CARE HOMES FOR OLDER PEOPLE
Oak House Chard Street Axminster Devon EX13 5EB Lead Inspector
Teresa Anderson Unannounced Inspection 24th September 2007 10:30 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 DS0000057492.V341718.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. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Oak 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 oakdash@aol.com oakdash@aol.com Mrs Angela Martha Christina Baker Mrs Sarah Jane Mary Dennis, Mr Howard Norman Dennis, Mr David Malcolm Baker Mrs 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 DS0000057492.V341718.R01.S.doc Version 5.2 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. Date of last inspection Brief Description of the Service: Oak House provides care and accommodation for up to 17 older people who have needs relating to old age and/or dementia. The house is a four-storey 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 staircases link all floors. The home has a large lounge divided into smaller seating areas together with a dining room on the ground floor. There is a further dining room in the lower ground floor, a part of which sometimes doubles as a staff seating area. The home has a courtyard garden at the rear and limited parking at the front of the home. Information about this service, including CSCI reports, is available direct from the home. As at September 2007 the fees charged range from £300.00 to £795.50 (double room) per week. Additional charges apply for items and services such as transport, escort service for hospital services, newspapers and chiropody. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. One inspector carried out the site visit that started at 10.30am and finished at 6.00pm. During that time we looked closely at the care and services offered to three people as a way of judging people’s experiences and the standard of care and accommodation generally. Where possible we spoke with these people in depth. We also contacted relatives and health or social care professionals involved in their care. We looked at their care assessments and care plans closely, and spoke with staff about their knowledge and understanding of these plans. We looked at their bedrooms and we looked at the overall environment from their perspective. We also spoke with approximately 10 other people living here, with the managers, the owners, with carers and with kitchen and domestic staff. Some of the people living here have dementia and are unable to engage in the inspection process or have a conversation with us. We looked at how they were engaged and how staff interacted and engaged with them as a way of helping to gauge their wellbeing. We looked around the building at all communal areas and saw many of the bedrooms. We looked at records including medication, staffing, accident and incident reports, training, fire safety and recruitment. Prior to the visit to the home we sent surveys to 10 people who live here and 5 were returned; to 10 relatives and 3 were returned; to 10 care staff working at the home and 4 were returned; to health and social care staff and 4 were returned. Their feedback and comments are included in the report. In addition, and before we visited the home, the owners provided information about the management of the home and an assessment of what the home does well and what they plan to improve upon. What the service does well:
People who consider coming to live at this home have the information they need on which to made a decision. They are assessed before they move in to ensure that the home can meet their needs and are helped to settle into the home. Each person living here has a plan of care and his or her healthcare needs are well met through timely and appropriate referrals to health and social care professionals. People say ‘they look after me well’ and ‘I get all the care I need’. People also say that staff respect their privacy and dignity and we saw examples of this during the inspection. People say that staff are ‘caring’ and
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 6 ‘kind’ and that they feel safe making their grumbles known, and safe generally. Staff have training in ‘safeguarding adults’ and demonstrate a good understanding of this. All staff, except one, hold or are working towards a National Vocational Qualification in care which is well above the recommended standard of 50 . People living here mostly have their social needs met although the owners are aware that this is an area that needs to be kept under review. Activities include trips out on the local charabang (which are a real favourite) arts and crafts sessions and line dancing. Visitors are made welcome and kept informed about changes and updates. The food provided at this home is cooked on the premises and provides variety and nutrition. People tend to eat the main meal of the day in one of the two dining rooms, but can have it in their bedroom if they wish. Comments about the food included ‘it is good’, ‘average’ and ‘very nice and lots of it’. The Registered Manager of this home is also one of the owners. She has appointed two deputy managers and has recently reviewed the organisation of the home to ensure that services are more person centred and responsive. People’s belongings are kept safe and secure. What has improved since the last inspection? What they could do better:
