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Inspection on 19/08/05 for Oak Lodge Nursing Home

Also see our care home review for Oak Lodge Nursing Home for more information

This inspection was carried out on 19th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The qualified nurses and care staff were extremely good at caring for the residents who were ill and needed lots of specialised care. The staff made sure that all the necessary equipment needed for their care was available. The care plans were very good. They contained a lot of important information about what the residents needed help with, and how they were to be cared for. The home had a group of qualified nursing staff and care assistants who had worked there for a long time. The residents said that they liked the staff and trusted them to look after them. Comments such as " they are very good" " I can`t thank them enough" were made to the inspector. Relatives commented, "The staff were very good indeed". They stated that they looked after their relative well and were very professional in their approach.

What has improved since the last inspection?

Although all of the building was not looked at in detail on this inspection, the inspector saw that many of the bedrooms and corridors had been redecorated and new carpets had been fitted in some places.

What the care home could do better:

Staff need to make sure that the medicine records are always filled in correctly. The home needs to carry on providing new carpets for the bedrooms that need them. The home needs to look at employing somebody to do the small repair jobs around the home.

CARE HOMES FOR OLDER PEOPLE OAK LODGE 514 Bury New Road Prestwich Manchester M25 3AN Lead Inspector Grace Tarney Unannounced 19 August 2005 th 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 F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oak Lodge Address 514 Bury New Road Prestwich Manchester M25 3AN 0161 798 0005 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) Mr S R Latimer & Dr Kumar Kotegaonkar Mrs Mavis Birkinshaw CRH N Care Home with Nursing 41 Category(ies) of OP Older Persons - 41 registration, with number of places OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 11th March 2005 Brief Description of the Service: Oak Lodge is a Care home providing nursing and personal care for older people. It is a large detached converted house and is situated on the main bus routes leading into the centre of Bury, Prestwich Village, Salford and Manchester. There is nearby access to the motorway network. The home is very close to supermarkets and shops. The main door at the front of the home and the conservatory allow level access for wheelchair users and people who have problems climbing steps. The home is registered to care for 41 residents and provides accommodation in mainly single bedrooms on the ground and first floors. The bedrooms on the first floor are reached either by stairs or a passenger lift. There is a large lounge area to the side of the home and in front of this is the conservatory. This looks out onto a small garden area. The conservatory is designated for those residents who wish to smoke. There is also a large dining room and at the far end of this, there are two small, but bright sitting rooms. The toilets and bathrooms have aids to assist any resident with a disability or mobility problem. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not told that this inspection was to take place. This was an unannounced inspection. The Inspector spent 6 hours at the home. During this time she looked at care and medicine records to ensure that the health and care needs of the residents were being met. The inspector then visited some residents in their own bedrooms to check out the care that was being provided for them. She also looked at records about the handling of complaints. In order to obtain information about the home the inspector also spent time speaking to 5 residents, 2 relatives, 2 qualified nurses, 2 care assistants and the housekeeper. Not all the National Minimum Standards were looked at on this visit. During the next inspection the inspector will look at the rest of the Standards that are considered to be important for residents safety and wellbeing. These are the Standards that have to be inspected at least once a year. What the service does well: What has improved since the last inspection? What they could do better: OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 6 Staff need to make sure that the medicine records are always filled in correctly. The home needs to carry on providing new carpets for the bedrooms that need them. The home needs to look at employing somebody to do the small repair jobs around the home. 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 F56 F06 S17320 Oak Lodge V221955 190805 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 F56 F06 S17320 Oak Lodge V221955 190805 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) 3 The system for ensuring that all prospective residents had a detailed assessment undertaken before their admission to the home, gave an assurance both to residents, relatives and staff, that a resident was only admitted if the home could meet their needs. EVIDENCE: Before any resident was admitted to the home an assessment of their needs was undertaken either by a senior member of the nursing staff from the home or from the professional i.e. care manager, requesting their admission. The home also admitted people from the Rapid Response Team. Rapid Response is a system whereby people who require urgent nursing care but not admission to hospital, can be cared for on a 24 hour basis by qualified nurses for a short period of time, normally no longer than 2 weeks. When a person was admitted under this scheme they had an assessment undertaken by qualified nurses. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 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) 7.8.9,10 &11. The care plans reflected the support needs of the residents. Care practices ensured that the residents’ health care needs were met, that they were treated with respect and their dignity was upheld. Although some areas of concern were identified, the medication system in place was safe and residents received their medicines correctly. EVIDENCE: Individual care plans were in place for each resident. The care plans of two residents were examined. The care plans in use were “core” care plans that were accurately individualised. The care plans gave clear instruction and guidance on how the care needs of the residents were to be met when problems had been identified. The daily report was kept with the care plan. This is good practice. The care plans were evaluated as and when necessary, but at least on a monthly basis. Risk assessments were in place and covered such areas as moving and handling, nutrition, pressure sores, the use of bed rails and falls. The residents were weighed at least on a monthly basis and the weight recorded on a chart kept in their care plan. