Inspection on 10/08/06 for Forest Oaks Home For The Elderly

This inspection was carried out on 10th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Forest Oaks Home For The Elderly 13/01/06

Forest Oaks Home For The Elderly 09/09/05

Forest Oaks Home For The Elderly 14/12/04

Forest Oaks Home For The Elderly 27/05/04

Forest Oaks Home For The Elderly 25/06/03

Forest Oaks Home For The Elderly 29/10/02

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Forest Oaks Home For The Elderly The Rise Brockenhurst Hampshire SO42 7SJ Lead Inspector Marilyn Lewis Unannounced Inspection 10th August 2006 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 Forest Oaks Home For The Elderly DS0000011426.V302110.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. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forest Oaks Home For The Elderly Address The Rise Brockenhurst Hampshire SO42 7SJ 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) 01590 622424 01590 623555 The Wilverley Association Limited Glynis Anne Garman Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th January 2006 Brief Description of the Service: Forest Oaks is a care home providing personal care and accommodation for thirty service users and sixteen service users in need of nursing care. The home is registered to accommodate a total of 46 service users in the old age category of over 65 years. Forest Oaks is one of two care homes that is administered by the Wilverley Association Ltd, which is a registered charity and as such all the members of the governing committee are volunteers. The home was purpose built some years ago and is surrounded by pleasant well-maintained gardens. The home is divided into two distinctive areas. Residents in the residential rooms are accommodated in single rooms on all three floors of one wing of the home. The sixteen service users in need of nursing care are accommodated on the ground floor in single rooms. Forty-two of the forty-six rooms are fitted with en-suite facilities. Forest Oaks is situated in the New Forest Village of Brockenhurst and is close to the village amenities that are widely used by the residential service users. The registered manager stated in the pre inspection questionnaire that fees were £360 per week for service users in the residential wing and £673 for those requiring nursing care. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10th August 2006. The inspector toured the home and met with nine residents, a nurse, two carers, three visitors, the deputy manager and the registered manager, Mrs Glynis Garman. During the visit care plans were sampled for five residents and records seen included those for staff recruitment and training, complaints, accidents and fire safety training and fire drills. A specialist pharmacist inspector undertook a pharmacist inspection at the same time. This followed a medication error that was notified to the Commission for Social Care Inspection. The inspection involved looking at the medication handling procedures and looking at medication storage and records. What the service does well: The home had a relaxed, friendly atmosphere and residents spoken with said that the staff were friendly and caring and that they treated them with respect at all times. One resident said that staff were ‘lovely’ and another said that they were ‘very happy living at the home’. The registered manager or deputy manager undertake a care needs assessment for all who wish to become resident to ensure the home can meet their needs. Prospective residents and their relatives are able to visit the home, see the accommodation and meet with other residents before making a decision about living there. Residents are involved in the development and review of their individual care plans. The care plans seen provided good information for staff to follow to fully support the residents. Staff seek advice from GPs and other health professionals to ensure the residents health care needs are met. Residents know that any complaints will be taken seriously and will be acted upon. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 6 The home provides a clean, pleasant and homely environment for all who live and visit there. Residents spoken with liked their rooms and enjoyed spending time in the comfortable communal rooms and the gardens. A resident said that there always seemed to be enough staff on duty as ‘I don’t have to wait when I want some assistance’. A nurse also said that the staffing levels were good. Staff said that they received support and encouragement to attend training sessions and gain qualifications. Records seen indicated that staff had received training in health and safety issues including moving and handling and in the protection of vulnerable adults. Trained nurses said that they were able to attend training sessions required to maintain their personal development programme. Staff said that they received regular supervision and records seen confirmed this. The registered manager, who has been in post since January 2006, has many years experience in nursing and registered with the commission in May 2006. Residents and staff said that they felt able to talk with the registered manager at any time. What has improved since the last inspection? What they could do better: Medication procedures were not currently available to staff for reference, as the registered manager was reviewing them. It is important that this review is completed and staff have the written procedures available to work to or there could be inconsistent practice by nurses. Some residents hold and administer their own medications. However they had not had the risk of this assessed, which could put them or other residents at unnecessary risk. There was no information in the care plan of a resident who was prescribed a medicine to be given at a dose of one or two tablets, to guide staff on what dose should be given. This was putting the resident at risk by not having this medicine given in a clear and consistent way, which could have an adverse effect on their welfare. