Inspection on 15/11/05 for Oak House

This inspection was carried out on 15th November 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.

Other inspections for this house

Oak House 24/09/07

Oak House 25/07/06

Oak House 08/03/05

Oak House 23/09/04

Oak House 30/03/04

Similar services:

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

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

CARE HOMES FOR OLDER PEOPLE Oak House [formerly Dove House] Chard Street Axminster Devon EX13 5EB Lead Inspector Teresa Anderson Unannounced Inspection 15th November 2005 11:00 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 Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oak House [formerly Dove House] Address Chard Street Axminster Devon EX13 5EB 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) 01297 33163 01297 33342 Ms Angela Martha Christina Baker Mrs Sarah Jane Mary Dennis, Mr Howard Norman Dennis, Mr David Malcolm Baker Ms Angela Martha Christina Baker Care Home 17 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (17) of places Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. If it is proposed to amend the Partnership Agreement in such a way that Mr David Malcolm Baker or Mr Howard Norman Dennis become actively involved in carrying on the care home or in its day to day management the partners will advise the Commission for Social Care Inspection in writing without delay. 29th June 2005 Date of last inspection Brief Description of the Service: Oak House provides care and accomodation for up to 17 older people who may have dementia. The house is a four story listed building which has been converted for use as a care home. It is situated in the heart of Axminster, on the main road through Axminster and close to all amenities. A passenger lift and two stair cases link all floors. The home has a large lounge divided into small seating areas and a lounge cum dining room on the ground floor. There is a further dining room in the lower ground floor, a part of which doubles as a staff seating area and a smoking area. The home has a courtyard garden at the rear and limited parking at the front of the home. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second programmed inspection of the year. As such this report should be read in conjunction with the report of June 2005. This unannounced inspection took place over three and a half hours when the inspector saw all of the communal areas of the home, some of the bedrooms and the office accommodation. Approximately six residents were spoken with, all of whom had communication difficulties, and more were seen. The inspector also spoke with one of the owners, the deputy manager and one other member of care staff. Records in relation to recruitment, resident’s monies, care plans, risk assessments and medication were inspected. What the service does well: What has improved since the last inspection? Since the last inspection all medication received into the home is being recorded. One bathroom where there was a risk of scalding has been risk assessed and appropriate measures put in place. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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 Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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 the following standard(s): These standards were all inspected in June. EVIDENCE: Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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 the following standard(s): 7 and 9 Resident’s benefit from a system of medicine handling that promotes their safety. Their safety would be further supported if risk assessments were improved. EVIDENCE: Care plans for residents who live at Oak House are, on the whole, comprehensive and contain good information about the resident, their families, lives, likes and dislikes. The system is well thought out and supports good care and good planning of care. Because many of the residents have a dementia type illness care plans should include detailed risk assessments that help staff to strike the balance between promoting safety whilst also upholding rights to freedom and independence. Whilst the deputy manager talked of how this is achieved for each resident, care plans did not reflect this information meaning that there is a risk of inconsistency care. The deputy manager had already recognised that this needed reviewing. Since the last inspection the minor changes needed to medication documentation have been made. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 10 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. Some residents may not have a lifestyle which meets their recreational needs and interests and some residents are not fully helped to exercise control and choice over their daily lives. Residents benefit from contact with the local community and with family and friends and from a diet which is healthy, varied and they enjoy. EVIDENCE: The management at Oak House work hard to support all residents to make choices and to receive care in a way that is preferred. This is achieved through a sound ethos, through training and through good supervision arrangements. However, some care plans lack the detail required to ensure that all staff have clear information and guidance about how each resident would like to live their days. For example, the preferred time of getting up or going to bed, how they like their tea and what they like their tea served in (mug or cup, china or pottery). These small things can mean a great deal when mental health is failing. Information about residents and their preferences can be particularly important when a resident cannot verbalise their needs and wants and/or has a tendency to challenge the service. For example, the deputy manager was able to describe in great detail to the inspector how to approach and speak with one resident who has a tendency to be easily irritated. This important information was not in the care plan. This lack of clear guidance