Inspection on 15/12/05 for Oak House Residential Home

This inspection was carried out on 15th December 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 Residential Home 03/10/07

Oak House Residential Home 05/04/06

Oak House Residential Home 07/06/05

Oak House Residential Home 25/02/05

Oak House Residential Home 13/07/04

Oak House Residential Home 26/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Oak House Residential Home Pond Lane Greetham Rutland LE15 7NW Lead Inspector Paula Dutton Unannounced Inspection 15th December 2005 10:00 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 Residential Home DS0000006462.V272520.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 Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oak House Residential Home Address Pond Lane Greetham Rutland LE15 7NW 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) 01572 812647 01572 813633 Mr Donald Walker Mr Donald Walker Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability over 65 years of age (2) of places Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person falling within category PD(E) may be admitted to the home when 2 persons of that category are already accommodated within the home. 07/06/05 Date of last inspection Brief Description of the Service: Oak House is a residential care home for older persons situated in Greetham in the heart of Rutland. It is registered to care for twenty-two residents. Oak House is situated in an old building with much history. As the home has developed the building has undergone extensive renovation retaining much of it’s traditional character. The home is carefully and appropriately furnished and is tastefully decorated throughout. All bedrooms have en-suite facilities with toilets and sinks, and eight en-suite facilities have baths fitted with mechanical hoists. Although two rooms are registered to accommodate shared occupancy, they are currently under single occupancy. There are two lounges for residents and a separate dining room as well as additional seating located around the home. The outside of the building has undergone significant improvements and development continues. There is a large landscaped garden, with raised beds and walkways. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of one day. The owner and manager were available during this inspection. A tour of the premises took place and seven residents spoke to the inspector. One member of staff was interviewed about care practices. Discussion took place with the assistant manager. Two residents’ records were viewed plus the accident record and staff rota. A visiting doctor spoke to the inspector. This process of gathering information is known as ‘case tracking’ and considers outcomes for residents. What the service does well: This is a very well managed service. Some strengths within the service include: • • • • • • • • Clear and supportive daily contact with the owner. Continuity and stability within the senior team. Daily contact with the chef who speaks to each resident about their choices. Responsive and productive professional relationships with outside health professionals. Careful and consistent care for those who are bedbound. A specific member of staff working with residents to promote the use of occupational therapies. All rooms have ensuite toilets and hand basins but, in addition, eight rooms offer an assisted bath within the ensuite facility. A programme of investment and continual improvement to the premises offers an exceptional environment. Some comments were received from residents: • • • ‘It’s all good here’. ‘Yes we can get about easily’. ‘The food is good and you always have a choice’. Some comments were received from a visiting Doctor: • • • • ‘The home is well run and staff always show an interest in the welfare of residents’. ‘Staff are timely in contacting the surgery and demonstrate a good understanding of health needs’. ‘Consultations occur in residents’ bedrooms privately’. ‘I can’t think of any negative comments’. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 Residential Home DS0000006462.V272520.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 Residential Home DS0000006462.V272520.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): 3, 4, 5 Information is exchanged between potential residents and the home so that an informed decision about moving to the home can be made. EVIDENCE: Discussion with the owner and manager demonstrated there is a good exchange of information so that all parties can make informed choices about whether or not the home is suitable to meet the needs of a potential resident. A trial period is offered to new residents before making the decision to reside permanently at the home. A discussion took place with the owner about gathering information prior to offering a trial stay to a potential resident. The owner and manager showed a professional approach to assessing individual needs and consideration to the existing dynamics within the home. Discussion occurred between the inspector and owner about the home’s registration details and how those inform the admissions process. Oak House Residential Home DS0000006462.V272520.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, 8, 9, 10, 11 Through clear leadership, good relations with health professionals and caring staff the residents’ health and welfare needs are met. EVIDENCE: The home provides a written care plan and risk assessments for each residents. These documents are written by the manager and consultation takes place with the resident and/or their family. Evidence of care plans showed each identified need is recorded and the actions to be taken by staff to meet those needs. Discussion took place with the manager about compiling a specific care plan for skin care after seeking advice from a District Nurse. A commitment was made by the manager to review skin care needs of residents where necessary. The residents who receive medication have medicines individually stored within their ensuite facility in a lockable metal cupboard. Some creams were viewed for a resident who had skin care needs. One cream was labelled ‘store in a fridge’ but was not stored correctly. A commitment was made by the manager to review the storage of creams where necessary. