Inspection on 19/12/07 for Oaklands Nursing Home

This is the latest available inspection report for this service, carried out on 19th December 2007.

CSCI found this care home to be providing an Good 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.

Other inspections for this house

Oaklands Nursing Home 16/01/06

Oaklands Nursing Home 28/07/05

Oaklands Nursing Home 30/09/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Oaklands Nursing Home 43 Bodenham Road Hereford HR1 2TP Lead Inspector Wendy Barrett Key Unannounced Inspection 19th December 2007 09:00 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 Oaklands Nursing Home DS0000059478.V348466.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. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Nursing Home Address 43 Bodenham Road Hereford HR1 2TP 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) 01432 272775 01432 351596 Oaklandscare@aol.com Oaklands Care Services Limited Mrs Pamela Ann Newman Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (3), Physical disability of places over 65 years of age (30) Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Conditions of Registration 1. Oakland Care Services Limited will carry out a review of the heating, surface temperatures of radiators and pipes, water temperature controls and legionella precautions in Oaklands Nursing Home. The review, together with an action plan to rectify any deficits identified, will be submitted to the Commission for Social Care Inspection within 3 months of the date of registration. 2. Oakland Care Services Limited will increase the amount of day space provided for service users and will fit a new passenger lift to replace the undersized lift within 2 years of the date of registration. 3. Oakland Care Services Limited will provide a set of architects plans for Oaklands Nursing Home to the Commission for Social Care Inspection within 6 months of the date of registration. Room sun lounge may be occupied by the service user named in the variation dated 26/2/07, until it is no longer required or another room becomes available. Registration will then return to 30. 29th June 2006 2. Date of last inspection Brief Description of the Service: Oaklands is registered to provide nursing care for up to 30 people whose needs arise from the ageing process, or from a physical disability. The home provides accommodation for male & female residents. Oaklands is a large Victorian house with 2 modern, purpose built extensions. The accommodation is on four floors and there are 2 shaft lifts and 1 platform lift to access these. Oaklands is situated in an established residential area less than a mile from the centre of Hereford city, where the majority of local facilities are based. There are 14 single bedrooms and 8 shared bedrooms. On the ground floor there are 3 lounges and 1 dining area for communal use. The gardens are large and some areas are accessible to the service users. Information about the service is produced in large print literature and is displayed at the home for all to read. Every resident receives a copy of a service user guide when they are admitted. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 5 Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 6 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 report has been written with reference to information gathered in a variety of ways. Mrs. Newman submitted a comprehensive annual quality assurance assessment report to the Commission, survey questionnaires were sent out to a sample of relatives, care professionals and staff at the home, two inspection visits (the first unannounced), and information held by the Commission e.g. notifications of events affecting the wellbeing of residents and reported by the home since the last inspection, complaints information. What the service does well: What has improved since the last inspection? Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 7 The meals service and management of nutritional needs has been developed. Mrs. Newman and the staff have received further training to help them protect the residents’ rights and also protect them from any abusive behaviours. The safety of the premises has been strengthened with additional work to fire safety arrangements and water quality controls. The recruitment of new staff has been strengthened so that applicants are thoroughly checked for their suitability to work with vulnerable adults. There are more care staff involving themselves in obtaining an recognised national qualification in care. 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. Oaklands Nursing Home DS0000059478.V348466.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 Oaklands Nursing Home DS0000059478.V348466.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, and 5 (NMS 6 is not relevant to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information literature is regularly updated to make sure it includes all the information required under regulation. New residents are only admitted when Mrs. Newman has gathered all the information she needs to decide if the placement will be suitable. Residents and relatives are happy with their experience of admission to the home and there is a lot of effort to make sure they have enough information to decide if the home will suit them. EVIDENCE: A Statement of Purpose has been written to describe the service and this is displayed at the home for anyone to read. A resident had a copy of a large print Service User Guide in her bedroom. She had received this when she was Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 10 admitted to the home. All new residents get a copy of the guide so they know what to expect from the home. They also get a copy of a statement of terms and conditions with details of the fees and any additional