Inspection on 30/05/07 for Oak Lodge Nursing Home

This inspection was carried out on 30th May 2007.

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 02/11/09

Oak Lodge Nursing Home 12/11/08

Oak Lodge Nursing Home 03/03/06

Oak Lodge Nursing Home 19/08/05

Oak Lodge Nursing Home 11/03/05

Oak Lodge Nursing Home 11/08/04

Oak Lodge Nursing Home 03/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Oak Lodge Nursing Home 514 Bury New Road Prestwich Manchester Lancashire M25 3AN Lead Inspector Unannounced Inspection 30th May 2007 09:15 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.V335730.R02.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 DS0000017320.V335730.R02.S.doc Version 5.2 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) None 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.V335730.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2006 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. The inspectors were informed that the weekly fees within the home ranged from £388 for residential care to £494 for nursing care. Also the fees for those residents being funded for Rapid Response or Continuing Care ranged from £500 to £650 per week. Additional charges are made for private chiropody, hairdressing and newspapers. This information was received on the 11th May 2007. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 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 although the home was aware that an inspection was due. This was because several weeks before the inspection questionnaires were sent out to the residents, their relatives and to the home itself. The questionnaires that were sent out to the residents and relatives were called Have Your Say and they asked what people thought about their care and of the quality of the service provided for them. 2 relative questionnaires were received. Some of their responses are detailed in different sections of this report. 2 Inspectors visited the home and were there for 8 hours. During this time they looked at care and medicine records to ensure that the health and care needs of the residents were being met. They then visited residents in their own bedrooms or in the lounge areas. The Inspectors then looked around the home at some of the bedrooms, bathrooms and toilets to check if they were clean, well decorated and suitably adapted for disabled access. The Inspectors also looked at what the residents had for their lunch and the food stocks within the home. They also looked at how many staff were provided on each shift to make sure the residents needs were being met, and also looked at how management recruit and train their staff. How the home manages the residents’ spending money was also looked into. To make sure that the home and the equipment in it were safe some of the maintenance and service records were looked at. In order to get further information about the home the Inspectors also spent time speaking to 3 residents, 1 care assistant, a visiting district nurse and physiotherapist, the manager and deputy manager, one of the owners and the external management consultant. What the service does well: The manager makes sure that the home only cares for those people whose needs the staff can meet. The residents’ care plans contain a lot of important information about what they need help with, and how they are to be cared for. The staff make sure that they continually look at anything that may be a risk to the residents. They then make sure that they write down in the residents care plan when they have done this, and what action they have taken to reduce the risk. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 6 The qualified nurses and care staff are extremely good at caring for the residents who are very ill and need lots of specialised care. Management make sure that all the necessary equipment needed for their care is available. Residents feel that they are well looked after by the staff and the following comments were made both by residents and relatives: ‘The attention given is more than I expected in a care home’. Enough staff are on duty to meet the needs of the residents. The staff make sure that the residents are clean, comfortable and well dressed. The staff teams work well together and good systems are in place for sharing information about residents. What has improved since the last inspection? What they could do better: Management should look at ways of improving the way that they check out the quality of care and the services provided by showing that residents are involved in decisions that affect them. The owners and senior management must look at ways of making sure that meetings with individual staff happen regularly, so that they are able to discuss their work and responsibilities and receive support in carrying out their duties. These meetings should be recorded to show any areas of development and training needs. All people must have a current Criminal Records Disclosure Check prior to working in the home. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Oak Lodge Nursing Home DS0000017320.V335730.R02.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 DS0000017320.V335730.