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 7 Controlled Drugs were stored securely but the cupboard was not of the required standard. Residents spoken with did not feel the food provided met their expectations. The registered manager was addressing this issue and had displayed alternative menus for residents to comment on before implementing the changes. Staff records did not contain all the information required to confirm that all the checks had been completed, including Criminal Records Bureau checks (CRB), to ensure the safety of residents. This was an outstanding requirement of the last inspection dated 13th January 2006. Records seen indicated that not all staff had attended a fire drill in the last year, which could put resident’s safety at risk. Some residents are independent and able to leave the home for visits to family and friends and shopping, as they wish. The home does not have a system in place to notify staff of which residents are away from the home should an emergency situation arise at the establishment. 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. Forest Oaks Home For The Elderly DS0000011426.V302110.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 Forest Oaks Home For The Elderly DS0000011426.V302110.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 and 6 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Prospective residents and their relatives are able to visit the home before making a decision about living there and a full care needs assessment is undertaken to ensure the home can meet their needs. The home does not provide intermediate care. EVIDENCE: The registered manager said that she was in the process of reviewing the home’s Statement of Purpose and Service User Guide so these were not assessed on this occasion. Records seen indicated that a full care needs assessment was undertaken by the registered manager or the deputy manager before people were offered a place at the home to ensure the home could meet their needs. The assessments seen for a person due to be admitted to the home were very detailed and contained risk assessments, the past medical history, current Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 10 medication and social interests. Reports from hospital staff for one resident were included in the assessments. The registered manager said that prospective residents and their relatives were welcome to visit the home before making a decision about living there. A resident confirmed this saying that she had visited the home and seen her room and met other residents before moving in. The home admits people for respite care but does not provide intermediate care. Forest Oaks Home For The Elderly DS0000011426.V302110.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Residents are involved in their care planning, their health care needs are met and they feel that staff treat them with respect. The lack of risk assessments for some of those residents who wish to selfadminister their medicines could put their health at risk. EVIDENCE: Care plans were seen for five residents, three who required nursing care and two who lived in the residential wing. The plans covered assessments on all aspects of care including mobility, pressure area care, nutrition and falls. Risk assessments included in the plans for moving and handling gave details of the specialist equipment to be used such as which type of hoist and what size sling. The care plans had been reviewed regularly and had been signed by the residents to confirm that they had been involved in the reviews. A resident said that she had discussed her care plan with a staff member and had agreed that it documented her wishes. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 12 Care at night was also recorded that included the residents preferences for having curtains open or closed, how many pillows and blankets they liked and whether the door should be left open or closed. Residents spoken with said that they were able to receive visits from their GP when they asked for one. Some residents made appointments to visit their GP at the local surgery and also went to see their optician and dentist as they wished. One resident said that she ‘liked to remain independent’. The records seen also indicated that residents were visited by other health professionals as required, such as the continence advisor and residents who required nursing care while in the home for respite were visited by the district nurse. A specialist pharmacist inspection was undertaken on the 10th August 2006 following a medication error, which was notified, to the Commission for Social Care Inspection. This inspection involved looking at the medication handling procedures and looking at medication storage and records. Medication procedures were not currently available to the staff for reference, as they were being reviewed by the manager, to include new procedures introduced following the recent medication error. It is important that this review is completed and that staff have written procedures available to work to or there could be inconsistent practices by the nurses. The standard of record keeping was adequate. Records were kept of medicines coming into the home and of any medicines disposed of. Records were kept when medication was given to service users. Whilst most service users had their medication given to them by the registered nurses some did hold and administer some of their own medications. However they had not had the risk of this assessed, which could be putting them or other service users at unnecessary risk. One service user was prescribed a night sedative medicine to be given at a dose of one or two tablets. There was no information available in the care plan guiding staff on what dose should be given. This was putting the service user at risk by not having this medicine given in a clear and consistent way, which could have an adverse effect on their welfare. Medication was stored securely for the protection of the service users. Medication cupboards and trolleys were clean and orderly with the keys being held by the nursing staff. Controlled Drugs were stored securely but the cupboard being used was not of a standard that complies with the Misuse of Drugs Act (Safe Custody) Regulations 1973, which the home must comply with being registered to look after people who need nursing care. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 13 All of the residents spoken with said that staff were caring, friendly and always treated them with respect. During the visit staff were observed to knock on doors and wait before entering and to address residents in a friendly but respectful manner. Forest Oaks Home For The Elderly DS0000011426.V302110.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Residents are able to exercise control over their lives, participate in suitable social, religious activities and receive visitors as they wish. The registered manager is addressing the issues over the choice and quality of the food provided that does not meet the resident’s expectations. EVIDENCE: Resident’s social interests and hobbies were documented in their care plans. A social board displayed in the sitting area near the dining room gave details of the social activities arranged and included painting classes, exercise sessions, manicures, video evenings and trips out for pub lunches and to places of interest. A resident said that boat trips for the disabled were arranged twice a year that were very enjoyable. The registered manager said that a ‘Pimms before lunch’ event was to take place in the gardens the next day and residents said that they were looking forward to it. Residents who wish are able to participate in a communion service held once a month in the home. One of the residents is a clergyman and he takes the Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 15 service and will provide communion for residents at other times on request. A resident also visits her local church in the week. Many of the residents in the residential wing are independent and go into the local town or visit friends and relatives, as they wish. Three relatives visiting residents at the time of the inspector’s visit said that they always felt welcome at the home and were able to visit as they wished. Residents spoken with all said that the food provided at the home was not as good as they would wish. Comments included ‘the meals are boring’ and ‘I can eat it but it is not really enjoyable’. Lunch on the day of the visit was a choice of braised steak or vegetable rissoles with buttered cabbage, carrots and mashed potatoes, followed by treacle tart and custard for pudding. One resident did not wish either option and had a cheese omelette. The meals looked well presented. The registered manager showed the inspector the results of a recent questionnaire survey on the quality of food provided that did not reflect the strong opinions voiced by residents on the day of the visit or the comments that had been made to the registered manager with regard to the food provided. Meals are provided by an external catering company and the registered manager had requested the cook to review the menus. A new menu had been developed for the remaining summer time. This was displayed for residents to make comments on the meals offered before the menu began the following week. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 16 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Residents know that all complaints will be taken seriously and acted upon and they are protected by staff awareness for the protection of vulnerable adults. EVIDENCE: The home has a complaints policy in place that indicates who will investigate the complaint and time scales for the process. The complaints records seen indicated that the three complaints received by the registered manager since the last inspection had been investigated promptly and acted upon. Three residents spoken with said that they would discuss any concerns they had with the registered manager and felt that they would be taken seriously and investigated. The residents also said that they would receive feedback on any actions to be taken. Records seen indicated that staff received training in abuse awareness and the home has procedures in place to be followed should abuse be suspected, including whistle blowing. Two staff members spoken with confirmed that they had received training and knew about the procedures. Forest Oaks Home For The Elderly DS0000011426.V302110.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. The judgement has been made using available information including a visit to the service. Forest Oaks provides a clean, pleasant, homely environment for all who live and visit there. EVIDENCE: The home was purpose built and provides accommodation over three floors accessed by stairs and a passenger lift. Residents are accommodated in fortysix single rooms, forty-two of which have en-suite facilities and the remainder are fitted with hand basins. Resident’s rooms particularly in the residential wing contained many personal items including small pieces of furniture, photographs and ornaments. The providers ask residents in the residential wing to, if possible, furnish their rooms themselves while in the nursing wing furniture and fittings are provided by the charity. Residents in the nursing wing are however able to bring their personal possessions if they wish. Keys