Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Oak Bank Care Home Oak Bank Manchester Lancs M9 5YA The quality rating for this care home is: The rating was made on: new service which has yet to be given a quality rating A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Geraldine Blow Date: 2 2 0 1 2 0 0 9 Information about the care home
Name of care home: Address: Oak Bank Care Home Oak Bank Manchester Lancs M9 5YA Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sarita Labhwantee Chohan Type of registration: Number of places registered: Unity Homes Limited care home 64 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability 0 1 Over 65 63 1 Conditions of registration: Date of last inspection Brief description of the care home Oak Bank Care Home is registered to provide accommodation for up to 64 older people. The home has very recently been taken over by Unity Homes Limited. The home is located in the Harpurhey area of Manchester. Local shops and amenities are within easy walking distance of the home. There is a well-maintained garden area to the front, rear and side of the property. The back of the property provides a patio area. There are ample parking facilities at the front of the property. At present there are 58 single and 3 double rooms. All rooms are provided with a wash hand basin and two Care Homes for Older People Page 2 of 11 single rooms offer en-suite facilities. There are several lounge and dining areas and a hairdressing room on the first floor. Care Homes for Older People Page 3 of 11 What we found:
At the end of October 2008, we (the Commission) received a copy of a letter sent to the registered manager of Oakbank Nursing Home. The letter detailed a number of concerns and recommendations made following a review of eighteen residents living at the home, by a care manager from Manchester social services. A follow up monitoring visit was undertaken in December 2008 by the care manager and a contracts officer from the Local Authoritys contracts unit and again concerns were identified. These concerns were then discussed as part of a Safeguarding strategy meeting. During the strategy meeting other concerns were identified, that had been raised by various health care professionals. At the time of the original concerns being identified the home was registered to the previous provider. The new provider took over ownership of the home on 16 January 2009. As a result of the concerns raised it was decided to carry out a random (unannounced) inspection to focus on the following issues: To ensure the environment is clean and odour free. To ensure the sluice equipment is in working order and appropriate infection control measures are in place. Ensure basic moving and handling equipment is available. To ensure that individual care plans are detailed and clearly identify residents needs, wishes and personal preferences. There is an accurate record of care given. To ensure that residents privacy and dignity is respected and residents are not routinely sat in nightwear from mid afternoon. The visit took place on 22 January 2009 by Geraldine Blow, Regulation Inspector and Liz Williams, Regulation Manager. At the time of the visit the manager was on maternity leave. During the time spent at the home we spoke to the deputy manager, the manager who is responsible for the residents assessed as requiring personal care only and the son of the new provider. In addition we also spoke to several people living at the home and some members of staff. Several care files were examined and a tour of the building was undertaken. During a tour of the building it was identified that not all areas of the home provide a well maintained environment for the people living there. However we were assured that a complete refurbishment of the home is planned and we are to be sent the proposed plans for that refurbishment. It was of concern that the sluice room was being used a store room. Clean bedding, Care Homes for Older People Page 4 of 11 including quilts, quilt covers, blankets, pillows, wheelchairs and walking frames were being stored on shelving to one wall, in the sluice sink and in front of and by the side of the sluice sink. Due to the risk of cross infection staff were requested to remove all the stored items from the sluice. We were told that the sluice sink was being used to wash bedpans and urinals, however access to the sink was severely restricted due to the items being stored. There were no up to date infection control policies, procedures or guidance available. Due to the concerns raised we contacted the Infection Control Nurse who said she would arrange a visit to home to offer advice. The staff spoken to detailed the moving and handling equipment available for use. These included 2 manual hoists and slings, a moving and handling belt, a slip board and 2 slide sheets. We were informed that it was the intention of the new provider to purchase electric hoists for use in the home. Three care files were examined and shortfalls were identified in each file. Not all of the residents care needs had been incorporated into the individual plans of care. For example, it was identified that one resident had Dementia and could be verbally abusive and argumentative. A plan of care had not been implemented to address this care need, which could put the resident, other residents and staff at potential risk. It was also of concern that there was an entry from a health care professional stating that the resident was at a particular health risk. There was nothing documented what had been done to address this risk and when asked staff said they knew nothing about it and as far as they knew no action had been taken. None of the care files examined had a social care plan. Care plans were not seen to promote personal choice or preferences. For example all files seen documented that residents were to be offered the chance of a bath or shower at least once a week and the daily evaluation entries evidenced that a bath or shower was only given once a week and not offered in between. In discussion staff said that most people are in bed by approximately 7.00pm. There was no evidence in the care plans that this was the persons preferred choice of daily routine. It was also stated that only people assessed as needing bed rest would go to their rooms in an afternoon. Care