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Inspection on 09/09/05 for Forest Oaks Home For The Elderly

Also see our care home review for Forest Oaks Home For The Elderly for more information

This inspection was carried out on 9th September 2005.

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 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

The home has a dedicated team of staff who provide a high level of care to all the residents in the home. All the residents spoken to stated that the staff made them feel safe and respected at all times. Review of care for all residents is undertaken regularly and involves both the resident, and family members. The home places great emphasis on the residents being supported to maintain their maximum level of independence for as long as possible. The residents confirmed that the staff are very supportive and that they are always involved in the planning of any activities and social events in the home. Residents also told the inspector that the staff in the home were always respectful towards them and that "they were very happy living in Forest Oaks and would recommend it to anybody".

What has improved since the last inspection?

All the requirements and recommendations made at the last inspection have been addressed within the stipulated time scales. Care plans seen by the inspector are detailed and regularly reviewed. There is evidence that the residents and their families have been involved in the writing of the care plans. The number of domestic staff employed by the home has been increased and the cleanliness of the home is very much improved. It was reported to the inspector that the catering staff now have a structured cleaning programme for the kitchen and food preparation areas.

What the care home could do better:

Constant monitoring of staff and services provided in the home will ensure that a high standard of care continues to be provided.

CARE HOMES FOR OLDER PEOPLE Forest Oaks Nursing Home for the Elderly The Rise Brockenhurst Hampshire SO42 7SJ Lead Inspector Sue Maynard Unannounced 9 September 2005, 9:00 th 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 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 Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 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 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 Mrs Carol Sims Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than 16 beds may be used at any one time for service users who are in need of nursing care. 2 No more than 30 beds may be used at any one time for service users who are in need of personal care only. Date of last inspection 14/12/04 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 is purpose build some years ago and is housed on three floors and is surrounded by pleasant well-maintained gardens. The home is divided into two distinctive areas. All residential rooms have en-suite facilities and are accommodated 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. 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. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was the first of two statutory inspections for the year 2005/2006. The inspection was conducted by one inspector and lasted five and a half hours. The Registered Manager for the home was unavailable to assist the inspector during the inspection. The senior RGN on duty helped with the inspection and provided the inspector with documents and the information required by the inspector. The inspector toured the nursing wing of the home and spoke to members of staff and residents. No requirements or recommendations were made at this inspection What the service does well: What has improved since the last inspection? All the requirements and recommendations made at the last inspection have been addressed within the stipulated time scales. Care plans seen by the inspector are detailed and regularly reviewed. There is evidence that the residents and their families have been involved in the writing of the care plans. The number of domestic staff employed by the home has been increased and the cleanliness of the home is very much improved. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 6 It was reported to the inspector that the catering staff now have a structured cleaning programme for the kitchen and food preparation areas. 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. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 8 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 standard(s) 3 Arrangements for assessments are in place to ascertain the needs of the residents to be admitted to the home to ensure that their needs can be met. Standard 6 does not apply. EVIDENCE: A full pre-admission assessment is undertaken for all prospective residents to the home both for the residential wing of the home and the nursing wing. The majority of residents in the nursing wing have previously been living in the residential wing of the home and are now in need of nursing care. A reassessment ascertains their current needs. Evidence of these assessments were seen in the records. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7,8,9 and 10 The home ensures that arrangements for the personal and healthcare needs of the residents promotes their wellbeing and upholds their dignity. EVIDENCE: The inspector examined samples of records for four residents on the nursing wing. These were found to be very comprehensive and detailed. Information was available documenting the personal details of each resident including contact details for their next of kin, date of birth and the name of their GP. Risk assessments have been undertaken for nutrition, mobility, and risk of falls and tissue viability. Care plans detail all the care needs of the residents and the records showed that re-assessment and review of the care plans is undertaken at least every month. The resident or their representative has signed all the care plans. The records for one resident identified that there had been some significant weight loss. A new care plan had been written to address the changed needs and the action plan highlighted how these new needs were to be addressed. GP’s who visit record their findings and recommendations in the resident’s notes. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 10 On admission to the nursing wing of the home senior nurses discuss with the residents what their needs and expectations are and how they feel the home can meet these needs. Families are encouraged to be part of these discussions as the home thinks that family involvement is of great importance at all times. This ensures that the staff are carrying out all aspects of care with the full approval of both the resident and their family. Residents spoken to by the inspector told her that all aspects of their care were always fully discussed with them and that they were free to make decisions about all aspects of their daily lives. Medication records were found to be in order. A new policy and procedure for the disposal of all drugs has been compiled. These have been put in place to meet the new national guidelines that have been introduced for the safe disposal of drugs. A secure storage place for the drugs has been identified until the company responsible for their disposal collects them. The home is about to change to a new system of administration for their medication. The new system is to be implemented by the pharmacy that supplies all medications to the home and they will support the trained staff during the transition period. The trained nurse who was present during the inspection was very positive about the new system and thought it would rule out the possibility for any administration errors. The home maintains records for the receipt of medications to the home and for the medications that are to be disposed of. Residents in the home spoken to by the inspector confirmed that the staff are always mindful of their privacy and that the staff treated them with dignity and kindness at all times. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12,13,14 and 15 The management of the social activities creates a positive, varied and interesting life for the residents, which meets their expectations for living in the home. The arrangements for meals ensure residents have a nourishing and well balanced diet. EVIDENCE: The residents in both wings of the home are encouraged and supported to maintain the interests and social activities that they undertook prior to their admission. Three of the health care assistants working in the home have undertaken training for the provision of activities in a care setting. A very full programme of activities is provided. These include: Arts and crafts. Several of the residents are still able to follow their love of painting and some of their pictures are displayed around the home. Fund raising. The home has recently held a summer fete. Visits to local village events, such as the summer carnival in Brockenhurst. Activities within the home include, board games watching videos and discussions about current affairs. Arrangements for any activities are always discussed with the residents and their wishes are always respected. The families of the residents are always Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 12 made welcome and many of them attend social occasions such as the summer fete and cheese and wine parties and coffee mornings held in the home. All the residents spoken to by the inspector confirmed that they have no restrictions and are able to make choices about all aspects of their daily lives. The residents confirmed that they were given a choice of meals at each meal and that the kitchen would supply an alternative if they did not like the choices that were offered. Comments were made that the quality of the food was variable and that it changed depending on which chef was on duty. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 and 18 Complaints are handled objectively and residents are confident that their concerns are listened to and acted upon promptly. Staff are aware of the procedure for the protection of vulnerable adults ensuring that any suspicion of or allegation of abuse is dealt with appropriately. EVIDENCE: The home has a detailed complaints procedure that is available to all the residents in the home. No complaints against the home have been received by CSCI since the last inspection. Residents spoken to confirmed that they would report any concerns to the manager of the home or in her absence to the senior nurse on duty. They were confident that their concerns are always taken seriously and acted upon. Robust policies and procedures for the reporting of allegations of abuse within the home are in place. Staff members spoken to confirmed that they are aware of the procedure and that they receive regular training for the awareness and reporting of abuse within the care home setting. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 26 Standard 19 was not assessed at this inspection. Arrangements for cleaning in the home ensure that the residents live in a safe and comfortable environment. EVIDENCE: Requirements were made at the last inspection about the shortage of domestic staff affecting the standards of general cleanliness in the home. Additional domestic staff have now been employed and the home and the standards of cleanliness and tidiness of the home were found to be much improved. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Staff is employed in such numbers and the skill mix is satisfactory as to ensure that the needs of the residents are met. Staff undertake training that enables them to be competent to do their jobs. EVIDENCE: Staff rotas showed that the manager for the home ensures that the correct number of trained and care staff are on duty over a twenty-four hour period. In the event of staff sickness or annual leave, arrangements are made that other staff members or agency staff adequately covers any shortfalls in numbers. Generally comments from the residents spoken to were positive and they thought that the number of staff on duty were sufficient to meet their needs. Residents also stated that staff was always polite and caring. Staff spoken to confirmed that they have a very comprehensive training programme that has been implemented by the training co-ordinator employed by the home. The training programme includes: Safe manual handling and use of appropriate equipment Fire safety Infection control and all aspects of health and safety Abuse awareness First aid Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 16 Notification of training sessions were displayed on the staff notice board and staff members had signed to confirm that would be attending. Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards 33, 35 and 38 were not assessed at this inspection. EVIDENCE: Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 19 Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Forest Oaks Nursing Home for the Elderly H54 S11426 Forest Oaks V248112 090905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Hampshire Area 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. 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