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed before they are admitted to the home and this gives an assurance to everybody, that a person is only admitted if the home can meet their needs. EVIDENCE: Before any resident was admitted to the home an assessment of their needs was undertaken, either by the manager or a senior member of the nursing staff from the home. The 2 assessments looked at were detailed and gave a clear indication of the residents’ needs and what they could and could not do for themselves. The home also admits 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 Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 10 under this scheme they had an assessment undertaken by qualified nurses in the community. Standard 6 does not apply. The home does not provide Intermediate Care. Oak Lodge Nursing Home DS0000017320.V335730.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans and care practices ensure that the residents’ needs are met in a very safe, caring and dignified way. EVIDENCE: Individual care plans were in place for each resident. The care plans of 3 of the residents were inspected. The care plans were very detailed and gave clear instruction and guidance on how the care needs of the residents were to be met when problems had been identified. The staff looked at whether or not there was any risk in relation to the residents developing pressure sores and also if they were at risk due to problems with their diet and fluid intake. These are called risk assessments. They also assessed if it was safe to use bed rails. Risk assessments were in place for whether a resident was at risk of falling. They also looked at and they wrote down, how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 12 Inspection of the care files identified that the residents had access to health care professionals, such as dentists, opticians and chiropodists. A district nurse and a private physiotherapist were visiting residents whilst the Inspectors were in the home. The district nurse said “there are absolutely no problems with the staff they are very obliging and work well together. They are very quick to respond if we make any requests for any treatments to be carried out”. The physiotherapist also said “I think the nurses are very good and offer the support that we have requested”. Equipment necessary for the prevention and treatment of pressure sores was available and in use. The following comments were made in the survey cards received: “So far all nursing and care given has met her needs perfectly”. “Nursing care is excellent but the main thing that keeps its high standard is the constant vigilance and support of the managers who are always available and open to discussion. It seems like a partnership where have I have a part rather than just handing my neighbour over to strangers”. “I also like the way managers always are aware of things and when needed, guide staff in the way of how to do things to maintain the ethos of the home”. Following a discussion with some of the residents they made the following comments: “The staff look after you”. “Yes, they are all very nice”. A safe system of medicine management was in place. Medicines were stored securely and recorded accurately. Staff were seen to be discreet when providing assistance. Staff demonstrated by example their knowledge of maintaining privacy and dignity, by knocking on doors, closing toilet doors and speaking to residents in a quiet and respectful way. The residents looked clean and comfortable and were suitably dressed. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 &15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a choice in how they spend their day and find some enjoyment with the activities available. EVIDENCE: The Inspectors saw that some residents spent their day in the large lounge, some in the conservatory and some in the smaller lounges. They told the Inspectors that this was their choice and that they could more or less do as they pleased. An activities organiser visits the home twice a week and does various activities with the residents as well as organising visiting entertainers. Staff told the Inspectors that an entertainer had been in the home the previous day. Staff also told the Inspectors that the local library asks for the residents’ reading preferences then sends a selection of books and then collects them after 4-6 weeks. 4 of the residents also have a newspaper of their own delivered every day. There is a notice board in the conservatory inviting residents to a regular afternoon dance at the Elizabethan suite. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 14 Management have informed the Inspectors that in the future they wish to increase the amount and variety of social activities and involve the residents in this. A Roman Catholic minister routinely visits the home every second Friday for communion and ministrations. Although the Church of England clergy do not visit regularly they will visit people on an individual basis. Management told the Inspectors that all religions are respected and people are free to practice their faith. Staff and residents said that the hairdresser visits 2 afternoons per week on a Monday and Tuesday. Evidence of this was seen in the personal finance ledger. There is a Polish resident in the home and although she speaks English she is able to chat with the Polish staff in her own language. Comments from the survey cards were: “The residents seem to follow up their own inclinations. Those wishing to read are made comfortable and the surface suitable to the reading level is provided”. “The staff unobtrusively allow residents to do what they can, but usually being ready to step in to help if needed”. Residents spoken to said that their friends and families could visit whenever they wanted and that staff made them welcome. Those spoken to said that they preferred to see their visitors in the lounges but their bedrooms could be used if they wanted to see them