charges. Contracts are drawn up with self-funding residents or with local authorities that financially support placements. All the information literature is regularly updated to make sure it contains the necessary details and to make sure they are accurate e.g. the statement of terms and conditions of residence was revised to bring it in line with amended regulatory requirements. The Commission has recently been contacted by a relative over concerns about charges made for the provision of toiletries. Examples of contractual documents confirmed that charges for toiletries are additional charges and are not included in the standard fee. They are, therefore, optional although Mrs. Newman confirmed that relatives are encouraged to allow the home to supply toiletries. This is because sometimes relatives do not always make sure there is a supply of toiletries for staff to use and this seriously affects the staff’ ability to provide satisfactory care. The home also prefers to use liquid soaps because bar soaps do increase the risk of cross infections. This is reasonable. Toiletries purchased by the home were seen in residents’ bedrooms and were good quality, branded products. Records were also seen that listed the provision of articles to each resident as evidence of expenditure to justify any charges made. Residents and relatives find the admission experience comfortable. Mrs. Newman takes a lot of time to gather information about any potential resident and she only agrees to admit when she is satisfied the home can meet the identified care needs and expectations. She writes comprehensive preadmission assessment reports so that the staff will have the information they need at the point of admission. All 13 staff survey responses confirmed that they felt they were kept informed about residents and their needs. Potential residents, or their relatives, are encouraged to have a look around the home so they can get an idea whether it will suit them. A couple were observed being welcomed into the home for a look around on the day of the inspection visit. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ care is planned and provided with good attention to health and personal care needs and to the wishes of the individual resident. The staff receive relevant training to give them the information they need to work well with the residents. Medication is handled safely by staff who have written guidance and receive regular training to update their knowledge. EVIDENCE: The residents and their relatives are generally very happy with the care. Only one relative expressed any concern about the care-most were very satisfied. A resident commented that ‘they do lots of little things for you’ and her son was very pleased that his mother’s health had improved when she moved into Oaklands. Another resident said ‘I was very ill when I arrived. I’m so much better now’. Mrs. Newman has been improving the way the care is planned to Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 12 be sure that it suits the particular resident. For instance, one resident is reluctant to allow staff to help him with personal care, so they don’t push him. Sometimes this means that there is a delay before he has the attention he needs but his wishes are respected and records are maintained to explain any shortfalls. He explained that he likes to stay in bed longer when the weather is miserable and the staff respect his wishes and adjust their work programme to accommodate him. This ‘oerson centred approach’ is also reflected in the way staff care for people who are reaching the end of their lives. Mrs. Newman is working with other health care professionals to introduce ‘end of life pathways’ that are designed (in consultation with the patient) to make a person’s last days as comfortable and pain free as possible. Comments from a G.P. and a specialist nurse confirmed confidence in the staff’ attention to health care needs-‘making sure patients are reviewed regularly’. There was a comment from another health care professional that suggested staff relied too much on food supplements and should provide more staff to help with feeding. However, the next section of this report includes evidence that describes recent additional staff attention in making sure residents are supported to enjoy their meals and protected from a risk of malnutrition. Attention to residents’ nutritional needs has been developed since the arrival of a qualifed chef. He works closely with Mrs. Newman and has regular contact with the residents so he knows what is required. He was preparing a few liquidised meals, and some food supplements are used for those residents who are struggling to eat well. The chef is kept informed of residents’ weights so he can adjust individual diets if he notes any significant changes. The staff conduct a special assessment exercise every month so that they can identify any resident who is at risk of malnutrition. The staff feel they receive training that is relevant to the type of work they have to do. The records of one nurse included reference to training in medication, wound care, supra pubic lecture, dementia awareness and Mental Capacity Act during 2007. A care assistant had received a variety of instruction and training in 2007, including nutrition, dementia care and manual handling. Mrs Newman has strengthened the way medication is managed at the home e.g. she has changed the way medication is packaged and has arranged for two medicine trolleys to be available for use. Storage temperatures are being controlled and recorded so the medication is kept in good condition. A sample check of administration records and stock balances indicated that the nurses are following their procedures and handling the medication safely. They should be reminded to make sure two staff check handwritten entries for accuracy, and initial the administration record to confirm this has been done. