Inspection on 20/07/06 for Oak Lodge Nursing Home

This inspection was carried out on 20th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Lodge Nursing Home 16/07/07

Oak Lodge Nursing Home 28/02/06

Oak Lodge Nursing Home 23/09/05

Oak Lodge Nursing Home 14/03/05

Oak Lodge Nursing Home 03/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Oak Lodge Nursing Home Lordsleaze Lane Chard Somerset TA20 2HN Lead Inspector Gail Richardson Unannounced Inspection 20th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Lodge Nursing Home Address Lordsleaze Lane Chard Somerset TA20 2HN 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) 01460 67258 01460 68068 oaklodge@majesticare.co.uk Majestic Number One Limited Acting Manager Caroline Orrell Care Home 47 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (39) of places Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Elderly persons of either sex, not less than 60 years, who require general nursing care No more than 39 persons requiring nursing care may be accommodated. Up to 10 places for elderly persons, of either sex, in the category OP, who require personal care only. Eight places exclusively in The Acorns for elderly persons of either sex, in the category DE(E) who require personal care only. There will be a named Care Co-ordinator and designated staff team for The Acorns. To provide care for one named person under the age of 60. Date of last inspection Brief Description of the Service: Oak Lodge was first registered in 1989 and is now owned by a growing care company. The home is situated in a private lane a short distance from the rural town of Chard. The home is partly converted house with a purpose built extension with accommodation provided on two floors. The home offers general nursing care for up to 39 older people. The home also has 8 beds registered to provide personal care for people with dementia care needs using a person-centred model of care. This provision is in a separate area of the home called The Acorns that is reached through the main reception area of the home and has a keypad secured entrance. The main area of the home has a pleasant outlook onto private gardens from two large downstairs communal rooms and a conservatory. The Acorns has been fully refurbished to provide domestic style accommodation including a kitchen/diner and lounge. The separate Acorns garden has been designed to be safe and secure with separate access for those people living there. Both these areas of the home have identified staff teams. Activities are provided during the week and include a weekly mini-bus trip. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place over 6.5 hours on the 23th July 2006 by inspectors Gail Richardson and Shelagh Laver. A tour of the home took place and all the bedrooms and communal areas were seen. There were 46 service users currently residing at the home, this includes 36 nursing patients, 3 residential patients the 8 service users residing in the Acorns. The inspectors spoke to 15 service users and 11 members of staff, the Acting Manager was available throughout most of the inspection. As part of this inspection the inspectors surveyed the opinions of a random selection of service users and their representatives, GP’s , District Nurses and Care Workers. A good amount of responses were received. Records relating to care, staff , finances and health and safety were examined The inspectors noted that service users appeared settled and comfortable and there was a pleasant , calm atmosphere within the home. The service users looked well cared for, an attention to detail of personal care was evident. Staff spoken to were complimentary about working in the home and were supportive of the new management of the home. Inspectors observed staff working and noted that service users were treated with dignity and respect at all times. The inspectors would like to thank the service users and staff for their time and hospitality through out the inspection. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. What the service does well: The inspectors spent time in the Acorns and observed that the atmosphere within the unit was calm and cheerful. The unit provides a high standard of person centred dementia care and benefits from the management and ethos of the Dementia Unit Manager Carol Parker. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 6 Service users appeared settled and were observed moving freely around the unit, interacting with staff and other service users. The environment is appropriately designed and decorated to provide a homely sense of security and comfort. Service users are supported and encouraged by staff to retain as much independence as possible. Staff are encouraged and supported by the management of the home to undertake training to develop their skills to provide a high standard of care for service users. The atmosphere of the home was pleasant and all service users looked comfortable and well cared for. Service users benefit from the pleasant, homely surroundings and attractive and usable gardens. What has improved since the last inspection? The monitoring of food and fluid intake has been reviewed to ensure that it is systematic and accurate and action is taken where necessary. Evidence of this practice was seen at inspection. The manager has purchased new weighing scales and service users are now weighed monthly. The dining arrangements of the home have been reorganised. All service users now receive the help they need at mealtimes to ensure they eat hot meal and have a full drink in a pleasant dining environment. The company recruitment policy is now being followed and all recruitment records contained the documents required. Staff confirmed that they receive formal supervision at least 6 times per year. Staff are now aware of the risks of holding open fire doors with equipment and the manager ensures this practise no longer happens. All staff are now aware of the potential risks when using bedrails and what action they must take to minimise the risks. A full audit of bedrails has taken place and the homes handyman now checks the bedrails every month. All creams were labelled clearly with the services users name and date the cream was opened. Clothing protection has been purchased for service users to ensure adequate supplies are now available for all service users. The home has purchased a mini bus and further equipment for the home. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 7 Acting Manager has provided an alternative for alerting attention for use by the service user. A bell is provided for any occasions that the call system may not be working. Staff are now aware that the Data sheets for chemicals used, are now stored in the cleaning cupboard. 