in private. The Inspectors did not eat with the residents but checked out what they had been offered for lunch. The Inspectors saw that earlier on in the day the tables were nicely set with napkins and condiments. There was a choice of main course and dessert. The main meal is at lunchtime with a lighter meal in the evening. There is always soup and sandwiches as an alternative to the lighter meal. Hot and cold drinks were being served throughout the day. Members of staff told the Inspector that food and drinks are available out of hours and that milky drinks are always available. The food stocks were looked at. They were good. There was plenty of fresh fruit and vegetables and ample stocks of dry food stores such as tinned fish, meats, fresh orange juice, fruit and dairy produce including whole milk and butter. The storage situation needs to be improved however, because container bags of pastry and sponge mixes were left unsealed and a packet of biscuits was left open and stored on the floor. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 15 Resident comments about the meals were: “Yes I enjoyed my meal”. “The cook is always spot on”. Any cultural or dietary needs, likes and dislikes were looked at when a resident is first admitted to the home. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and staff have a good knowledge and understanding of what abuse is, thereby reducing the possible risk of harm to residents. EVIDENCE: The complaints procedure was displayed and it is also included in the Service User Guide. It is easy to understand and gives an assurance that complaints will be responded to within 28 days. 2 complaints have been made to the CSCI within the last 12 months. 1 was not substantiated and the manager of the home is investigating the most recent one. A relative commented: “I know how to make a complaint. Information is given in the literature before start of residency and also in the contract”. A copy of the Local Authorities Vulnerable Adults Procedure was in place and a discussion with the senior staff identified that they were very aware of the procedure to follow in the event of any allegation of abuse. Some staff have undertaken training in the protection of vulnerable adults but quite a few staff members still require the training. Management are aware of this and intend to schedule in the training in the near future. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 24 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in suitably adapted, clean 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. 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 the seating. The conservatory is designated for those residents who wish to smoke. Management told the Inspectors that they are looking to improve on the smoking area so that it complies with the new law about smoking that comes into force on the 1st July 2007. The lounge and large conservatory were well furnished and carpeted. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 18 There is a large dining room and at the far end of this there is a conservatory area that is divided into two small sitting rooms. These rooms were without any curtains or blinds. This could cause temperature problems throughout the year. On the day of inspection the rooms did feel cold although it was a fairly warm day and the radiator was not turned on in the room directly off the dining room. The temperature measured 19 degrees C. This is slightly below what it should have been. Consideration needs to be given to providing some type of screening to these conservatory windows. The carpet on the ground floor corridor was quite soiled. The Inspectors discussed the condition of the carpet with the manager and her deputy, as they were aware that the carpet had been replaced within the last 2 years. The manager agreed that the condition was due to the fact that the area was a thoroughfare leading to bedrooms, bathrooms, toilets and the lounge. 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 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. The ground floor bathroom was being used for storage and it had a very “damp type” smell. The manager agreed that the room did smell damp and that this bathroom is used occasionally by residents for bathing. It should therefore be free of storage and odours so that residents can be bathed in a pleasant clutter free environment. 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. A relative commented on the survey form that the security of the bedrooms was an issue and that, to prevent residents entering other peoples’ bedrooms, the security of the bedrooms could be improved. This relative did state that management had been informed of their concern. The Inspectors discussed the issue of making sure that each resident was asked on admission if they wanted a safety lock and key for their bedroom and that it was explained to the resident or/and their family that staff could get into their room in the event of an emergency. This is ensuring that the residents can make an informed choice. All the rooms throughout the home 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 offensive odours. Hand washing facilities were in place in bedrooms, bathrooms and toilets. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 19 Clinical waste was handled appropriately and the home had a contract for the removal of clinical waste and for outside laundry services. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by very experienced and skilled nursing and care staff, however a formal process of recruiting staff needs to be in place to ensure the suitability of new staff so that they are able to appropriately meet the needs of the residents. EVIDENCE: Inspection of the duty rotas and a discussion with staff and residents showed that there was enough staff on duty over a 24-hour period to meet the needs of the 29 residents living at the home. 24-hour nursing care continues to be provided by qualified nurses who are supported by suitably trained care assistants. Management has recently introduced the system of having senior care workers to further support the qualified nurses. The nurse manager and her deputy felt that this was a positive move forward. Comments from a relative were: “The care staff have the right skills and experience to look after people properly. I am particularly pleased to see the numbers of staff allows time for staff to pass the time of day as well as just caring for bodily needs of residents. This keeps individuality going and makes residents feel valued and respected”. 50 of the care staff have obtained or are doing their NVQ level 2 or 3 in care. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 21 The personnel files of 5 staff members were inspected. 4 were overseas workers, 3 who had been in the employ of the home for at least 12 months and 2 who had been recently employed. They had a completed application form, 2 professional references, a criminal record disclosure (CRB) check and a health status declaration. It was identified that in the personnel files of 4 of the overseas workers there were no interview notes. The Inspectors were told that they were recruited from an agency in Leeds and were then sent on to the home. The external consultant told the Inspectors that they were not formally interviewed and that the manager had an informal chat with them before employing them. The Inspectors discussed the issue with the manager who stated that she does not review their details before they arrive in this country nor meet with the overseas workers prior to them starting work but if she felt they were unsuitable she would then inform the agency. The Inspectors recommended that the manager should have a more formal system of assessing staff suitability prior to them commencing work in the home and a record of interview should be kept on the care workers’ file. The Inspectors also identified that the activities person had no CRB check and neither did the external consultant. The Inspectors were told that the reasoning for this was that they were self employed. Regardless of employment status, management has a responsibility to ensure that any person that they contract with who has access to vulnerable adults in their care must have a CRB disclosure check. The deputy manager, who is in charge of the training programme at the home told the Inspectors that the manager has signed up with Bury Partnership in relation to the Skills for Care training and that it was very beneficial for everybody. Staff are paid to attend training days. The partnership is in the process of planning the next round of training. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are needed to ensure that there are clear systems of communication in place and identified responsibilities in relation to delegated management tasks. This will ensure that the residents are protected and the service runs effectively with everybody knowing what their responsibilities are. EVIDENCE: The registered manager is a Registered General Nurse with extensive experience of nursing both within the NHS and the private sector. She has worked at the home for over 18 years. She has also obtained the ENB 998 teaching and assessing course. The manager has not yet undertaken any management training. 1 of the owners told the Inspectors that he had very Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 23 recently discussed the training with the manager and asked her to enrol on the course. An office administrator is not currently employed at Oak Lodge. These tasks had been divided between the registered manager and the external consultant. Following a discussion with the external consultant and the registered manager information provided to the Inspectors however was conflicting in relation to which areas of management and administration they undertook. For example there was conflicting information in relation to just when and by whom the fire systems are checked. The registered manager was not sufficiently informed of those tasks currently being undertaken by others working in the home or aware that as the registered manager she has the overall responsibility for the management and day to day control of the home. The registered manager and the registered provider have a responsibility to ensure that any person that they contract with, who has access to vulnerable adults in their care, has a CRB disclosure check. This issue has been the subject of immediate requirements made during the previous 2 inspection visits. The providers need to establish a sustained pattern of meeting this requirement to ensure that the residents are suitably safeguarded. There was no evidence to show that management regularly review their practice in relation to reviewing the quality of care provided at the home although they have sent out questionnaires to visitors and local GPs. Apart from their monthly visit records where they spoke to 1 resident on each visit, there was no evidence to show that they had sought the views of the residents. The Inspectors were shown the survey results from a questionnaire that was sent out to local GPs in respect