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Inspection on 03/03/06 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 3rd March 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 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 home continues to have a group of qualified nursing staff and care assistants who have worked there for a long time. The staff were very aware of the residents` needs. The residents said that they liked the staff and felt safe in the home. One resident told the Inspector that the staff were "smashing". Another resident said that they were "good girls". Activities were considered to be an important part of the residents` day. The activities person who worked at the home was aware of what each resident liked, and was able, to do.

What has improved since the last inspection?

There continues to be an ongoing programme of redecoration and refurbishment throughout the home. The home has provided some specialist nursing "profiling" beds. These ensure the comfort of the resident and make it easier and safer for the staff to care for them.

What the care home could do better:

The home needs to look at employing somebody to do the small repair jobs around the home. Management must make sure that the way they recruit staff is done safely. They must make sure that staff do not start work for them unless they have sent off for a Criminal Records Bureau (police) check and they have been informed that the employee is not a risk to the residents.

CARE HOMES FOR OLDER PEOPLE Oak Lodge Nursing Home 514 Bury New Road Prestwich Manchester Lancashire M25 3AN Lead Inspector Grace Tarney Unannounced Inspection 10:30 3 March 2006 rd 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 DS0000017320.V285008.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 Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oak Lodge Nursing Home Address 514 Bury New Road Prestwich Manchester Lancashire M25 3AN 0161 798 0005 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) Mr S R Latimer Dr Kumar Shamroa Kotegaonkar Mrs Mavis Birkenshaw Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Oak Lodge Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th August 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 Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 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 5 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. To make sure that the home and the equipment in it was safe, the Inspector looked at the maintenance and service records. She also looked at how the management recruit their staff and how they handle the residents’ spending money. The Inspector then looked around the building at the bedrooms, bathrooms toilets and sitting areas to check if they were clean and well decorated. She then visited residents in their own bedrooms to check out the care that was being provided for them. In order to obtain information about the home, the inspector also spent time speaking to 3 residents, the registered manager, the deputy, the administrator, the activities organiser 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? Oak Lodge Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 6 There continues to be an ongoing programme of redecoration and refurbishment throughout the home. The home has provided some specialist nursing “profiling” beds. These ensure the comfort of the resident and make it easier and safer for the staff to care for them. 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 DS0000017320.V285008.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 Nursing Home DS0000017320.V285008.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): EVIDENCE: Standard 3 was not inspected on this visit. It was looked at during the inspection of the 19th of August 05. There were no requirements. Standard 6 does not apply. The home does not provide intermediate care. Oak Lodge Nursing Home DS0000017320.V285008.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): 9 The medication system in place was safe and residents received their medicines correctly. EVIDENCE: Standards 7, 8,10 and 11 were looked at during the last inspection. There were no requirements. It was identified during the last inspection that the care plans reflected the support needs of the residents and that care practices ensured the residents’ health care needs were met. Only standard 9 was looked out during this inspection. This was to check compliance with previous requirements following the inspection of the 19th of August 05. The requirement to ensure that medications were segregated into some form of order had been complied with. A large storage cupboard had been provided. A safe system of medication management was in place however several transcriptions of medications had not been signed, checked and countersigned. Signing and checking transcriptions reduces the risk of drug errors. Oak Lodge Nursing Home DS0000017320.V285008.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): 12,13 & 14 The home enables residents to exercise as much personal freedom and choice as possible. EVIDENCE: The home has appointed an activities organiser. She works at the home 3 days per week and undertakes various activities. The Inspector joined in a game of bingo that was being played in the conservatory. The residents told the inspector that they liked having “things to do”. A discussion with the residents and staff confirmed that the residents were able to receive visitors in private and that they were able to choose whom they see and do not see. Residents are encouraged to bring personal possessions into the home. Many of their bedrooms were highly personalised with small pieces of their own furniture, pictures, photographs and ornaments etc. Oak Lodge Nursing Home DS0000017320.V285008.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): EVIDENCE: Standards 16 17 & 18 were looked out during the last inspection. There were no requirements. Oak Lodge Nursing Home DS0000017320.V285008.