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 Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12345 The overall quality rating in this section is assessed as good. The home has a thorough pre-admission procedure and provides good opportunities for the service user to make a decision about moving in. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide which is made available to service users, prospective service users and their representatives. Prior to admission service users and their representatives have the opportunity to visit the home to view prospective rooms and communal areas. Two service users confirmed that their representatives had visited the home prior to admission. 11 surveys were returned to the inspector and 9 of these confirmed that they received enough information prior to admission. Five service user records were examined. Each service user had received a pre-admission visit by the Manager or a representative from the home. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 10 Their needs were assessed and documented. Further information from other health care professionals is also taken into account. The home ensures that it can meet the needs of the person assessed and will identify any equipment requirements prior to admission. The home is able to meet the needs of the current service users. The homes current fee range is £450 to £750 when self funding. Contracts are issued to all service users and were seen to contain the information required. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 11 The overall quality rating in this section is assessed as adequate. Each resident has a care plan. The plan in most cases includes the basic information necessary to plan the individuals care and includes a risk assessment element . The homes medications systems are good. Staff are aware of the need to treat residents with respect and to consider dignity when delivering personal care. EVIDENCE: Five care plans were examined, 4 from the home and one from the Acorns. The overall quality of the care plans was good. Evidence was seen of care planning, care given and review of outcomes. Aspects of care were identified at an initial assessment and care plans provided for each care issue identified. One record of care plan needs indicated the time service users wished to get up and go to bed. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 12 Evidence of service user/representative input was varied, however, evidence was seen of input from members of the multi disciplinary team. The manager confirmed the active input of the dietician, tissue viability and district nurse support. The manager advised that regular care plan audits take place and further development of the care plans is proposed to provide a more person centred approach to planning and care plan review. On the day of inspection it was noted that some service users being nursed in their bedrooms did not have access to a nurse call bell. The manager is required to ensure that staff are made aware that service users have access to the nurse call systems at all times. The medications systems are well organised. The Medication Administration Records sheets were without gaps, variable doses were recorded, homely remedies were clearly written and recorded and the storage and recording of controlled drugs was appropriate. The current practice within the home is that one staff member signs for the disposal of medication. It is recommended that two staff sign when disposing of medication. The recording of creams used is recorded on the care chart stored in the service users bedrooms. Service users receiving dietary supplements are recorded on the food/fluid chart also maintained in the service users bedrooms. On a tour of the building creams stored in service users en-suite bathrooms were mostly named and recorded the date of opening. The Acorns has a system of lockable storage for medications in each service users bedrooms. The inspectors witnessed staff interacting with service users throughout the home. Service users were treated with respect and dignity and were spoken to kindly at all times. All service users and relatives spoken to, were happy to comment on the kindness and caring attitude of the staff. For example, “Staff are good to you“ and “I am happy here , the staff seem very nice “, Further comments on the surveys included” I am happy and I love the trips out and the caring staff. I am happy with the care I am getting.” In the nursing unit, care is provided for service users who have come to end of their lives. The inspector viewed the care plan and notes of one service user being cared for at this time, input was evidenced from a variety of health care Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 13 professionals. All aspects of care needed, had been planned and accessed prior to admission. Staff training has been provided to ensure that appropriate care is available at all times. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 The overall quality rating in this section is assessed as good. Service users are able to choose a variety of lifestyle patterns in the home. Residents enjoy the flexibility of meal arrangements and enjoyed being able to eat in their own room if they wished. The home provides a varied and wholesome diet. EVIDENCE: The home employs an activities organiser 35 hours per week. A entertainments board advertises forthcoming events. Photographs seen around the home evidence that activities including trips out occur regularly. Staff informed the inspector that trips go out every Thursday and these trips are recorded and notes made on the level of enjoyment for the service users. This enables an audit of the activity to take place and review further choices of location. Each service users bedroom has a list of the activities planned for the week. Service users spoken to were aware of the activities available, but several chose not to participate. Surveys received indicated that service users felt that there activities available to them, 6-always, 3 usually and 2-sometimes. A comment made by one service user was : Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 15 “There is not a lot of daytime simulation. Staff chatting to residents and giving them a little one to one social time does not happen because of shortages” However on the day of inspection it was noted by both inspectors that staffing levels appeared adequate. The inspector observed the house news sheet which included forthcoming events and news items for service users and staff. The activities coordinating team were busy organising an open day for the weekend with an Hawaiian theme. Service users and staff were involved in planning the day. On the day of inspection there was one staff member doing a jigsaw with a group of service users and evidence of “Talking Books”, crosswords