Inspection on 05/07/05 for Oak Lodge

This inspection was carried out on 5th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oak Lodge 21/07/08

Oak Lodge 30/08/06

Oak Lodge 31/01/06

Oak Lodge 21/10/04

Oak Lodge 27/04/04

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 Lodge 2 Peveril Road Old Duston Northampton NN5 6JW Lead Inspector Kathy Jones Unannounced 05 July 2005 @ 12:05 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 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 C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oak Lodge Address 2 Peveril Road Old Duston Northampton NN5 6JW 01604 752525 Telephone number Fax number Email 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 Only 31 Category(ies) of Older People (OP) 31 registration, with number Dementia - over 65 (DE(E)) 31 of places Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 21/10/04 Brief Description of the Service: Oak Lodge is situated in Duston in a quiet residential street. Oak Lodge provides care for up to thirty-one older people. The home is owned by Restgate Limited and is situated near shops and other community facilities. Northampton Town Centre is a few miles away and is accessible by the local bus service. Oak Lodge has a passenger lift providing access to the first floor on one side of the house however there are two steps from the lift to the first floor bedrooms. A stairlift has been removed and a new stairlift is going to be installed to provide access at the other side of the house. The home has twenty five single bedrooms with twelve of them having en-suite facilities. There are three double bedrooms with one having 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 C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over approximately four hours on the afternoon of a weekday. Prior to the inspection Inspectors spent one and a half hours reading preinspection information submitted by the home, the last inspection report, the homes service history and comment cards submitted by Residents and their Relatives. Six comment cards were received from relatives/visitors and four from Residents. This information was used to plan the key areas to be inspected. The inspection involved talking to Residents about their life in the home and reviewing a sample of care records to see how their care is planned and supported. Inspectors met with the Manager to discuss previous requirements and the actions taken to address them were sample checked. Observations of Staff practice were made during the inspection. Discussion with Staff was very limited on this occasion due to Inspectors not wishing to impact on the care provided to Residents. What the service does well: What has improved since the last inspection? Some progress has been made on developing and improving care plans which are in place to plan and support the care provided to Residents and Staff were receptive to Inspectors comments regarding further improvements. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 6 Radiator covers have been fitted to most of the radiators, which had high surface temperatures when in use and posed a risk to Residents. Covers for the rest of the radiators are due to be fitted. Other improvements to health and safety include removal of bolts from the outside of two bedroom doors and the fitting of restrictors to some windows. 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 Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 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 standard(s) This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection however the Manager confirmed that the home has a statement of purpose that sets out for prospective Residents details of what the home provides. The Manager has agreed to forward a copy of the document to the Commission for Social Care Inspection for their records. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 9 Residents independence is encouraged in areas such as self medication however the shortfalls in planning of care and instruction to staff have the potential to put Service Users at risk particularly in relation to movement and handling. EVIDENCE: Comment cards from six relatives/visitors stated that they are satisfied with the overall care provided; four from Residents confirmed that they felt well cared for. Care plans and records were sample checked for two Residents including a recently admitted Resident to ascertain the care provided. Discussion with the Manager and a member of Staff indicated that improvements have been made to the care plans since the last inspection however plans remain brief and do not adequately cover all identified care needs. For example movement and handling and pressure area care. Discussion with a Resident confirmed that health care services are accessed on behalf of Residents for example the District Nurse who provides pressure area care. Care plans did not identify those Residents at risk of pressure sores or Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 10 those receiving treatment. Advice was given to include this and any actions required of staff based on the advice of the District Nurse such as the use of pressure relieving equipment or turning. There is a medication policy in place; the content was not reviewed during the inspection however the Manager confirmed that it has been updated following the last inspection and will forward a copy to the Commission for Social Care Inspection. Systems are in place for the safe administration of medication and excessive stocks are not held. The majority of medication is delivered to the home in cassettes made up by the pharmacist who Staff advised visits three times a year to check the medication systems. One Resident manages their own medication and the Manager confirmed that they have a lockable facility in their bedroom to store the medication. This Resident’s care file was not reviewed however the Manager was advised to ensure that a risk assessment for self medication is in place. A Resident told Inspectors that Staff look after her medication while she is in the home but that she manages it when she goes on holiday. Medication administration records highlight that the resident had been on holiday however there is no procedure for checking and recording the quantity of medication coming into and out of the care of the home. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 14 The home has flexible visiting arrangements and routines and a range of activities appropriate to the interests of Residents. EVIDENCE: No activities were in evidence on the afternoon of the inspection however a list of forthcoming activities is displayed in the home and pre inspection information identifies a range of activities provided by the home including theatre trips, walks, ball games and light exercise, sing a longs and reminiscence sessions. Comment cards and conversations with four Residents confirmed that they were happy with the activities provided and have a choice as to if they participate or not. Six relatives/visitors have confirmed that they are welcomed into the home at any time and can visit in private. Discussion with one Resident confirmed that the home is supportive of her independence and that the routines of the home are flexible enough for her to maintain control over her life. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 The home has procedures for dealing with concerns and complaints, which are available to Residents, relatives and visitors. EVIDENCE: The Commission for Social Care Inspection had received no complaints since the last inspection at the time of this inspection. Pre-inspection information submitted by the Registered Manager confirms that the home have received no complaints in the last twelve months. A copy of the complaints procedure was displayed in the home and the Manager advised that copies are given to new Residents and their relatives. Four relatives confirmed that they were aware of the complaint procedure and two said they were not. All four comments received from Residents confirmed that they knew who to talk to if they were unhappy with their care; they also confirmed that they felt safe in the home. The home has an adult protection procedure and the process for reporting any allegations of abuse was clearly displayed in the office. Discussion with the Manager confirmed that she is aware of the importance of acting on any concerns. Adult protection was not discussed with staff on this occasion however some staff training on protection of vulnerable adults has been arranged. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 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 standard(s) 19, 21 and 25 Although the home was warm and comfortable some areas were in poor condition requiring re-decoration, refurbishment and appropriate aids and adaptations particularly in relation bathing facilities. EVIDENCE: A limited tour of the premises was carried out, which included review of the action taken in respect of previous requirements. Locks on two Residents bedroom doors were seen, a bathroom on the top floor and some of the communal areas of the home. Two Residents bedrooms were seen, these were clean, tidy and appeared comfortable. There are three floors to the home and a passenger lift provides access to one side of the home. There are some steps from the lift to bedrooms on the first floor which were seen to be causing difficulties for one Resident however the Manager advised that arrangements are being made to move the Resident to a ground floor room. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 14 The Registered Manager advised that a stair lift has recently been removed and is due to be replaced, this will provide access to the upper floors at the other side of the house. The Manager did confirm that no Residents were inconvenienced by the lack of the stair lift, as they were all sufficiently mobile to be able to use the stairs at the present time. The Manager confirmed that bolts had been removed from two bedroom doors as required at the previous inspection. Locks have now been put on these two bedroom doors, which were found to be of the type, which require a long star shaped key. If locked from the outside the door requires the use of a key to release it from the inside. One of the Residents who has this type of lock confirmed that she is able to manage the key easily. The Manager was advised to contact the Fire Officer to check if he is happy with this type of lock as the usual advice is that the locks should be of a type which can be opened from the inside easily without the need for a key. (A requirement has been made under standard 38 Health and Safety) The Manager confirmed that other actions taken since the last inspection include removal of free standing radiators, fitting of radiator covers (some still to be done as wrong size delivered), removal of trailing wires, fitting of restrictors to windows and making call bells accessible. Work is still to be carried out in relation to the type of light switches in bathrooms. A small window on the top floor with a small ledge outside had no restrictor fitted, a Staff member advised that this is usually locked when the Resident is in the room however the key was noted to be in a prominent position and no risk assessment had been undertaken in relation to the Resident occupying the room. The bathroom on the top floor was noted to be in very poor decorative order and the sanitary ware in poor condition. A Staff member advised that this bathroom is not used for bathing as the bath is a domestic type bath with no bath hoist and is not suitable for the majority of Residents. All Residents are currently using one bathroom on the ground floor. The Manager advised that the Owners have plans for redecorating and refurbishing the home however was not aware of the specific timescales for this. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Staffing levels are insufficient to meet the needs of Residents. EVIDENCE: Staffing levels on the afternoon of the inspection were very low given the numbers of Residents and their dependency needs and the layout of the building. A sample check of staff rotas indicated that staffing levels are very low for the number and needs of the Residents. The staffing hours recorded on the rota for the week of the inspection were also significantly lower than those quoted as provided in the pre-inspection information. Staff training files and the recruitment process could not be checked during this inspection, as the Manager did not have the keys for the filing cabinet with her. As a previous requirement relating to recruitment processes was not checked on the previous inspection the Manager was advised to check Staff recruitment complies with current regulations and protect Residents. Details of how to access current regulations was provided by the Inspector. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Movement and handling practices do not protect Residents or Staff from the risk of injury. EVIDENCE: Action has been taken in respect of health and safety issues identified during the previous inspection as detailed under the environment section of this report. A requirement had been made about the lack of restrictors on first floor windows, which the Manager confirmed had been addressed however a bedroom on the second floor was found not to have a restrictor. In view of this the Inspector would recommend a full health and safety check of the building be carried out to ensure Residents are not put at unnecessary risk. Observations of movement and handling practice identified that a Resident and Staff member were at risk of injury. Inspectors called a second member of Staff to assist. Review of the Residents movement and handling plan identified that the particular movement being undertaken was not incorporated in the plan. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 18 Yes Are there any outstanding requirements from the last inspection? 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 8 Regulation 12 (1) (a & b), 13 (5) Requirement Timescale for action 30.08.05 2. 3. 9 19 4. 5. 27 38 6. 38 Care plans must include details of those Residents receiving treatment from the District Nurse for pressure sores and include any actions required of Staff. 13 (2) All medication received into and leaving the home must be recorded. 23 (2) (a, A full re-decoration and d, j, n ) refurbishment plan which includes provision of adequate bathing facilities and contains timescales for completion must be forwarded to the Commission for Social Care Inspection. 18 (1) (a) Staffing levels must be maintained at a level which meets the needs of Residents. 13 (5) Movement and handling plans must take account of any stairs which need to be negotiated and safe movement and handling practices followed. 13 (4) (c ) A full Health and Safety review of the premises must be undertaken to include the need for restrictors on all windows and action taken in respect of risks identified. Details must forwarded to the Commission for C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc 15.08.05 30.08.05 15.08.05 15.08.05 30.08.05 Oak Lodge Version 1.40 Page 19 Social Care Inspection. 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 7 Good Practice Recommendations Work should continue on improving the level of detail provided in care plans. Oak Lodge C51 C08 S12875 Oak Lodge V235529 050705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Northamptonshire Area Office Newland House, First Floor Campbell Square Northampton, NN1 3EB 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. 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