk of potential errors. Evidence: Up to date detailed care plans are in place which cover the full range of needs and support that is required. Regular recording is completed by staff of any ongoing issues or concerns about care and records are also kept of any involvement from health professionals. Relatives commented in the surveys that they were kept informed of any health issues or concerns. Staff spoken with demonstrated a good awareness of the care planning system, and were able to explain how they kept themselves updated about changes to peoples needs or required support. There are handover meetings between shifts and also communication books that are completed. People spoken to, and completed surveys, were very positive about the quality of care and support that is provided by the staff team. Care Homes for Older People Page 11 of 24 Evidence: Feedback from outside professionals involved with the home was very positive about the care and support that is provided and also about communication and liaison with staff and management. Care plans are regularly reviewed by the senior staff and where appropriate plans include information from outside health professionals. A sample of risk assessments were seen and these had all been appropriately reviewed. Two relatives spoken to on the day of the inspection, stated that they could not fault the personal care that was provided and they thought their relatives support needs were being fully met by the staff team who were very caring. Staff were observed interacting and supporting people in a respectful and positive manner during the inspection visit. The home has an effective system for the storing and administering of medication. A sample of records were seen and these were correctly completed. Risk assessments are completed for those people living in the home who wish to self administer their medication. Secure storage is also provided in their rooms. All medication is regularly audited by the senior staff. Staff complete training before they administer medication Care Homes for Older People Page 12 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities are provided and supported for the participation in or observation of various activities and efforts are made to ascertain unmet needs to improve the quality of care for people. Families and friends are made welcome in the home promoting a friendly, relaxed and caring atmosphere. The meals are nutritious and balanced, offering good variety to the residents Evidence: Information from surveys and interviews with people living in the home confirmed that a good variety of activities are provided and supported. There was also evidence of how the staff and management actively try and find out what people would like to do and what any unmet needs are. As well as activities in the home such as concerts and games there are also trips out into the community. People spoken to said they were satisfied with the variety and frequency of activities and also confirmed that they were always given the choice of whether to participate or not. Care Homes for Older People Page 13 of 24 Evidence: People explained how they could choose to spend time in their rooms or in the communal areas and examples were also given of how religious needs were supported by the home. Information is also contained in the care plans about backgrounds and interests which help the staff relate to and communicate with people effectively. It was observed by the Inspector that there was a calm, relaxed and friendly atmosphere within the home. Several relatives commented that they were always made welcome and that staff were friendly and helpful. People were generally very positive about the quality food and every person confirmed that sufficient portions and variety was provided. Two people commented that the food was not always cooked to their liking. There was evidence that the staff try and ascertain individual preferences and give choice wherever it is required. People were observed being provided with different options on the day of the inspection visit. A sample of menus were seen and these showed that a varied and healthy diet was offered. People are encouraged to eat communally but have the option of eating on their own in their rooms if they choose. The kitchen was briefly visited and this appeared to be clean and tidy with all produce appropriately stored and labelled. Care Homes for Older People Page 14 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A satisfactory complaints system enables residents and their families to feel assured that their views would be listened to and acted upon. In depth staff training and written guidance is provided to ensure that residents are offered a good level of protection against abuse. Evidence: All staff complete some basic adult protection training as part of their induction and most have then also completed additional Alerters Training. The home has implemented a system for some people who live in the home which involves wearing a wrist band which will trigger a warning bell for the staff if they leave the premises. The person concerned and relatives are involved in this decision. This promotes dignity and independence whilst protecting the security of the home, as the front door can be opened from the inside but not from outside. People spoken to who live in the home said they felt safe and that the staff and management treated them with respect. Staff spoken to were confident that any issues raised or concerns expressed would be dealt with by the management of the home. People living in the home also said they were happy to raise any issues that concerned them The service has a complaints procedure and complaints record. Care Homes for Older People Page 15 of 24 Evidence: There have been no formal complaints about the home since the last inspection. The development plan prepared following the completion of the in house survey of residents and relatives views about the home showed that any identified issues, however minor, were addressed appropriately. This survey is completed annually. The home provides fully documented policies to address all forms of abuse. The policies are readily available for staff to read. Information on sourcing advocacy support is provided if the residents require this facility. POVA (Protection of Vulnerable Adults) legislation is correctly followed by the home. Care Homes for Older People Page 16 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are provided with a good standard of clean comfortable accommodation that is well maintained and decorated to a high standard. Evidence: All parts of the home and grounds appeared to be well maintained and it was evident that all the communal areas and bedrooms were decorated to a high standard. People spoken to were very positive about their accommodation and also confirmed that repairs are carried out promptly. People have also been supported and encouraged to personalize their rooms if they choose. The home was clean and free from odors and appeared hygienic throughout. People confirmed that their laundry was dealt with efficiently and their clothes were well looked after. All servicing was up to date and recorded and a safe environment was being maintained. Care Homes for Older People Page 17 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of the people living in the home are met by a motivated and well trained staff team who provide a high standard of personal care and treat individuals with respect. Evidence: At the time of this inspection there were sufficient staff on duty, with four care assistants and one matron supervising on the early shift. The registered managers and deputy were also available and there were also cleaning staff and a cook on duty. The rotas seen demonstrated that good staffing levels are maintained and that there are sufficient staff on duty to meet the needs of the people living in the home. Each month staff are allocated to different residents which helps to promote consistency. Staff stated they felt well supported in their roles and evidence from interviews and surveys suggested they are very motivated to providing good quality care and support. All staff receive regular formal supervision, which is recorded, and their training needs and training updates are monitored by the managers. The training is well organized and documentation is kept up to date and in order. Staff were positive about the training that is provided and supported. More than 50 per cent of the staff have now completed NVQ training. Records also showed that there was a relatively low turnover of staff and low levels of sickness absence. Information from surveys and interviews with people living in the home showed that staff provide a high Care Homes for Older People Page 18 of 24 Evidence: standard of personal care and support and treat people with respect and dignity. Staff were observed during the visit talking and relating to people in professional and caring manner. Surveys from relatives also commented that the staff are very approachable and well informed and that any issues or concerns are communicated appropriately. A sample of staff records were checked and these were found to be in order with all the necessary checks having been completed. All new staff undertake if necessary, depending on experience, the common induction standards and all new staff have competencies and skills observed by the senior staff and signed off when they are satisfied that a satisfactory standard has been demonstrated Care Homes for Older People Page 19 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are robust management systems in place to ensure that the financial interests, and the health, safety and welfare of people using the service are safeguarded. There is also evidence of a commitment in the Home to improve the services for the benefit of the residents living there. Evidence: The home is run by two registered managers, one of whom is also the Provider, and also a deputy manager. Responsibilities are delegated where necessary and feedback from surveys was positive about the approachability of the management team and their responsiveness to any concerns or issues. This was from staff, residents and relatives. The home is well organized and efficiently and professionally administered. There is a clearly demonstrated commitment and motivation to provide a high standard of care and support. The service evaluates its performance, seeks honest feedback from stakeholders and has a development plan that is reviewed and updated. The service is Care Homes for Older People Page 20 of 24 Evidence: proactive in keeping itself updated with good practice, training initiatives and changes in regulations. The manager and deputy have both completed training on the Mental capacity Act and the Deprivation Liberty Act. There are clear lines of accountability within the service. There also appears to be a very inclusive and supportive ethos in this home. Records relating to personal finances were not inspected during this visit. Health and safety is closely monitored and all records were up to date and demonstrated that safety checks and servicing were being completed. The fire safety checks had all been completed and the fire risk assessment had been appropriately reviewed and updated where necessary. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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