and other activities were seen in service users rooms. Service users were sat in the lounge in smaller groups and the TV was switched on. Service users who remain in their rooms received visits from the activities coordinator and this was recorded in the care plan. Activities within the Acorn unit are designed specifically for service users with dementia care needs. A life history record is taken of all service users within the unit and activities tailored to suit their preferences. The Acorns has developed a sensory garden at the rear of the unit with access to a greenhouse. One service user was enjoying sitting on the patio area under an umbrella. One survey comment was: “ I am very happy in the acorns. I enjoy it here.” Lunch was seen as part of the inspection. A choice was offered and the food appeared plentiful and appetising. The main dining room is very attractive and the tables were laid with tablecloths and napkins. Sherry, soft drinks and fresh fruit were available. At the previous inspection issued had been raised about the use of the lounge as a dining area. The manager has now resolved this situation and all service users who wish to, now eat in the dining room. Inspectors observed that service users had plate guards and clothing protection as required and the staff assisted in an appropriate and discreet manner. The choice of lunch was; Sweet and Sour Pork with boiled potato, cauliflower and green beans. The Alternative was ham salad. For desert the choice was homemade apple pie and cream or strawberry jelly with fresh strawberries. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 16 The cook who has had training in basic food hygiene and nutritional needs of the elderly creates the menu. Specialised diets are available and pureed diet is served separately. The cook explained that for a service user who has a poor appetite further support and advise was sought from the dietician and the kitchen staff keep a personal book of all the service users particular likes and dislikes. The inspectors noted that the tea trolley was well stocked but all items were uncovered and the trolley was stood for some time in the lounge. It is recommend that all items stored on the tea trolley are kept covered including the sugar and biscuits. Service users surveys indicated that they enjoyed the meals; always-2, usually-8,sometimes-1. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 17 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 The overall quality rating in this section is assessed as good. The home has a complaints procedure that is up to date, very clearly written, and is easy to understand. Residents and others associated with the home demonstrate a good understanding of how to make a complaint and they are very clear of what can be expected to happen if a complaint is made. All service users are registered to vote. The policies and procedures regarding protection of residents are of a high quality and are regularly reviewed and updated. EVIDENCE: The home has a complaints procedure, which is displayed and contains all the required information. The complaints file was examined by the inspector. One complaint had been received since the previous inspection. This complaint had been recorded clearly, fully investigated within a reasonable time scale and the out come recorded. Service users and relatives spoken to were confident that should they have any complaints they could approach the management of the home and their issues would be taken seriously. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 18 Survey results indicted that 4 service users would always know who to complain to,3 said usually and one said sometimes. Staff recruitment procedures, training and supervision support the protection of service users from the risk of abuse. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 19 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 The overall quality rating in this section is assessed as adequate Service users benefit from a comfortable, homely, well maintained environment. Service users are able to personalise their own rooms. The homes environment is able to meet the assessed needs of the service users. The garden areas offer accessible outdoor communal space. The home provides specialist equipment to ensure the needs of service users are met. Divan beds used in the home require assessment to ensure they are suitable for service users needs. Access to call bells for service users requires review to ensure service users have access to staff at all times. The home is pleasantly decorated to a high standard and is clean and odour free. EVIDENCE: Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 20 A tour of the home was made by the inspectors and all bedrooms and communal areas were seen. All the bedrooms seen were comfortable and service users had been supported to personalise their own rooms. The inspectors found the home to be a good quality, safe environment for those living at the home. There are suitable and sufficient toilet and bathing facilities. The upstairs bathroom was being repaired on the day of inspection. It was noted that some service users were being nursed on divan beds. The registered manager is recommended to audit the use of divan beds to ensure that all nursing patients are cared for in a nursing bed. A further audit is recommended of all flip top bins in use as several were noted to be broken. The inspectors noted that several service users who remained in their rooms did not have access to the nurse call system. This was discussed with the manager at the time of inspection and this practice requires review. The design of the Acorns supports service users to find their way around and be able to identify their own room easily. The unit has developed a comfortable homely atmosphere by creating a domestic style environment. Access to specialised equipment was seen throughout the home and the manager confirmed that further pressure relieving mattresses have been ordered. The general standard of cleanliness was good. The cleaning staff confirmed that they received sufficient training and that they considered the domestic hours sufficient to maintain the hygiene of the home. One service user commented” The home is always clean.” A further comment was” the cleaner should look under the bed.” Survey results confirmed that 9 service users felt the home was clean and 2 said usually. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 21 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 The overall quality rating in this section is assessed as good. Staff numbers are sufficient to meet service users needs. Staff receive induction training. Staff receive further training to enable them to ensure service users needs are met. The homes recruitment procedures are robust and complete and protect the service user. EVIDENCE: On the day of inspection there were 2 qualified staff on in the morning with 5 care staff and 2 activity staff. Also on duty were 3 domestic staff, 1 laundry staff and 2 kitchen staff. The maintenance man was also on duty and no agency staff have been used recently. Survey results established that 3 service users felt that there were always available,7 said usually and one said sometimes. One comment was “Not always enough staff available.” A further comment was “on the basic call button it will take a long time”” Sometimes takes staff a little time to get to me” and “Staff are available most of the time. And “Staff are available most of the time.” And “The senior staff have too much paperwork to interact with the residents.” Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 22 On the day of inspection there were two staff on duty in The Acorns. Staff rotas evidenced a consistent level of staff on duty. There is a training plan for the year which covers induction training and all basic training needs. Training is encouraged the staff have access to internal training . All staff spoken to confirmed that staff training was ongoing and regular. A POVA training course had taken place the day before inspection. Certificates were seen of courses undertaken in dementia care and person centred care by the Dementia Care Coordinator. Over 50 of staff have achieved NVQ level 2 and the manager is about to undertake the A1Assessors Award. One staff member commented that the staff training provided had helped the staff work more effectively as a team. Four staff files were evidenced. These staff members had been employed since the previous inspection. All contained evidence of a thorough company recruitment process. Application forms include details of previous employment and any gaps in employment history are explored and recorded at interview. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 23 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 33 35 36 37 38 The overall quality rating in this section is assessed as adequate. The home is registering a new manager ,the Acting Manager has a positive leadership and management style. Where the home is responsible for resident’s money, it maintains very clear records that are routinely kept up to date and can be used to track individual residents finances. Staff are appropriately supervised and supported. Storage of records is in line with the Data Protection Act. The Health and Safety of service users and staff are adequate. Some maintenance issues remain outstanding. EVIDENCE: Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 24 The acting manager Caroline Orrell is a Registered General Nurse with previous, varied nursing experience. She works to continuously improve services and provide an increased quality of life for residents. There is a strong ethos of being open and transparent and improving communication in all areas of the running of the home. Discussions with the inspectors confirmed that she has a clear understanding of the needs of the service users living at the home. Quality assurance audits of service users and relative’s comments were evidenced. These comments had been audited and the manager confirmed that action was being taken to address any issues. The home has also developed a service users survey called “Living in the Home”. These surveys were clearly written in large print and required tick box replies and comments were invited. An audit of response was underway. There are established systems in place for dealing with service users finances. The inspector evidenced that each service users personal monies were stored in individual envelopes with a running total of deposits and withdrawals. Staff supervision records were evidenced and staff also confirmed that supervision takes place. One staff member commented that they considered supervision to be a valuable practice. An audit of accidents was seen and evidence noted that the manager reviews and countersigns all accident records. Qualified staff supervise senior care staff and they in turn supervise other care staff. Instruction had been given to support them with the supervision process. Records required for inspection were held appropriately, well managed and made available. Most health and safety arrangements were satisfactory. The manager is required to make arrangements to rectify the following hazards. The cleaning cupboard which stores substances which are hazardous to health only has one key. Therefore, staff leave the door open until the end of shift. This practice is required to be reviewed and further keys supplied to all domestic staff to ensure the door is locked at all times. The hot water outlet temperatures are recorded randomly for 3 outlets and all bathrooms each week. It is required that all outlets are tested and recorded every month. The manager has confirmed that this will happen in future. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 25 Comprehensive maintenance records were seen. These included : * Fire Extinguishers * Hoist Servicing * Emergency lighting * PAT Tests * LOWLER servicing * Gas Servicing * Electrical Hard Wiring * Fire System * Laundry Equipment Service * Lift servicing * Nurse call servicing * Sluice Machines * Chlorination Certificate * Environmental Health Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 2 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 3 3 X 3 3 3 1 Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12(1)(a) Requirement The acting manager is required to ensure that staff are made aware that service users have access to the nurse call systems at all times. The acting manager is required to ensure that substances hazardous to health are stored securely at all times. Further keys are required to ensure the cleaning cupboard can be locked at all times. Timescale for action 30/09/06 2. OP38 13(4)(a) 30/09/06 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 OP9 OP15 OP22 Good Practice Recommendations It is recommended that two staff sign when disposing of medication. It is recommend that all items stored on the tea trolley are kept covered including the sugar and biscuits. It is recommended that the acting manager ensure that all DS0000003274.V303728.R01.S.doc Version 5.2 Page 28 Oak Lodge Nursing Home 4. 5. OP38 OP38 service users receiving nursing care are nursed on hospital beds. It is recommended that the manager ensures that all hot water outlets are tested to ensure they do not exceed 43 degree and recorded every month. The inspectors recommend that flip top bins which are broken are replaced. Oak Lodge Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Nursing Home DS0000003274.V303728.R01.S.doc Version 5.2 Page 30 - 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!