plans need reviewing, to ensure that wherever possible, they fully reflect the persons wishes in all aspects of their daily living. There was a bath book which listed when residents had a bath, had their hair done and included residents weight recordings. This is seen as very institutionalised; it does not promote the individuality or dignity of residents and is in breach of The Data Protection Act as there were numerous residents details on one page. There was a daily evaluation record. However many of the entries were vague and from discussions with staff it was clear that the record did not accurately reflect the actual care given. It was also of concern that a member of staff altered a care plan by crossing out an identified care need to monitor a persons blood sugar levels without carrying out a review of that particular care plan. Care Homes for Older People Page 5 of 11 It was of concern that of the fluid records seen the last recorded drink, for residents receiving nursing care, was consistently 5pm. This means that either the recording of fluids was not accurate or residents were going from 5pm until 8.00am or 8.30 am without any fluids. During the course of the visit residents were seen to be dressed in day clothes, unless it was their choice to be in nightwear. Staff told us that sometimes residents do wear nightclothes in the afternoon or early evening but that it is always their choice to do so. However, this statement could not be evidenced as it had not been documented in their individual plan of care or in their daily log. It was discussed with staff that to promote privacy and dignity residents should be encouraged, where possible, to dress appropriately for the time of day or if it is their choice to wear nightwear that their personal preferences are clearly documented in their care plans and evidenced in the daily evaluation. Care plans did state that staff maintained the privacy and dignity of people when providing personal care. However, a member of staff was seen shaving a resident whilst he was sitting in a communal area. It is recommended that this activity is carried out in the privacy of their own room or bathroom. Residents spoke highly of the staff at the home. One person said that staff are good, they look after us. Residents said they enjoyed the food, however two people said that they do not always ask for an alternative to the main menu or for second portions as staff would have to run around. One person had chosen to remain in their room in the morning, only coming out to eat their lunch. Staff were seen to support this person to eat in an environment of their choice, by providing a meal in two different areas so that they could choose where they were most comfortable eating. It was of concern that most residents who were sat in chairs in the lounges had portable tables in front of them. This was discussed with staff, with one member of staff saying that they would only remove the tables if they felt the resident was very steady on their feet. The use of the tables in this way is regarded as a form of restraint and must only be used after a full risk assessment process has been followed, taking into account the persons capacity to make decisions under the Mental Capacity Act. What the care home does well: What they could do better:
There must be a system in place to reduce the risk of cross infection in accordance with current legislation and published professional guidance. We have contacted Infection Control with our concerns and they are to undertake a visit to the home to offer advice and guidance on infection control. To ensure the health and safety of the people living at the home all recommendations made by Infection Control must be met and it is recommended that up to date infection control guidance, policies and procedures are implemented. Care Homes for Older People
Page 6 of 11 The care planning process needs improvements to ensure that all personal, social and health care needs of the residents are being appropriately met. The plans of care should include details of residents personal choice and preferences. An accurate record must be maintained of residents fluid intake so that appropriate action can be taken if sufficient fluids are not taken. It is recommended that all records promote the dignity of residents and that advice is sought to ensure that records are kept in line with The Data Protection Act. Risk assessments must be undertaken, taking into account the residents capacity to make decisions under the Mental Capacity Act before any form of restraint is used. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 13 A full risk assessment must be undertaken, taking into account the residents capacity to make decisions under the Mental Capacity Act. before any form of restraint is used To ensure that no resident is unnecessarly subject to any form of restraint. 30/01/2009 2 7 15 Each resident must have a 19/02/2009 detailed plan of care for each identified care need. To ensure that the health and welfare of residents is fully met. 3 8 17 An accurate record must be maintained of residents fluid intake. To ensure that residents are sufficiently hydrated and appropriate action can be taken if sufficient fluids are not taken. 29/01/2009 4 26 13 All recommendations made by the Infection Control nurse must be met. 19/02/2009 Care Homes for Older People Page 9 of 11 To reduce the risk of cross infection and ensure that any unnecessary risk to the health or safety of residents are identified and so far as possible eliminated. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 7 1. It is recommended that all records promote the dignity of residents and that advice is sought to ensure that records are kept in line with The Data Protection Act. 2. It is recommended that residents individual plans of care include details of their personal choice, preferences and social care needs. 3. It is recommended that the daily evaluations are written in sufficient detail to accurately reflect the care given over a 24 hour period. 2 3 10 26 To ensure the privacy and dignity of residents any personal care should be carried out in their bedroom or bathroom. It is recommended that up to date infection control guidance, policies and procedures are implemented. Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