are provided for residents who wish to Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 18 hold them and it was evident during the inspection visit that some residents liked to lock their room doors when they were not in the room. Residents spoken with in both wings said that they liked their rooms and thought them suitable for their needs. One resident said ‘I have all that I need’. The home has an ongoing programme of redecoration and refurbishment. New carpeting had been laid in the hallway and corridors and the carpeting in the main sitting room and small lounge was due to be replaced later in the week. In the library a new armchair had been provided that a resident said was ‘very comfortable’. The library provides a quiet room that residents said they often used for playing bridge. There is a separate dining room on the ground floor and coffee and tea is served in a lounge area nearby and in the main lounges. Residents may also have beverages and meals served in their rooms if they wish. A small kitchen is provided on each floor to allow residents and their visitors to make drinks and snacks and some residents, who have been risk, assessed as able to do so, also have the equipment in their rooms to make drinks as they wish. A call alarm system is available throughout the home and call alarms were seen to be available and accessible to residents, including those sitting in chairs in their rooms. Specialist equipment such as hoists is provided for residents assessed as requiring it. Sufficient bathroom and toilet facilities are provided on each floor. Visitors to the home are asked to complete the visitor record book on entering and leaving the premises. Some residents in the residential wing are independent and are able to leave the home as they wish such as when they wish to visit their GP, go shopping or visit friends and relatives. The home does not have a system in place for residents to indicate that they are leaving or re entering the premises and therefore staff do not always know if all the residents are at home or not. It would be best practice to put a system in place for residents who leave the home independently to document they are doing so. During the inspection visit it was noted that people were walking through the grounds of the home. The registered manager said that people visiting a local supermarket used a walkway along the drive of the home. Mrs Garman said that she would complete a risk assessment to assess the risk this poses to residents, particularly as some residents with rooms on the ground floor have doors that open out into the grounds. Residents have access to a pleasant garden area that has seats and tables provided. A resident said that they often sat with their visitors in the garden. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 19 At the time of the visit all areas of the home seen including the main kitchen looked clean and in good order. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Resident’s needs are met by the sufficient number and skill mix of staff employed by the home and by staff receiving the training required to do their jobs. Recruitment records for staff were stored in another home and therefore evidence that appropriate checks had been undertaken to ensure the safety and well being of the residents was not available. EVIDENCE: The home employs the registered manager, deputy manager, eleven nurses and nineteen carers. Separate staff are employed for administration, catering and domestic duties. Residents spoken with said that they felt sufficient staff were on duty at any one time. A resident said that when they rang the call bell for assistance staff came quickly. Five of the carers hold National Vocational Qualifications (NVQ) in care level 2 or above, three are currently in the process of completing the course and a further three are due to start the training in October 2006. When the three carers start their course in October the home will have met the standard for more than 50 of care staff to hold or be in the process of obtaining NVQ level 2 or above. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 21 At the time of the last inspection, dated 13th January 2006, a requirement was made for evidence of appropriate police checks, personal identification and written references to be available in all staff recruitment files. Records seen for five staff members during this inspection still did not contain all the information required. Two had dates for the completion of Criminal Records Bureau (CRB) checks and three did not have any information for the checks. One file only contained application and health check forms. Three files held two written references while another had one reference. The registered manager said that all the checks had been completed but that the main staff files were kept at another home owned and managed by the charity. When asked if the files could be brought to the home during the inspection, the registered manager said that the person responsible for the recruitment files was not available that day. A further requirement has been made for staff records to contain all the information required Schedule 2 of the Care Homes Regulations. Following the inspection visit the registered manager contacted the inspector to confirm that CRB checks had been completed for all staff employed at the home. The charity employs a training manager who is responsible for the training programme for staff in each of its homes. Records seen indicated that all staff received induction training that was in line with the requirements of Skills for Care. All staff received training in moving and handling, health and safety, protection of vulnerable adults, infection control and first aid. New staff members were expected to complete the induction course and then commence NVQ training. Two trained nurses spoken with said that they were encouraged and supported by the registered manager and the training manager to attend training sessions to maintain their personal development requirements. Nurses were linked to carers to train in areas such as continence care and palliative care. All trained nurses had attended training in the administration of medication in July 2006. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home is managed in the best interests of the service users whose financial interests are safeguarded by the home’s policy on handling money. Residents are supported by staff who receive regular supervision and training in health and safety procedures but their safety could be put at risk by staff who have not attended fire drills. EVIDENCE: Glynis Garman has been the manager of the home since January 2006 and registered with the commission in May 2006. Mrs Garman is a trained nurse with many years nursing experience and is due to commence the Registered Managers Award in September 2006. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 23 Staff spoken with said that they received good support from Mrs Garman and the deputy manager, whose main responsibilities are for running the nursing wing. Meetings are held, on a two monthly basis, for residents to voice their opinions about the quality of care provided at the home. Minutes were taken at the meetings and feedback was given at future meetings or in note format for each resident. Mrs Garman has an open door approach to management and residents spoken with said that they were able to speak with the registered manager or the deputy manager as they wished. Since Mrs Garman has taken up her post one meeting has been held for staff. The meeting was a general meeting for all staff. The registered manager said that arrangements were being made for separate meetings to be held for nursing staff and carers as well as general meetings to allow for discussions to take place that were relevant to each specific group. The charity also has a ‘House Committee’, a group of volunteers who visit the home and chat with residents and raise any issues voiced by the residents. Residents all said that they felt any issues raised would be looked into and that they would receive feedback from the registered manager. The home has procedures in place for handling resident’s money. Small amounts of money are held for some residents. Records seen indicated that receipts were kept for all transactions and that monies were stored individually and securely. Records seen for two residents matched the amount of money held. The registered manager and the deputy manager provide regular supervision for the nursing staff, who in turn supervise the care staff. A nurse spoken with confirmed that she received supervision and that she had received training to provide the supervision for care staff. Two carers also confirmed that they received regular supervision that covered all aspects of their work including training requirements and performance issues. The registered manager said that she was currently reviewing the home’s policies and procedures to ensure they provided staff with up to date information. Staff receive training in health and safety including moving and handling and fire safety but records for fire drill attendance indicated that seventeen staff members had not attended a fire drill in the last year. Following the inspection visit the registered manager notified the inspector that fire drills were being arranged for all staff who had not attended fire drills. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 24 Certificates and records seen for the maintenance of specialist equipment such as the hoists and bath aids and checks on electrical items indicated that regular checks were carried out. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 25 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 2 Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 26 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) 13(4)(b) 13(2) Requirement A document risk assessment must be in place for all service users who undertake to selfadminister their own medication. A controlled drugs cupboard, which complies with the Misuse of Drugs (Safe Custody) Regulations 1973, must be provided for the secure storage of any Controlled Drugs, including Temazepam, which are prescribed for service users. The review of policies and procedures, relating to the safe handling of medication, must be completed and copies made available to the staff. For the registered person to ensure individual protocols are produced for administration of medication prescribed ‘as required’ or at a variable dosage. The registered person must ensure that evidence of appropriate police checks, personal identification and written references be available in all staff recruitment files. This is an outstanding DS0000011426.V302110.R01.S.doc Timescale for action 07/09/06 2 OP9 05/10/06 3 OP9 13(2) 21/09/06 4 OP9 13(2) 07/09/06 5. OP29 Sch 2 Reg 7,9,19 30/09/06 Forest Oaks Home For The Elderly Version 5.2 Page 27 requirement of the inspection dated 13/01/06. 6. OP38 23 (4) (e) The registered person must ensure that staff attend fire drills at suitable intervals and that records of attendance are kept available at the home at all times. 30/09/06 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 OP38 Good Practice Recommendations A system that records service users leaving and returning to the premises would enhance the security of service users. Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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 Forest Oaks Home For The Elderly DS0000011426.V302110.R01.S.doc Version 5.2 Page 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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