Information about this home is available to people considering coming to live here and has recently been updated. However, it is not yet available in a format that might help those people with dementia to be involved in the decision about where they live. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 7 Those people with diabetes should have a plan of care that gives staff clear instructions. These should include the range of blood sugar results that are considered normal for that person and instructions to follow if results fall outside these limits. Care plans should also always include instructions for staff on how care is to be given so that they can all give consistent care. This should include information about how people are to be helped to remain continent or how their incontinence is to be managed. In addition any care given or changes to the plan should be recorded so that reviews are meaningful. All medication given or applied by staff should be signed for at the time they are given and by the person who gives them. In addition all medications leaving the home should be recorded to ensure that all medicines can be accounted for. Staff should also know the temperature at which medicines should be stored so that they can ensure this happens. Peoples social needs should be kept under review to help ensure that their needs and preferences are met and to help prevent boredom. The standard to which their clothes are cared for should also be kept under review. The general maintenance of the home needs to improve. This includes ensuring that sash windows open and close without risk of injury and maintaining window frames to prevent further deterioration. We have requested a plan of routine maintenance from the owners so that we can see their plans. In addition infection control procedures need to improve with the provision of liquid soap, paper towels and pedal bins. The plan of the home to be used in case of fire should be updated, doors should close to prevent the spread of fire and any freestanding appliances should not pose risks of potential scalding. Policies and procedures relating to the management of the home should be reviewed annually, and where necessary, amended to ensure that staff have up to date information based on best practice. Staff should not be allowed to use their own ‘bonus point’ cards when making purchases on behalf of the people who live here. 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. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 8 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 DS0000057492.V341718.R01.S.doc Version 5.2 Page 9 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, 2 and 3. Standard 6 was not inspected as this home does not provide intermediate care. Quality in this outcome area is good. People who come to live here can be assured that their needs will be assessed and that they will be helped to settle in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has developed a guide to the home that is informative and comprehensive. This includes some photographs of the home so that people who are unable to visit before moving in can see the home. In addition to this there is a shorter guide which acts as a quick reference guide. All the people who responded in surveys say that they (or a member of their family) have a contract and that they had enough information about the home to make a decision. One person explained that they had been invited to look around the home but felt they had enough information in the brochure.
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 10 As this is a home for people with dementia, it is good practice to have information available in a simple format. This is not yet available. Prior to admission to the home being agreed each person is assessed by one or both of the owners. These assessments cover all their needs, ensuring that the home can be sure that they can meet those needs. One health care professional who visits the home reported overhearing a carer being less than sensitive to a person who had recently moved in. When asked people say that whilst some staff are better than others, they were generally helped to settle in by staff who were thoughtful and helped them to personalise their rooms with their belongings. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 11 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. The people who live here have their health needs met although care planning and recording could be improved to help ensure consistently good care is given. Peoples’ medication needs are met but record keeping in relation to these need to be improved. People’s privacy and dignity is respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys the people who live here say that they always receive the medical support they need and when spoken with they say that staff call the doctor or nurse quickly when needed. Records in people’s care plans confirm this. In addition care plans demonstrate that people see allied health professionals such as the chiropodist, optician and dentist as needed. Healthcare professionals who visit the home say that staff generally seek advice and meet people’s needs.