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have varied and regular opportunities to get involved in activities that suit them. They are consulted about the running of the home and the way they prefer to spend their days. Mrs. Newman and the staff work hard to respect the wishes of each resident and their relatives. Residents and relatives appreciate a high quality catering service that is managed to be sure that it meets each resident’s dietary needs and preferences. EVIDENCE: Several visiting relatives were met at the home during the inspection visit. They were all very happy with the way staff welcomed them into the home and included them in decisions about care. A relative said she was always offered a cup of tea when she came into the home. The staff are ‘cheerful’-there was Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 14 mention of a male cleaner who always waves and smiles to greet visitors when he passes them in the home. Residents seen at the home were obviously spending their day as they wished-some preferring to stay in their bedroom, some sitting in communal lounges, and a few residents who spent part or all of the day resting in bed. One lady said ‘they always ask me if I want to do social activities but I prefer to read my magazines and books.’ Another lady said ‘we now go out for walks (I went out to the post box today), we do cooking, decorate cakes, bingo, music ‘n movement, concerts (we had one yesterday). I have lots of visitors so I don’t get bored’. A social care register provided records of these various social activities and individual residents’ participation. There is also a photograph album to show what entertainments etc. have been enjoyed in the past. A new chef has been appointed recently and he explained how he was managing the catering service with Mrs. Newman. The Commission visited the home in the Spring of 2007 to follow up a concern that the meals were not satisfactory. There were some shortfalls identified at this visit e.g. insufficient protein portions. It was, therefore, reassuring to hear from the chef that he had increased portion sizes and he actually goes out and buys meat from a local butcher. The amount of fresh produce has also been increased and menus revised to include more home made food. Residents and relatives have noticed the improvements made by Mrs. Newman and the chef. A relative commented that more residents are encouraged and supported to eat in the dining room now. A resident said ‘I had a lovely breakfast today-I ask for small food portions and its good wholesome food’. She also mentioned cookery sessions that the chef arranged for interested residents. Another resident also felt very satisfied with the catering service-‘the chef is marvellous-I have meals in my bedroom-my choice’. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives know how to raise concerns about the service and they are confident these will be listened to. The staff also feel confident they know how to respond to any concerns raised with them. Residents are protected from abuse through an ongoing programme of staff training and awareness of human rights issues. EVIDENCE: Residents and relatives know how to make a complaint and were confident their concerns would be received well. They are given a copy of the home’s complaints procedure. A resident said she would be happy to raise any concerns with Mrs. Newman and felt she would be ‘receptive’. Staff survey responses indicated that they knew how to respond to any concerns raised with them. The Commission has been made aware of two concerns about the service at Oaklands since the last key inspection. The first concern related to an unsatisfactory catering service. A random inspection identified a few shortfalls. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 16 Mrs. Newman has responded positively to these findings by undertaking a considerable amount of work to improve the quality of the meals. The previous section in this report describes significant improvements as a result of this attention. The second concern relates to fee arrangements and additional charges and had already been raised with the Providers by a concerned relative. The general situation regarding additional charges was checked during this inspection and found to be satisfactory. There is a record of all complaints made at the home and action taken in response to these. There were three entries during the past year and two of these were relatively minor issues-a dirty tooth pot and spoiled laundry (that was replaced by the Provider). The third entry related to the recent concern regarding additional charges. Keeping records like this demonstrates an open approach by the home’s management and this is the best way to make sure residents’ best interests are protected. There haven’t been any recent allegations of abuse arising from the service. There are various methods adopted at the home to protect residents from abuse. All staff receive training in abuse awareness and further training has been arranged for March/April 2008. Staff also receive guidance about the use of restraints. Mrs. Newman has familiarised herself with the Mental Capacity Act so that she knows how to protect the rights and best interest of residents who lack capacity to make informed decisions about their financial affairs and their healthcare. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recent investment has significantly improved the appearance of this Home creating a more comfortable and safer environment for those living there and visiting. The current building does not allow for some desirable improvements e.g. reduction in shared rooms, and the potential risk to residents from uncovered heated surfaces needs more robust management. There are firm plans to extend the premises during this coming year and further improve the quality of the accommodation and facilities. Keeping the home clean and hygienic is recognised as essential in protecting residents from cross infections, and staff have the guidance and equipment they need to address this. EVIDENCE: Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 18 The provider has done extensive upgrading work & redecoration since taking over in May 2004. Building regulation approval has recently been obtained for an extension to the premises. This will allow the Provider to sort out some of the more significant shortfalls. Residents are happy with their accommodation and their comfort is obviously taken seriously. A resident said-‘I like where my room is. I find it a bit darkthe window is small. I mentioned it to the owner and he immediately gave me a standard lamp’. Another resident was very happy with his bedroom. He used to have a room downstairs but he was offered another room because ‘I didn’t want to share and it was rather small’. The dining room has been refurbished and now offers a very pleasant area for residents to sit together at meal times. A staff member did say that the lift is very small and there is a need for wheelchairs in good working condition. However, a resident mentioned how staff check his wheelchair regularly and a new lift will be included as part of the extension work. Recent inspections of the service have identified concerns about the safety and efficiency of the central heating system. A requirement was made in a letter to the Provider in January 2006 ‘all radiators in the home where residents have access must be of a ‘low surface temperature’ type or must be covered to prevent burns’. Anyone who falls against a heated surface and is unable to move away from it is likely to suffer serious injury if these safety measures are not in place. There was a new heating system installed in 2005. In March 2006 the Provider confirmed that this made it possible to set temperatures centrally in the boiler room. However, two heating radiators were very hot to touch when the current inspection took place. Neither was covered to protect residents from potential injury. A resident did say that she had turned up her bedroom radiator that morning. This confirms that there is no central control of surface temperatures although records of monthly checks of radiator surface temperatures were being maintained at the home and did indicate satisfactory temperatures. An urgent requirement was, therefore, made in a letter to the Provider to assess related risks and to eliminate them as far as possible. Heating radiators were cooler when checked at the second visit of this inspection but there remains the potential for residents to raise the temperature by turning up individual radiator controls. The laundry, although small is functional and a good system is in place for the management of infection control. Infection control measures in the rest of the building are well addressed e.g. all resident bedrooms are supplied with liquid soaps and paper towels to encourage good hand washing procedures. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers of staff provided are sufficient to ensure that the residents care needs are met. The procedures for employment of staff have improved since the last inspection and offer protection for the people living at the Home. The procedures do need further revision to fully comply with current requirements. The homes induction policy & programme has been developed to ensure the safety of residents and staff. A programme of training is in place for nurses, care staff and support staff and this is generally effective. Where there is a need for more work this is already being addressed. EVIDENCE: Most survey responses suggested that there are always or usually enough staff on duty to meet the residents’ needs. There were one or two less positive responses e.g. a health care professional would like to see improved availability and communication with senior staff. However, two other health care professionals were satisfied with attention from staff. Staffing arrangements on the day of the first unannounced inspection visit were satisfactory with no evidence that residents’ care was being rushed or compromised. Residents confirmed this view-‘yes, there are enough staff and they treat me well. They normally knock on the door before they come in’. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 20 Mrs. Newman has adjusted duty rotas to better suit the needs of residents and availability of individual workers and she plans to try and reduce the level of staff turnover and improve the diversity of the staff team. The majority of staff survey responses confirmed their view that they get the training they need to meet the needs of the residents. Training records from a sample of two nurses and a care assistant supported this view. The care assistant qualified as a nurse in her own country but is not able to practice in England. She has completed national vocational qualifications (NVQ) at level 2 and 3 since coming to England and is working on an assessor award so she can assess other staff who are working on an NVQ qualification. There should be a higher percentage of care assistants who hold this award but nine were working towards it at the time of this inspection so there is clearly a commitment to improving the situation. Catering and housekeeping NVQ’s are also being offered to support staff. This is a good idea because these aspects of the staff’s work also play an important part in the overall service. Staff felt well supported by Mrs. Newman-‘Mrs. Newman is always availableshe spends a lot of time here’. When new staff are recruited they are carefully checked to be sure they will be safe