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 24 25 &26. The residents live in suitably adapted, clean, safe and comfortable surroundings. EVIDENCE: There is ramped access to the front of the home and there is adequate parking to the side. The entrance hall is very welcoming with adequate seating. The inspector walked around the home. There is a large lounge area to the side of the home and adjacent to this is the conservatory that looks out onto a garden area where there is a small amount of seating. The conservatory is designated for those residents who wish to smoke. There is a large dining room and at the far end of this there are two small sitting rooms. Furnishings in the communal areas were seen to be satisfactory. There were enough toilets and bathrooms to meet the needs of the residents. Toilets were in close proximity to bedrooms and communal areas. Each toilet Oak Lodge Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 13 and bathroom had a lock on the door to ensure privacy and the facilities were clearly marked. The toilets were clean and were suitably adapted for disabled use. It was evident that there was an ongoing programme of redecoration and refurbishment. The corridors and several of the bedrooms had recently been redecorated. Some of the bedrooms also had new carpets in place. The protective plates on several of the bedroom doors were either coming away from the door or had been removed. This made the doors look unsightly. All bedrooms remain without a door lock. A previous discussion with the provider in respect of this issue identified that it is the policy of the home to ask residents if they wish to have a lock on their door or not. Their wishes are then recorded in their care plan. Evidence of this was seen. The inspector saw that 2 nursing profiling beds have recently been provided. The heating within the home was adequate. All the rooms were centrally heated with radiators that were suitably protected. Thermostatic control valves were in place on immersion baths and showers. The home was clean and free from odours. Hand washing facilities were in place in bedrooms, bathrooms and toilets. Clinical waste was handled appropriately and the home had a contract for the removal of clinical waste. Oak Lodge Nursing Home DS0000017320.V285008.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 & 29. The residents were cared for by sufficient numbers of staff that were suitably qualified, experienced and trained and therefore had the knowledge and skills to meet the residents’ needs. The inadequate recruitment procedure could place residents at risk of harm. EVIDENCE: Examination of the duty rotas and a discussion with staff and residents identified that there was sufficient care staff on duty to meet the needs of the 35 residents, 17 of which were of residential status. The home still does not have its’ own handyman. Staff have to rely on the services of a handyman who is employed elsewhere. The personnel files of three staff members were inspected. Two of the files were satisfactory and contained all the necessary references and CRB disclosure checks. One staff member however, had been employed before a CRB disclosure check and POVA first had been applied for by the home. This staff member had brought with her the CRB disclosure check from her previous employment. This is not acceptable and not in accordance with legislation. CRB disclosures are not portable. An immediate requirement form was issued in respect of this. Confirmation that the home has sent for a POVA first and enhanced CRB has been received by the CSCI. Oak Lodge Nursing Home DS0000017320.V285008.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 &38. The experience and qualifications of the manager ensures there is effective leadership and guidance to the staff thereby ensuring that the residents receive consistent quality care. A satisfactory accounting system was in place that ensured the residents’ interests were protected. Current practices within the home in relation to the maintenance of a safe environment, promoted and safeguarded the health, safety and welfare of the people using the service. EVIDENCE: The registered manager is a Registered General Nurse with extensive experience of nursing both within the NHS and the private sector. She has also obtained the ENB 998 teaching and assessing course. The manager has not yet undertaken any management training. Oak Lodge Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 16 Although a quality audit in relation to Catering, Health and Safety, Housekeeping, Maintenance and nursing records was undertaken on a quarterly basis there was no formal quality assurance system in place. Questionnaires have been developed for residents and relatives to complete but there was no evidence of any findings. Other ways of monitoring the service would be via questionnaires to other stakeholders i.e. district nurses, care managers etc and the results of any surveys should be published in the Service User Guide. The systems in place for the management of residents’ money were good. The home had a satisfactory accounting system in place. Receipts were retained for all financial transactions. The equipment and services within the home were serviced on a regular basis in accordance with the individual requirements. There was however, no documentation to show that the nurse call system had been serviced within the last 12 months. The fire logbook was up-to-date. All staff received Induction Training with regard to food hygiene, fire safety, moving and handling and infection control. Fire training was undertaken on an annual basis. Oak Lodge Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 3 3 x x 2 3 3 STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 2 Oak Lodge Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP24 Regulation 23 Requirement The protective plates on the bedroom doors must be replaced/repaired. (Previous requirement from 31/10/05 not complied with) Staff must not be employed until a CRB disclosure check has been applied for and returned or a satisfactory POVA first has been applied for and received. An immediate requirement form was issued in respect of this. This has been complied with. A system for reviewing the quality of care provided at the home must be established and maintained. Evidence to show that the nurse call system has been serviced must be forwarded to the CSCI. Timescale for action 30/06/06 2. OP29 19 10/03/06 3. OP33 24. 30/06/06 4 OP38 13 30/06/06 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 Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 19 No. 1. 2. 3 Refer to Standard OP9 OP27 OP31 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. The manager should undertake training at level 4 NVQ in management and care or equivalent. Oak Lodge Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office 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 Nursing Home DS0000017320.V285008.R01.S.doc Version 5.1 Page 21 - 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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