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 12 Care plans demonstrate that people are assessed and actions are taken in relation to preventing falls, pressure sores and malnutrition. No-one living here has a pressure sore and records show that people fall infrequently and that people’s weights are stable or increasing. Care plans also contain information relating to that person’s normal routine helping staff to follow each person’s routine and not the routine of the home. There is evidence in one care plan that staff have engaged healthcare professionals to improve this persons quality of life in relation to helping them to be continent. However, staff are not recording the effects that interventions are having and it is therefore difficult for healthcare professionals to evaluate the outcome. In addition care plans do not routinely provide information on how staff should help people to remain continent or to manage their incontinence. One visitor told us that sometimes the person they visit needs a clean pad and a wash. We noted in one care plan that the person this plan related to had experienced an acute episode of illness and the instructions about how this should be managed had not been well documented. Whilst staff spoken with demonstrate a good knowledge about what to do, not recording what needs to be done might lead to inconsistent delivery of care. Another person is described in their care plan as ‘aggressive’. There is no account of what this actually entails or what might bring these episodes on. Staff spoken with demonstrate an excellent understanding of what might make this person upset and they know what to do to prevent this. These instructions are not written in the care plan meaning that not all staff have this understanding and therefore not all staff are supporting this person adequately. Another person living at the home has diabetes. This person manages their own insulin injections and their blood tests. However, the care plan does not record an assessment of this person’s ability to manage their own injections. When spoken with, this person understanding of how to give their injection was incomplete. The care plan does not contain instructions relating to what is considered a normal or abnormal blood result for this person, and this person and staff do not know. Neither does the care plan contain instructions about what should be done if this persons blood results fall outside these normal limits. Staff report that this is being addressed. We looked at the medications of the people living here and found that staff generally manage them well and understand the medications they give. Notes in the diary indicate that some staff forget to sign when they have given some medicines and we found evidence of this on medicine charts. We counted the number of tablets that some people should have and found these to be in order. We also looked at records relating to some people who had left the
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 13 home. These are mostly in order. However, we found that when people are transferred out of the home to another care environment that the medicines that go with that person are not recorded. We also found that the fridge where medicines are kept might be running at a temperature that is too high as we recorded temperatures of 9C and 10C when the fridge had been opened for only a short time. At the last inspection we found the room temperature of the room where medications are kept was too warm. A fan has been installed in this room and this now feels cooler. However, staff are not aware of the temperature at which medicines, whether refrigerated or not, should be stored at. In surveys healthcare professionals say that this service respects peoples privacy and dignity always and sometimes. They say this depends on who is on duty. When spoken with people say that staff are generally good at this. Staff were seen ensuring that people’s personal care was given in private and were seen to sensitively help people to remain covered when for example lap blankets slipped. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 14 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 and 15. Quality in this outcome area is good. Improvements made are helping the people who live here to have their social care needs met although some people say they get bored. Support is offered in a way that promotes choice and flexibility. People benefit from a diet which is varied and nutritious and which they generally enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This service provides a programme of activities that includes weekly line dancing, arts and crafts, a coffee morning, cake decorating, trips out and tabletop games. In surveys one person says they always enjoy the activities offered and others say usually or sometimes. When spoken with people say they like the music and ‘doing things’. One person said ‘I like to sit and watch’, another said ‘I like the trips out’. However, they also say, they get bored. Since the last inspection the person who organises activities and how the work at the home is managed has changed. Staff say they want to work more
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 15 ‘holistically’ with the people who live here, responding to individual needs and doing more spontaneous things like reading the newspaper with/to people or taking people out to the shops. This has yet to commence. The activities organiser also has plans to help improve the quality of people’s social lives by involving care staff in engaging with people socially. Some of the people who live here have dementia and cannot participate in some activities. However, we observed signs of positive engagement with staff and signs of well being. People were smiling, made eye contact frequently, spoke with people respectfully and helped them to make choices. Visitors to the home say they are made welcome and that they are mostly kept up to date with changes. In surveys the people who live here say that they like the meals served at the home. Some people comment that there is more than one cook and that people have their preferences regarding their different styles. Another said that the food is always good. One cook reports that he is currently carrying out food and hygiene training and the owner reports that this person has also had training in cooking for people with diabetes. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 16 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 and 18. Quality in this outcome area is good. People who live here have their complaints heard and acted upon. They are kept safe and are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The commission has received three complaints about this service since the last inspection. All were referred to the owners to investigate. One complaint resulting in the owners identifying that a member of staff needed more support and training, and the other two were not upheld. The home has a clear complaints policy that is in the guide to the home. In surveys people say they know who to make a complaint to, and many comment they had not need to do this. Some relatives comment that they have the private telephone number of the owners and the owners confirm this is given to all the relatives of the people living here. The care plan of each person living here contains a reminder for staff that people have the right to make complaints and that these should be taken seriously and investigated. People say that they feel safe and well cared for. One person said staff are always lovely. Staff have received training in ‘Safeguarding Adults’ and demonstrate a good knowledge of what abuse is and what to do if an allegation were made.