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 10 A discussion with the residents identified that they had access to other health care professionals such as dentists, opticians, chiropodists, and where necessary, .district nurses. Equipment necessary for the prevention and treatment of pressure sores was available within the home. Continence aids were in use and the staff were aware of how to contact the continence nurse advisor for advice, if deemed necessary. Overall a safe system of medication management was in place. The medicine room was kept locked and medications were securely stored. Some issues were identified however in relation to the following: The stock medications were not segregated into any form of order. This could result in inadequate stock rotation and even drug errors. The Inspector was made aware that the home had recently changed pharmacist and this was an area that the pharmacist was intending to address. Transcriptions of medications were not signed checked and countersigned. Signing and checking transcriptions reduces the risk of drug errors. The temperature of the drugs fridge was not being recorded on a daily basis, as the thermometer was broken. To ensure that medications are stored at the correct temperature this must be addressed. When a prescription stated that one or two tablets were to be given, staff were not documenting just how many tablets had been administered. The residents said that the staff treat them with kindness and respect. During the inspection staff members spoke with residents in a kindly and respectful way. Staff spoken to gave examples of how privacy and dignity were promoted. They also gave good practice examples of how they would care for a resident who was terminally ill. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 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. The home enabled residents to exercise as much personal freedom and choice as possible and find enjoyment with the range of activities available. EVIDENCE: The residents spoken to said that they were satisfied with the way they were allowed to spend their day, more or less as they pleased. One resident told the inspector that the staff let her stay in her room if she doesnt want to eat in the dining room. The residents’ routines of daily living and their social interests were recorded in their care plans. The home has recently appointed a new activities organiser. She works at the home 2 afternoons per week and undertakes reminiscence sessions and organises events and outings. Staff told the Inspector that she is still in the process of finding out what the residents like to do. Residents told the Inspector that they are able to have visitors at any reasonable time and they can see their visitors in private. Relatives confirmed this. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 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 &18. The complaint system in place enabled residents to feel that their views are listened to and acted upon. Staff have a good knowledge and understanding of adult protection procedures thereby reducing the possible risk of harm or abuse. EVIDENCE: The complaints procedure was displayed in the reception area. It gave clear guidance about how to make a complaint and to whom. A copy of the Local Authorities Vulnerable Adults Procedure was in place and a discussion with staff identified that they were very aware of the procedure to follow in the event of any allegation of abuse. Training in the protection of vulnerable adults has been undertaken by some staff and is ongoing. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 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) EVIDENCE: Although all of the building was not looked at on this inspection the inspector identified that the carpets in bedrooms 8, 9, 23 and 25 needed replacement. They were either very stained or rucked. The inspector also noted that the protective plates on several of the bedroom doors were coming away from the door. Standards 19 and 26 will be a looked at in detail during the next inspection. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 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 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. The residents were cared for by sufficient numbers of staff that were suitably qualified and trained and therefore had the knowledge and skills to meet the residents’ needs. EVIDENCE: Examination of the duty rota and a discussion with staff showed that there was enough staff on duty to meet the care needs of the 36 residents. 24-hour nursing care continues to be provided by qualified nurses. They are supported by a suitably trained care assistants. In addition to the nursing and care staff the home employed a number of ancillary staff including a chef, kitchen assistant, domestics, a housekeeper and an administrative worker. Staff expressed a view that the home needs its’ own handyman. Presently they have to rely on the services of a handyman who is employed elsewhere. During a walk around the home, it became clear that some small repairs needed to be undertaken. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 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 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) EVIDENCE: Standard 33 35 and 38 will be looked at during the next inspection. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 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 3 x 3 x x x x x x x x OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 17 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 9 Regulation 13(2) Requirement Stock medications must be segregated into a form of order. Management must inform the CSCI of the action they have taken once their community pharmacist has resolved the issue with them.(This was a previous requirement and had not been complied with by the timescale of 30/4/05). To ensure that medications are stored at the correct temperature,the temperature of the drugs fridge must be taken and recorded on a daily basis. Staff must document the actual amount/number of tablets being given. The carpets in bedrooms 8, 9, 23 and 25 must be replaced. The protective plates on the bedroom doors must be replaced/repaired. Timescale for action 31/10/05. 2. 9 13(2) 20/8/05. 3. 4. 5. 9 24 24 13(2) 16(2)(c) 23(2)(b) & 13(4)(a) 20/8/05. 31/12/05. 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 18 No. 1. 2. Refer to Standard 9 27. Good Practice Recommendations To ensure the safety of the resident, transcriptions of medications should be checked, signed and countersigned by another member of the nursing staff. Serious consideration should be given to employing a designated handyman. OAK LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton, BL6 6HG 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 LODGE F56 F06 S17320 Oak Lodge V221955 190805 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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