of the Rapid Response system. Of the questionnaires returned 80 of the GPs had used Oak Lodge and had found the service to be rated good. The Inspectors also saw evidence of questionnaires that were sent out to local GPs and relatives during May 2006. The questionnaires asked for information in relation to the quality of service and facilities at Oak Lodge. The Inspectors were shown the Quality Audit tool that is not yet in use but a discussion with the external consultant showed that he would be working with the manager, the housekeeper and the operations officer (not yet in post) to expand the quality assurance programme so that there was a regular review of the care and facilities provided at the home. Following the inspection, at their request the Inspectors were sent copies of the Regulation 26 Notices from November 2006 to April 2007. These Notices are a record of monthly visits to the home that have to be undertaken by the owners or their representatives. The manager told the Inspectors that both owners do visit the home at least once a week. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 24 The systems in place for the management of residents’ money were good. The home had a satisfactory accounting system in place. They have recently introduced a ledger for recording any money paid in or out. Receipts are also kept for any purchases made. A discussion with the manager, 1 of the owners and the external consultant showed that there had been no 1-1-supervision sessions for the manager. The Inspectors were told that the owners did meet with the manager, her deputy and the consultant but this was to discuss general issues within the home. After the inspection the Inspectors were sent a record of a meeting of the 3/10/06. In view of the concerns identified following the last inspection of 9/11/2006 where several management requirements had not been met it is of concern that there has been no 1-1 supervision of the manager. To ensure that there is no misunderstanding about who does what, there needs to be regular supervision sessions whereby these and other issues can be discussed. A discussion with the manager and deputy showed that whilst they regularly observed and supervised the care staff when they were delivering care, there was no formal 1-1 supervision that focused on the personal development of the staff and the identification of training needs. The manager and her deputy said that they have a handover of information on every shift and daily discussions about care and care practices, but no staff meetings. 1 staff member told 1 of the Inspectors that she felt supported by the manager and her deputy and that they were very approachable. The manager now sends in to the CSCI, the notification documents that are required by law. Fire risk assessments were in place and the fire logbook was up-to-date. Regular checking and testing of the fire detection system, fire exits and emergency lights was undertaken and documented. Any accidents that happen are properly recorded. The information taken from the Annual Quality Assurance Assessment document filled in by management showed that the equipment and services within the home were serviced on a regular basis in accordance with the individual requirements. In addition the Inspectors checked the documentation in relation to the servicing of the passenger lift, the gas safety, servicing of small electrical appliances, the hoists and water temperatures. These were regularly serviced and up to date. Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 1 x 3 Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 26 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 OP29 Regulation 19(1)(b) Requirement To ensure that the welfare of the residents is protected, the manager must ensure that CRB disclosure checks are undertaken for any person who, in a working capacity, has access to vulnerable adults in their care. Staff working in the home must be properly supervised to ensure that they are aware of their roles and responsibilities and are delivering the right kind of care for people who use the service. This will also ensure that any training needs are identified. Supervision must be implemented by the specified date. Timescale for action 31/07/07 2. OP36 18(2) 31/07/07 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.V335730.R02.S.doc Version 5.2 Page 27 No. 1 2 3 4. Refer to Standard OP19 Good Practice Recommendations The carpet on the ground floor corridor needs to be kept clean or consideration given to replacing it with a more practical, durable floor covering. Consideration needs to be given to providing some type of screening to the small conservatory windows. So that residents can be bathed in a pleasant environment the storage should be removed from the downstairs bathroom. Management should ensure that each resident is asked if they want a safety lock and key for their bedroom and it should be explained to the resident or/and their family that staff can get into their room in the event of an emergency. To ensure that care workers are suitable they should be interviewed and information of the interview kept on the care workers file. The manager should undertake training at level 4 NVQ in management and care or equivalent. Management should seek the views of the residents with regards to the facilities in the home and the quality of care provided for them. OP20 OP21 OP24 5 OP29 6 7 OP31 OP33 Oak Lodge Nursing Home DS0000017320.V335730.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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