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 17 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 and 26. Quality in this outcome area is adequate. People living here enjoy their surroundings but these are not maintained well enough and some practices are putting people at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys people say the home is always fresh and clean. One person wrote ‘this is a very nice home to live in’. A relative wrote ‘a clean and welcoming environment’. However, when we arrived at the home the hall smelt of urine. When we looked around the home we found a bucket full of dirty water in the laundry. We also found that staff are using bar soap in the laundry instead of liquid soap as is good practice to prevent cross infection. We found that in some rooms liquid soap dispensers are empty and/or that there were no paper
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 18 towels available. One toilet had all the necessary equipment for hand washing but the positioning of the pedal bin made it unusable for some people. One of the owners carries out maintenance together with a maintenance man. Although some decoration is taking place, the home does not have a programme of routine maintenance. The wood in some of the upstairs windows needs attention. One sash window has to be kept open using a wedge, presenting a risk of injury. One person in an upstairs room says they get cold. Staff have provided this person with a free standing heater which becomes very hot to touch. This person has little sight and is being placed at risk of being burnt. No risk assessment had been undertaken. Fire checks are carried out as required by the fire services and staff demonstrate a good knowledge of what to do. During the inspection the fire alarm sounded and staff reacted appropriately. However, some doors can become wedged open by uneven floor surfaces and the plan of the building for use if there were a fire was written in 1991. Rooms are identified by number but staff do not know what these room numbers are because the rooms have names not numbers. In surveys some people say that more attention should be paid to how people’s clothes are cared for and that sometimes wardrobes are filled with pads leaving little room for clothes. We looked in wardrobes and found that there was room for clothes. The owners say that care of people’s clothes has been an issue and they are addressing this. One of the managers reports that they have recently been granted funding for a shower room and a sensory garden. It is planned that this work will be completed by December. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 19 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 adequate. People are supported by well trained staff who are employed in numbers which meet their needs. However, practice in relation to recruitment is potentially placing people at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys people, relatives and healthcare professionals say that some staff are better than others. The owners have recognised that communication needs to be improved and have put in place both staff and organisational changes as a way of addressing this. When spoken with people say that staff are kind and helpful and they don’t usually have to wait too long to get attention. The duty rota shows that each morning there is a manager on duty together with a shift leader and two carers. Until 8 or 9pm there is a shift leader and two carers and at night there are two waking carers. During the week extra support is provided by two administrators, the cook, a cleaner and an activities co-ordinator. Staff report they have a good induction which meets their needs and that they are never asked to care for anyone outside their area of knowledge or
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 20 expertise. The owners report that they have improved induction training by incorporating recommendations made by ‘Skills for Care’. All staff, except one, have a National Vocational Qualification (NVQ) in care or are working towards this. In addition extra training is provided based on the needs of the people living here. This includes basic and advanced training in caring for people with dementia. We looked at the recruitment files of three people working at the home. None contained all the information that is needed to ensure that robust recruitment procedures help to protect people. Two contained only one written reference; one contained references from friends; one did not contain an application form; one showed that a police check had been carried out after the person had started working at the home. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 21 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. People living here benefit from a home that is well managed, responsive to feedback and aims to improve safety and person centred care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager of this home is one of the owners, who also own two other care homes. As a consequence she is not at this home on a day-to-day basis and has appointed two managers. One of these holds the Registered Manager’s Award and one is a Nurse who is currently registered with the Nurses and Midwifery Council and has recently worked in a hospital environment. Staff say they work well with the managers and the owners.
Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 22 They say they are well supported and that they get good training. This training includes mandatory training in moving and handling people, fire training and infection control. People living here say they ‘like living here’ and they are’ happy here’. Established quality assurance systems are in place and include an annual satisfaction survey, residents and staff meetings. Good practices in relation to food and hygiene in the kitchen were observed. Records of fridge and freezer temperatures are kept and all areas appeared clean. A recent visit carried out by the Environmental Health Officer resulted in one recommendation only. The owners report in the pre-inspection questionnaire that the temperature of hot water is controlled by thermostatic valves in all sinks and in baths to prevent accidental scalding. We ran the hot water in some sinks and baths and found the water to be hot but not scalding. Staff report they always check the temperature of bathing water before bathing anyone and have recently replaced some thermometers to ensure that they work properly. Monies kept on behalf of the people who live here are kept safely and securely and access to this is limited. We checked three personal allowances and found them to be in order and all monies spent had a receipt. It was noted that individual staff members are using their own ‘bonus point’ cards when carrying out shopping for residents. They do not have their permission to do this. The questionnaire completed by the owners prior to the site visit indicates that they have an understanding of what the home does well and what needs improving. It also indicates that a number of policies need reviewing, as this has not happened for some years. Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 23 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 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 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 4 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 24 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 OP8 Regulation 12 (1) (a) (b) Requirement Timescale for action 31/10/07 2. OP9 13 (2) The normal blood sugar parameters for any person who has insulin dependent diabetes must be recorded together with the actions that need to be taken if blood sugars fall outside these normal limits. This will help to ensure that people are helped to stay healthy and that staff take appropriate actions when needed. In order to ensure that all 31/10/07 medications can be accounted for and to prevent errors, all medications given must be signed for by the person who gave them (including creams). In addition, all medicines leaving the home must be checked and recorded. Where people are looking after any of their own medicines, that person should be assessed in order that their competence is demonstrated, and this should be kept under review. In order to ensure that people
DS0000057492.V341718.R01.S.doc 3. OP9 13 (2) 31/10/07 4. OP19 23 (2) (b) 31/03/08
Page 25 Oak House Version 5.2 5. OP19 23 (4) are cared for in a suitable environment the premises must be kept in a good state of repair both internally and externally. This includes ensuring that window frames are well maintained and that sash windows are safe. In order to ensure that adequate precautions are taken against the risk of fire the Registered Manager should consult with the fire authority regarding the plan of the home used for fire purposes and those doors that do not close properly. A risk assessment should also be carried out and action taken in relation to the free standing heater being used. 31/10/07 6. OP26 13 (3) 7. OP29 19 In order to protect the people 31/10/07 who live here and staff from infection, washing facilities including liquid soap, paper towels and usable peddle bins must be provided. In order to protect the people 31/10/07 who live here from being cared for by inappropriate individuals robust recruitment checks must always be carried out on all staff. This includes all the information listed in Schedule 2. 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 OP1 Good Practice Recommendations Information about the home should be available in a
DS0000057492.V341718.R01.S.doc Version 5.2 Page 26 Oak House format that might help people with dementia to be involved in the decision about where they live. 2. OP7 All care that is planned and delivered should be written down in the care plan so that all staff know what actions need to be taken to meet needs. This should include information about how people are to be helped to remain continent or how their incontinence is to be managed. Staff should know the temperatures at which medicines should be stored so that they can ensure that medicines are stored safely. The social needs of people living in the home should be kept under review and these people should be helped to have a fulfilling life. A programme of routine maintenance should be produced and implemented so that priorities for repair and maintenance of the home can be determined to prevent further deterioration. How well peoples clothes are cared for should be kept under review and actions taken, if needed. When staff help people to buy items they must not use their own ‘bonus point’ cards. Policies and procedures should be reviewed annually, and where necessary amended to ensure that staff have the information they need and this is based on best practice. 3. OP9 4. OP12 5. OP19 6. 7. 8. OP26 OP35 OP38 Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Oak House DS0000057492.V341718.R01.S.doc Version 5.2 Page 28 - 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!
