CARE HOMES FOR OLDER PEOPLE
Oak Lodge 2 Peveril Road Old Duston Northampton Northants NN5 6JW Lead Inspector
Mr Gary Robinson Unannounced Inspection 10:30 31 January 2006
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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 Lodge DS0000012875.V277725.R01.S.doc Version 5.1 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 Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Oak Lodge Address 2 Peveril Road Old Duston Northampton Northants NN5 6JW 01604 752525 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) Restgate Limited Mrs Susan Emmerson-Ward Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (31) of places Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection Brief Description of the Service: Oak Lodge is situated in a quiet residential street in the Duston district of Northampton. The Home is registered to provide personal care, without nursing, for up to thirty-one older people. Although Northampton town centre is a few miles away, it is accessible by the local bus service, and there are local shops and other community facilities in the immediate locality of Oak Lodge. Within the home there is a passenger lift and a new stair lift has recently been installed in the premises. Oak Lodge has twenty-five single bedrooms with twelve rooms having en-suite facilities. There are three double bedrooms, one of which has en-suite facilities. There is a garden to the rear of the building, which the service users are able to enjoy in the warmer weather. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out just before lunchtime and took just over four hours. Oak Lodge was inspected using the method of ‘case tracking’. The process of ‘case tracking’ involves inspecting the standard of care received by a number of older people resident at the Home, and on this occasion meeting with two people in the privacy of their own bedroom to seek their views on the quality of care provided at Oak Lodge. A sample of records required to be kept at Oak Lodge that relate to the service provided for those people were also inspected. The Inspector also met with the Manager to review the action taken to address previous requirements arising from the last inspection on July 2005. What the service does well: What has improved since the last inspection? What they could do better:
Where restrictor mechanisms have been fitted to some bedroom windows to prevent the window opening out too far and posing a potential hazard, staff members do need to be mindful to regularly check that these mechanisms are in place. On this inspection it was observed that the service access door to the boiler had been left unlocked despite a notice on that door reminding staff to be vigilant about securing it.
Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 6 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 Lodge DS0000012875.V277725.R01.S.doc Version 5.1 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 Lodge DS0000012875.V277725.R01.S.doc Version 5.1 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 & 5 (Standard 6 is not applicable) Oak Lodge informs people about the service they will receive and overall residents can be confident of receiving the support and care they need. EVIDENCE: There is documentary evidence on file that supports the conclusion that each person’s care needs are appropriately assessed prior to admission to Oak Lodge. Residents confirmed that prior to their admission they were welcome to visit Oak Lodge to see if the Home suited their needs. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 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,& 10 (9 was inspected on the last inspection) Residents are encouraged to be independent and can rely upon being treated with respect and having their personal care needs sensitively met at Oak Lodge. EVIDENCE: Examples of completed and updated plans of care were inspected and these documents support the conclusion that residents are consulted about their care and the manner in which it will be provided. The residents who spoke with the Inspector in private all said they were treated well by the staff team and could rely upon them to provide the help and encouragement they needed. There are policies and procedures in place for the safe administration of all medicines kept within the Home. Lockable facilities are provided for each resident who wishes to administer their own medication. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 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): 15 (12,13,14 were inspected previously) Residents appear to thoroughly enjoy the food served at Oak Lodge and the meal seen being served was appetising, with good portions. EVIDENCE: The menu for the lunch was displayed on the notice board and the meal was seen being served at the time of inspection. The residents who spoke with the Inspector said they enjoyed their food at Oak Lodge. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 11 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): 16,17,& 18 were inspected previously. This section was not reviewed on this occasion but these key Standards were inspected at the previous inspection in July 2005. EVIDENCE: There are no complaints currently under investigation. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 12 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 Overall, the residents live in a homely environment that will be further improved by the ongoing programme of redecoration and refurbishment of the bathroom facilities. EVIDENCE: The Manager confirmed that the refurbishment of the first floor bathroom has been temporarily set back because of problems with the contractor, but this issue has been addressed and a new contractor has been engaged to complete the work. The communal areas and bedrooms seen at the time of inspection were clean, free from unpleasant odours, and comfortably furnished. There was evidence in residents’ bedrooms that they are encouraged to personalise their own room with their own belongings, items of furniture, etc. Where windows on the first and second floor are fitted with restrictors to prevent them being opened too far, staff members must be vigilant that these mechanisms are used and that they are mindful of the risk assessments in place for that particular room and individual. It was noted that in one
Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 13 particular room the mechanism had not been properly secured and this was pointed out to the Manager and was put right. It was discussed with the Manager that bedroom doors that lack privacy locks should have these fitted whenever the room becomes vacant or when the existing resident requests such a lock. It is good practice for each bedroom to have a safety lock fitted, whether or not the resident chooses to use it. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 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): 27,28,29 & 30 Staffing levels at the time of this unannounced inspection appeared to be satisfactory. EVIDENCE: There were five care workers, in addition to the Manager, on duty at the time of inspection. There was documentary evidence on file of staff members attending various relevant training courses. Residents who spoke with the inspector said that the staff members who attended to their needs knew their job and did it well. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 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): 31,33,35, & 36 The Manager is experienced and runs Oak Lodge sensitively and efficiently so that the residents can enjoy a good standard of care, but staff members do need to be mindful of their health and safety duties. EVIDENCE: There is documentary evidence that staff members are appropriately supervised and the standard of their work is regularly appraised. The policies and procedures of the Home cover the safe keeping of valuables and financial matters. The boiler room door had been left unlocked despite a prominent notice being affixed to the door reminding staff to ensure that it is kept locked. This was pointed out to the Manager and this was attended to. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X 3 X X Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard OP21 OP24 OP19 Good Practice Recommendations The refurbishment of the top floor bathroom should be considered as a priority in the programme of improvements to be carried out. Where bedroom door locks are not fitted because of the choice of resident the Manager should consider fitting such locks at the point when the room is next vacated. The Manager should review with each staff member the importance of ensuring that where a risk assessment has identified the need to keep a door locked, or a window restrictor to be used, that staff are continuing to be consistently mindful of the precautions required. Oak Lodge DS0000012875.V277725.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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