Inspection on 18/09/07 for Little Oaks Residential Home

This inspection was carried out on 18th September 2007.

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.

Other inspections for this house

Little Oaks Residential Home 11/10/06

Little Oaks Residential Home 07/02/06

Little Oaks Residential Home 10/08/05

Little Oaks Residential Home 03/02/05

Little Oaks Residential Home 22/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Little Oaks Residential Home Braxted Road Little Braxted Witham Essex CM8 3ED Lead Inspector Brian Bailey Unannounced Inspection 18th September 2007 10:20 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 Little Oaks Residential Home DS0000017869.V351087.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. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Oaks Residential Home Address Braxted Road Little Braxted Witham Essex CM8 3ED 01621 891974 N/A 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) Mrs Gillian Elaine Valentine Mr John Rand Valentine Manager post vacant Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 13 persons) 11th October 2006 Date of last inspection Brief Description of the Service: Little Oaks is an adapted detached property situated in the village of Little Braxted and close to Wickham Bishops. The home is in a rural setting but is near to a bus route. The nearest town is Witham where there are facilities such as shops, pubs, banks, supermarket, library and a post office. Accommodation for people at the home is provided on two floors and consists of eleven single and one shared bedroom, all rooms have en-suite WC facilities. A lounge/dining room overlooks the rear garden, which is private and secure. The home has a passenger lift. The home provides accommodation for older people with low to medium dependency levels. The aim of the home is for residents to live as independently as possible and be fully supported in their physical, emotional and social needs. The fees range from £358.00 to £494.00 depending on the source of funding. The cost of newspapers, toiletries, hairdressing and chiropody is additional. Inspection reports are available from the home and from the CSCI website www.csci.org.uk Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was looked at when compiling this report. Information held by us that included an annual quality assurance assessment completed by the manager and documentary evidence held at the home was examined, such as menus, staff rotas, care plans and staff files. Thirteen survey forms were returned to us from relatives, people living at the home and staff, which is a good response. The overall view of people is that the home is meeting people’s needs and expectations. A visit to the home took place on 18th September 2007; this included a tour of the premises, discussions with the manager and members of staff and conversations with people living in the home and visitors. Observations of how staff interact and communicate with people living in the home and their visitors have also been taken into account. On the day of the inspector’s visit the atmosphere in the home was relaxed and welcoming and we were given every assistance from the staff and people at the home. What the service does well: What has improved since the last inspection? Improvements have continued to be made at the house that include; the building of a new conservatory that leads from the dining room/lounge to the back garden, the provision of a new bath and hoist in the ground floor bathroom and the redecoration of rooms and the fitting of new carpets. Work was also in progress to convert a room on the first floor for use as a therapy room for people at the home. Policies and procedures had been amended following recommendations made at the last inspection of Little Oaks. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 6 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. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. Quality in this outcome area is good. People who use this service can expect to have the information they need to make an informed choice about entering the home and have their needs assessed prior to admission. The home does not offer intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose was seen at the last inspection and considered to contain up to date information about the service offered by Little Oaks, and met the requirements of the national minimum standards. The care records of two people were checked. These showed that the manager had visited and carried out an assessment of need before being able to confirm that the home would be able to meet the persons’ needs. The home does not provide an intermediate care service. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 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. 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. People who use this service can expect to have a care plan to help staff to meet their needs and have their health care needs met. They can also expect to be treated with respect and be protected by the medication administration practice. EVIDENCE: Care records for two people were checked. These continued to cover areas of care such as personal hygiene, dressing/undressing, nutrition, continence, cognition, communication and personal safety. There was also information about the social interests and family involvement of people. There were assessments for moving and handling and records of people’s weight. The care files contained information about the health care professionals involved with each person. There was also a record of any visit made to or by health care professionals and contact details for GPs, community nurses, chiropodist, optician and social workers. Each of the files contained a life history and recent photograph of the resident. The method of recording when Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 10 reviews of care plans have taken place should be recorded more methodically with the date and the name of the person completing the entry. Regulation 37 reports received from the home indicate that health needs are appropriately monitored and met. Two visitors spoken with said they had no concerns about the home and felt confident about the quality of care provided. Both said they were able to visit at any time and were always made welcome. The lunchtime medication round was observed. Practice was considered safe. People were offered ‘as required’ (PRN) medication and helped to manage tablets if they needed it. The medication administration records (MAR sheets) were inspected and found to be completed correctly. The practice of two carers checking that medication was administered and both signing records has continued and acts as an additional safeguard. From observation and discussion with people at the home and their visitors, it was evident that there are no restrictions or rules about where people have to spend their time. People were seen to come and go as they please and confirmed that they choose where they want to go. One person who was being cared for in bed was visited frequently to ensure there was nothing they needed. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. People who use this service can expect to be encouraged to maintain contact with family and friends, be offered meaningful activities and have a balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each individual’s file seen had a record of the activities the resident had been offered and participated in. They covered a range of sessions including, art and craft, going out to the pub, attending a church service, having a hand massage and nails painted and being visited by the ‘pat dog’. One person was passing their time knitting with the support of a staff member, and in the morning a game of bingo was held when most people joined in. Two people spoken with said they liked to have the choice of joining in with activities or not depending on how they were feeling. One person spoke of preferring to rest in their bedroom, whilst another person said they enjoyed reading, which took up most of their day. Visitors spoken with said there no restrictions as to when they could visit and were always made welcome by the staff. From observation, visitors had established excellent relationships with staff. They could visit their relative in Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 12 the communal rooms or in the person’s own room. They considered communication to be good and that they were kept informed about the health and care of their relative. All the individuals’ files seen had contact details of their next of kin, GP and social worker if relevant. Tables in the dining room were well laid out for meals with napkins and specialised cutlery if required. People were offered a choice and were served individual meals from the adjoining kitchen. The menus showed that a roast dinner is offered at least once a week. The evening meal choices vary from soup, sandwiches and a hot snack such as an omelette, cheese on toast or jacket potatoes. There was fresh fruit available for people to help themselves. The cook said most soups and cakes were home made. A buffet tea is organised for a people’s birthday and a birthday cake made. A good selection of food stock was available in the kitchen and the food storage cupboards, which were being replenished on the day of inspection. Food was stored and labelled correctly. People spoken with were complimentary about the food and said they had sufficient. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to have their complaints taken seriously and be protected by staff knowledge from abuse. EVIDENCE: The home’s complaints policy offers an investigation and feedback for any complaint. Residents and visitors spoken with were all clear about who to approach if they had any concerns. No complaints about the home had been received by CSCI. Survey forms returned to CSCI show that the majority of people know how to make a complaint although two people that live at the home said they didn’t. The manager has been trained as a trainer for POVA training. Staff spoken with said that they had received up to date POVA information and training. This was confirmed by documentary evidence. Staff were clear about their duty of care and the home includes a whistle blowing policy in the guidance for staff. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that live at this home can expect to live in a comfortable, homely and clean environment that has regular maintenance. People have benefited from the programme of improvement that has continued over the past year. EVIDENCE: Little Oaks is a detached two-storey property that has been adapted to meet the needs of older people. Bedrooms are located on the ground and second floor, which is accessed by a passenger lift. A number of bedrooms were seen and they were all personalised and furnished to an acceptable standard. Work has continued to upgrade the rooms and changes were in progress to convert a shared room for use as a therapy room. The home has a large lounge and dining room that is comfortably furnished and light and airy, overlooking the garden. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 15 Other improvements made include the provision of a new bath and hoist in the ground floor bathroom, new carpets fitted, the redecoration of some bedrooms, new worktops and cupboards fitted in the kitchen and a new conservatory erected in the back garden with access from the lounge/dining room. Further plans include redesigning the rear garden with a patio area. The home’s maintenance person has worked at the home for many years and from discussion is familiar with all aspect of the property. One of the comment cards returned to CSCI had remarked on the poor state of the garden. There were no unpleasant odours noted in the home on the day of inspection. The laundry was clean and tidy with all products that are subject to control of substances hazardous to health (COSHH) regulations safely stored. The home has a policy for the management of soiled linen and provides protective clothing for staff to prevent cross infection. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 16 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. People who use this service can expect to be supported by sufficient, welltrained staff to meet their needs. EVIDENCE: The duty rosters showed that during the day there were four carers for the morning shift, three for the afternoon shift and two for the night, one of those doing a sleep-in. In addition the manager worked most days as supernumerary and there was a cook in the kitchen. There is also a maintenance person. For the number of people accommodated as at September 2007, the staffing levels are considered to be good. Two staff files were checked. There was evidence to show that two references, a criminal record bureau disclosure check (CRB) are undertaken and staff contracts and conditions being held. Supervision records and supervision agreements were seen and showed staff had supervision approximately every eight weeks. From discussion with all staff, it was evident they had received training on POVA, Health & Safety, medication, moving and handling and food hygiene. Training certificates were available in the office. Records were also available to show that staff are provided with induction training. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 17 Of the fourteen care staff employed, five have obtained a National Vocational Qualification at level 2, which means that more staff will need take this training if the home is to meet the recommended target of 50 of staff are trained. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 18 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to have their opinions sought and be protected by the practice and procedures in the home. EVIDENCE: The home has established a good management team of staff that work well together. All staff spoken with were positive about the way the home is managed and all were very knowledgeable about the varying care needs of people that live at the home. The registered manager has a number of years experience working in residential care and has attained relevant qualifications for the post they now hold. Senior staff have also undertaken a number of training courses that enables them to train other staff on a range of topics. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 19 The system for managing peoples money has remained unchanged and was considered to be well organised at the last inspection. The home completed an Annual Quality Assurance Assessment, which was returned to us in CSCI. The information contained in this document has proved helpful and has contributed towards the completion of this report. The home has their own Quality Assurance system, which is reviewed regularly and the views of people at the home are sought. Surveys returned to us were generally very positive. One staff member stated, “The running of the home is very organised and streamlined. A person living at the home stated, ”Everybody here always tries to please you more” and “I cannot criticise anything” and finally a relative in response to a question about what the home does well stated, “Spending time with the residents and relatives, friendly, noting is too much trouble, caring and attentive and visiting hours are not restrictive. Some certificates for maintenance checks carried out on equipment were inspected. Fire alarms and emergency lighting are checked weekly and refrigerator and freezer temperatures are done daily and recorded. The home’s liability Insurance Policy expires on 22nd August 2008. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 20 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 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 Standard No Score 16 3 17 X 18 3 3 3 X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 21 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. 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 OP28 Good Practice Recommendations The manager should continue with plans to for more staff to take a National Vocational Qualification at level 2. Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Little Oaks Residential Home DS0000017869.V351087.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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