potentially Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 11 puts the resident at risk of becoming upset needlessly and increases the risk of staff being verbally or physically attacked. In addition she told the inspector how this resident likes to be woken and her preference for sleeping late. Again these important details were not in the care plan. Oak House has a really good system for providing entertainment and for engaging with residents. There are planned activities on a daily basis, one to one interactions and trips out for those who are able. In addition many spontaneous interactions or activities take place. However, the majority of planned activities tend to be female orientated and include bingo, craft, cooking and card making. Some male residents do join in with some of these activities and with other activities such as quizzes. However, on the whole there is a definite female bias. Visiting at Oak House is encouraged without restriction, unless the residents impose these themselves. There are strong links with the local community and the home engages with the events of the local town by celebrating them within the town where possible or by bringing the events into the home. Residents say the food is good and menus show that there is plenty of variety of healthy food on offer. Those who require help are assisted discreetly and sensitively. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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 the following standard(s): These standards were inspected in June. EVIDENCE: Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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 the following standard(s): 25 One minor adjustment would ensure that residents live in an environment which is modified to their vulnerability and which ensures their safety. EVIDENCE: At the last inspection the owners were requested to carry out a risk assessment on sinks that delivered hot water at approximately 50C and to take actions that minimise risks of scalding. This has now been done. All baths have thermostatic valves ensuring that hot water is delivered at close to 43C. One bath was checked and the temperature was close to 40C. Whilst staff check the bathing temperature prior to the resident getting into the water, this is not being recorded. Such records would demonstrate that checks that the thermostatic valves are working are undertaken and would help staff to determine the bathing temperature that each resident prefers. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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 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): 28 and 29 Residents are safely supported by a staff group who are well trained, and are themselves well supported. Resident’s safety is promoted by the homes recruitment systems. EVIDENCE: Staff at Oak House are encouraged to take advantage of training opportunities. As such many staff are or have undertaken NVQ training. Two staff have successfully completed NVQ 3 and one is due to complete this shortly. Two staff have commenced NVQ 4 training and two of the care staff (in addition to the registered manager) are undertaking the Registered Managers Award. Recent additional training has included food hygiene updates, dementia awareness training and safe administration of medicines training. All new staff receive comprehensive induction training. Three staff files were inspected. Although the inspector did not have access to all the information required, this has been supplied subsequently. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 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 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 and 35. Oak House is well managed by a person who empowers both the staff and the residents. Service users benefit from a system of managing their personal allowances that keeps them safe and secure. EVIDENCE: The Registered Manager at Oak House is Angela Baker, one of the four owners of this home. She is at the home approximately 3 or 4 days weekly. Angela is a registered nurse (although this is not a home that provides nursing), holds an Assessors Award (can assess NVQ competence) and is currently undertaking the Registered Managers Award training. Angela strongly supports an ethos of empowering both the residents and staff. The latter are provided with a high degree of support and training which includes supporting two care staff to undertake the Registered Managers Award. Residents and staff alike feel the home is well run and that they are Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 16 able to approach the manager, care manager, deputy manager or any of the owners. Residents personal allowances are stored safely, in separate ‘accounts’ and are audited internally. Three accounts were checked. Records were complete, receipts matched the financial entries and all monies were correct. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 17 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x 2 x STAFFING Standard No Score 27 x 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x x Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 18 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 2 3 4 Refer to Standard OP7 OP12 OP14 OP25 Good Practice Recommendations The registered person should ensure that care plans contain all the details necessary to meet resident’s needs. These should also include detailed risk assessments. The registered person should ensure that planned social activities meet the needs of male as well as female residents. The registered person should ensure that care plans provide the detail necessary to help staff to give residents as much control over their lives as possible. The registered person should record bathing records prior to each bath. Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Oak House [formerly Dove House] DS0000057492.V259159.R01.S.doc Version 5.0 Page 20 - 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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