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 10 Care plans showed assessment and instruction had been recorded to address the mobility needs of residents. Those at risk of falls were identified within care plans through a Falls Assessment Tool which measured the overall risk of falls. The manager is planning to complete training in how to be a moving and handling trainer. This will have a positive effect on the management of the risk of falls. The accident record showed any incidents of falls. A group of residents who all used walking frames discussed how they felt safe by using a walking frame. They stated they were free to move about the home as they choose. All residents stated the staff team were very kind and respectful. Observation found staff communicated effectively with residents. A resident stated staff always responded to her bell and were always happy to assist her. A visiting doctor stated the staff were always interested in the welfare of the residents. Discussion took place with the owner and manager about the bed care provided to a resident whilst she was dying. This resident was successfully cared for over a period of 18 months. An interview with a member of staff showed a detailed and practical knowledge of skin care and pressure area management had been acquired during this experience. This member of staff demonstrated a good level of awareness of what to look for and how to prevent pressure areas deteriorating. The manager stated she would considered refresher training for staff in the prevention and management of pressure areas. Bedrails were in use for a resident and permission to use bedrails had been gained from relatives. A discussion took place about accessing the Health and Social Care Protocol with the District Nursing team so that appropriate Delegated Tasks forms and risk assessments can be generated. A commitment was made by the manager to ensure this happens. Discussion took place about how the overall staff team provided support to relatives at a time where a resident was expected to pass away. The senior team recounted an event where support for relatives was sensitive, timely and practical. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 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 the following standard(s): 15 The service offers a good standard of food and drink to ensure residents’ nutritional needs are met. EVIDENCE: The owner and manager stated there is a varied and nutritional choice of meals offered around a 24 hour period. Observation found the kitchens to be clean, tidy and organised. The chef leaves the kitchen every day to go into the home. He meets with all of the residents to offer a choice of dinner and tea. The chef stated although choices are offered sometimes residents will make specific individual request which are accommodated. A group of five residents confirmed there are choices offered daily and they receive good food. The chef was aware of the needs of residents with dementia care needs and described how the team achieve a profile of preferences through offering choices of foods and observing the outcome. A record is kept of choices based on observation of those residents. This is good practice. If the chef finds a resident is not feeling so well that information is taken into account when offering a choice of food and drink. The chef will monitor residents’ welfare and pass on observations through written communications to the overall care staff team to follow up. This is good pratice. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 12 Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Residents’ rights are upheld and staff ensure residents are protected from abuse. EVIDENCE: The home offers a complaints policy and procedure. There have been no formal complaints in the last six months. Discussion took place briefly with five residents. The group agreed if they had any concerns they would approach the staff or the office. The home has policies and procedures to address the issues around abuse and how to prevent abuse of older people. A member of staff was interviewed on this subject. She demonstrated an awareness of different types of abuse and various sources of abuse. This member of staff had a good understanding of what was unacceptable. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Residents can access a safe, equipped and homely environment. This environment offers high standards and positive outcomes for residents. EVIDENCE: Discussion took place with the owner and manager about the continuing programme of investment and renewal in the property and environment. Careful consideration is given by the owner to any changes to the environment and the needs of the residents. All external areas of the property and grounds were very well maintained. A tour of the premises found all areas of the home to be very clean and tidy. Evidence was seen of residents’ personal property and possessions. All areas of the home were very tastefully decorated with small furnishings and fixtures throughout. All bedrooms offer ensuite toilets and hand basins. Eight of the bedrooms offer an assisted bath within the ensuite facility. Communal bathrooms are also Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 15 available including a bathroom offering an electrically operated Arjo assisted bath. A call bell system is fitted throughout the premises. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 There are sufficient numbers of competent staff on duty to meet the needs of residents. EVIDENCE: Evidence was seen of the staff rota. This detailed who was on duty. Additionally there was a list per duty of expected duties to be completed each shift. A member of staff is specifically employed to undertake occupational therapy tasks and exercises after consultation with an Occupational Therapist. This is to maintain the finer dexterity skills and hand-eye skills retained by residents. The night shift had been divided up and reflected on the rota so that staff completed noisier tasks at appropriate times. The phones to the building are redirected to the owner’s property during the night so that residents are not disturbed. The on - call support from the senior team is provided from the cottage to the rear of the property. The owner resides at the cottage and has renovated this property so that in the event of evacuation all residents will have access to this property. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 17 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, 32, 37 The service is effectively managed so that residents’ safety is ensured. EVIDENCE: The manager of the home demonstrated a good understanding of the needs of older people. The manager has a professional background in nursing and is currently commencing the Registered Manager’s Award and National Vocational Qualification in Care (Level Four). The manager is committed to promoting the safety of residents and is planning to complete training held at the British Red Cross in how to be a moving and handling trainer. The manager completes risk assessment tools for falls and monitors the number and nature of accidents occurring within the home. The owner, manager and assistant manager lead a friendly team of staff. A member of staff confirmed the staff team are welcoming and approachable. It was confirmed that the senior team offer support and praise for the work Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 18 completed by staff. This member of staff confirmed that formal and recorded supervision occurs where confidential discussion takes place and the opportunity is offered to staff to discuss the welfare of residents. Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 19 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 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 4 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 X X X 3 3 X Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 20 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. Refer to Standard Good Practice Recommendations Oak House Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Residential Home DS0000006462.V272520.R01.S.doc Version 5.0 Page 22 - 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!