to work with vulnerable adults e.g. written references and criminal records checks are completed before they start work. There are now requirements that this vetting is further strengthened by obtaining written verification of the reason why applicants have left previous caring positions, and making sure a full employment history is provided by the applicant (with any gaps explained). This additional work had not been fully addressed in the sample of staff records inspected at the home. Mrs. Newman has adopted an induction programme that is in line with national specifications. New staff also receive a preliminary induction to make sure they have all the information they need at the start of their employment e.g. fire procedures. Records of these induction programmes were available in a sample of staff files. A care assistant felt well informed and supported through regular staff meetings and Mrs. Newman’s responsive attitude. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36 and 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 managed by a qualified and competent manager who provides excellent leadership, guidance and direction to staff to ensure residents receive consistent quality care. There are systems for reviewing the quality of the service including consultation with residents. A system for the supervision of care staff has been implemented to ensure that the staff have the skills and competencies to meet residents care needs. Systems are in place to protect the health & safety of the residents and staff. EVIDENCE: Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 22 Staff, residents and relatives express considerable confidence in Mrs. Newman-‘superb management’, ‘Matron is marvellous’. She has extensive nurse management experience and staff feel well supported by her and describe regular opportunities to discuss their work. A couple of comments refer to some communication difficulties when Mrs. Newman is not on duty and senior staff are those who use English as a second language. Two staff from abroad communicated very well during the inspection and were able to discuss with clarity care plans and resident conditions. Mrs. Newman keeps her knowledge up to date so that the residents always benefit from emerging good practices and legislation e.g. she had familiarised herself with the implications of the Mental Capacity Act so that she could protect the rights of residents with limited capacity to represent themselves. The quality of the service is monitored through a quality assurance system that includes annual satisfaction questionnaires for residents, relatives’ meetings and regular updating of written policies and procedures. There are plans to further develop the system so that the findings can better inform future plans. The owners of the service visit the home frequently so that they can audit the running of the home and support Mrs. Newman. Mrs. Newman completed an annual quality assurance assessment report to inform this inspection. The report confirmed that data about the service is well recorded and easily retrievable and that the management team are achieving previously set objectives for improving the service and continuing to plan future work to this end. The owners and Mrs. Newman address health and safety through a regular programme of staff training, relevant policies and procedures for staff and regular audits of the premises. For example, a fire log is maintained at the home and this lists all the checks of fire safety equipment, training of staff in evacuation procedures and additional work either completed or planned to strengthen the safety of the residents’ accommodation. All bedroom doors are now fitted with magnetic catches and Ski pads have been purchased recently to assist with evacuation procedures. There are plans to extend emergency lighting to outdoor fire escapes. Key staff receive structured fire safety management training and other staff attend quarterly fire drills as well as in-house training on fire procedures. Water safety controls have been addressed by employing a specialist contractor to re-route pipe work etc. to deal with legionella. The contractor will review the water safety at the home at recommended intervals. Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 23 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 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 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 4 x 3 x 3 3 x 2 Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13(4)c Requirement Assess whether there are any unnecessary risks to residents from heated surfaces and, so far as possible, eliminate them. Immediate requirement contained in a letter to Mrs. Mawji dated 20th December 2007. Original timescale of 11th January 2008. Revised timescale relates to agreement with Mrs. Mawji on 11th January 2008 that she would submit action plan as response to requirement. Timescale for action 20/02/08 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 OP9 Good Practice Recommendations Handwritten instructions on medication administration records should be checked for accuracy by a second staff member and both staff should initial the record to confirm DS0000059478.V348466.R01.S.doc Version 5.2 Page 25 Oaklands Nursing Home 2. OP27 that this has been done. Visiting professionals and senior staff at the home should be consulted regarding the effectiveness of their communications when Mrs. Newman is not at work. Recruitment procedures should be strengthened by obtaining written verification of reasons why applicants have left previous caring posts, and by making sure applicants submit full employment histories. 3. OP29 Oaklands Nursing Home DS0000059478.V348466.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. 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