CARE HOMES FOR OLDER PEOPLE
Oakbridge House 455 Petre Street Grimesthorpe Sheffield S4 8NB Lead Inspector
Janice Griffin Unannounced 13 May 2005 7:30 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. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Oakbridge House Address 455 Petre Street Grimesthorpe Sheffield S4 8NB 0114 2420068 None None Oakbridge Health Care limited 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) Manager Postion Vacant N Care home with nursing 78 Category(ies) of OP Old Age (10) registration, with number DE (E) Dementia - over 65 (78) of places DE Dementia (10) Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The minimum numbers of staff on duty must comply at all times with the staffing levels submitted to the CSCI on 16th July 2004. Date of last inspection 14 March 2005 Brief Description of the Service: Oakbridge House provides a care service for 78 service users. The home is purpose built, and all areas within the home can be easily accessed by service users. There is a large car park to the front of the property and although the home is large it has been divided into smaller living units. Bedrooms are situated over three floors and service users can access these by using the lift. There are 66 single and 6 double bedrooms and all have en suite toilets and sinks provided. Extensive refurbishment is currently being undertaken at the home. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day between 7.30 am and 1.45pm. A tour of most parts of the home was carried out. A number of records, relating to those living in the home and management paperwork were checked. Time was spent talking with groups of service users in communal areas and individually with three service users. As the home accommodates some service users with dementia, time was spent observing the interaction between staff and service users. The provider, manager, and four members of the staff team were also consulted. What the service does well: What has improved since the last inspection?
The top floor had been refurbished, new carpets and furniture had been fitted to the bedroom and communal areas. The inspectors observed the breakfast and lunch being served and the quality of the food served was good. Service users said that they enjoyed the meals provided. Drinks and snacks were offered between meal breaks. Records of service users fluid and food monitoring are kept. The manager, staff and service providers have worked extremely hard over the last few months to improve the quality of the service provided. It was a pleasure to visit the home and see such a vast improvement in the care offered to the service users, the quality of parts of the environment, the meals provided, the attitude of the staff and the management of the medication systems. The temporary manager is commended for the efforts she has made to improve the service provided at this home. Staff said that they had received much more training, which has helped them to understand the service users care needs. Service users and staff commented upon a more ‘static’ staff group who seemed to enjoy working at the home which resulted in there being a pleasant relaxed atmosphere, described by one service user as being ‘the next best thing to home’. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 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. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 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 Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 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) These standards were not checked at this inspection they will be checked at a future inspection. EVIDENCE: Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 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) 8,9 and 10. Improvements had been made to the safe storage, administration and recording of medication. The service users had adequate supplies of their prescribed medication Service users told the inspectors that they were treated with respect and the staff respected their privacy and dignity. The inspectors observed staff closing doors and speaking with respect when assisting service users. Some service users on the ground floor had dirty fingernails. EVIDENCE: Service users who were able could retain control of their own medication, a lockable facility was provided to store such items. Records were kept of medication received, and disposed of. The member of staff spoken to confirmed that she had been trained to administer medication. A pharmacist had checked the home’s medication systems at regular intervals. All medication was noted to be securely stored. This promoted the safety of service users. Some service users on the ground floor had dirty fingernails this does not ensure that measures are in place to avoid cross infection. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 10 Staff interacted well with the service users, furthermore they were observed closing bedroom, toilet/bathroom doors when attending to service users. This promotes the dignity of service users. Bedrooms seen were personalised and observation of the interaction between service users and staff confirmed that personal autonomy and choice were well considered. This contributes to promoting the well being of service users. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 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) These standards were not checked at this inspection they will be checked at a future inspection. EVIDENCE: Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 12 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) These standards were not checked at this inspection they will be checked at a future inspection. EVIDENCE: Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 13 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) 19, 24 and 25. The home was very clean, with no unpleasant odours noticeable. Service users said their rooms were well maintained and kept clean. Since the last inspection a major refurbishment of the top floor has occurred. Other parts of the home did not come up to the required standards but the refurbishment of these areas should be completed by the end of the year. EVIDENCE: Since the last inspection a major refurbishment of the top floor has occurred. Corridors, bedrooms and lounges have been redecorated and new carpets and furniture has been purchased for the communal areas. This has markedly improved the standard of the environment on the top floor making the home a comfortable place to live. Bedrooms seen were personalised and looked homely. This confirms that personal autonomy and choice were well considered and respected by the staff team. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 14 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) 27,28 and 29. Staff were employed in sufficient numbers to meet the needs of the current numbers of service users (42). The recruitment information obtained for new staff was insufficient. The manager was ensuring that all staff were undertaking training which enabled them to meet the needs of the service users in the home. Some staff were not competent when assisting service users with mental health problems. EVIDENCE: Two staff members were trying to calm down an agitated service user and their efforts made the service user more agitated, it was clear from the observations made by the inspectors that some staff were not fully trained to deal with service users with mental health problems. This does not ensure that the service users are in safe hands at all times. The recruitment information obtained for new staff was insufficient, as gaps were noted in some staffs employment history. This does not adequately protect the welfare of service users who live at the home. Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 15 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) 31 and 38. There have been improvements in the management of the home, which has led to a more professional better-trained workforce; this will ultimately benefit the health, safety and welfare of the service users. The current manager is temporary as the manager’s post is vacant. A fire door was not fully closing on its rebate. EVIDENCE: Staff said the temporary manager was a good leader, professional and approachable. Her strong leadership qualities have been a major factor in the improvements to the quality of the care provided at the home. This ensures that the home is run for the benefit of the service user. Staff spoken to had an understanding of the home’s fire procedures; they had received training on moving and handling, fire and food safety. No fire exits were blocked and hazardous substances were securely stored, one fire door was not fully closing on its rebate. This does not promote the safety and welfare of the service users.
Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 16 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 1 x x x 1 x 1 x STAFFING Standard No Score 27 3 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x x x x x x 2 Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15,16 Requirement The service users care plans must contain all of the required detail as specified in the National Minimum Standards for older people. More information is required particularly in relation to service users leisure and social needs.This requirement has been outstanding since 2004. The service user plan must be discussed with the service user and their relatives. This plan must be regularly reviewed and reassessed. Minutes of each review must be retained on individual files.This requirement has been outstanding since 2004. The range of activities at the home must be increased for all service users according to their personal choice and preferences.The appropriate leisure and recreational equipment must be provided by the home for each individual according to their personal choice and preference.This requirement has been outstanding since 2004. Timescale for action 1/8/05 2. 8 15 1/8/05 3. 12 16 1/12/05 Oakbridge House J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 18 4. 19 23 5. 24 16 6. 24 16 7. 27 18 8. 31 8 9. 10. 11. 12. 28 29 38 8 18 18 23 13 Repairs and redecoration must be made to service users bedrooms and all communal areas.This requirement has been outstanding since 2004. Two double electric sockets must be provided in all service users bedrooms.This requirement has been outstanding since 2004. Service users bedroom doors must be fitted with a suitable lock that is in good working order.This requirement has been outstanding since 2004. The previously agreed staffing levels must be maintained at all times unless agreed by the CSCI.The vacant care staff post must be recruited to.This requirement has been outstanding since 2004. An application to register a manager must be submitted.This requirement has been outstanding since 2004. All care staff must have training on dealling with service users with mental health problems. Gaps in stffs employment history must be explored. All fire doors must fully close on their rebates. Staff must ensure that service users finger nails are kept clean. 1/12/05 1/12/05 1/12/05 1/7/05 30/6/05 1/7/05 Immediate Immediate Immediate 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 28 Good Practice Recommendations A minimum ratio of 50 of care staff must be trained to NVQ Level ll by 2005 (excluding the registered manager and registered nurses).
J55 38471 Oakbridge V218782 13.05.05 UI Stage 4.doc Version 1.30 Page 19 Oakbridge House Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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