Inspection on 04/01/06 for Oak Lodge Nursing Home

This inspection was carried out on 4th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 05/12/06

Oak Lodge Nursing Home 30/06/05

Oak Lodge Nursing Home 18/01/05

Oak Lodge Nursing Home 16/08/04

Oak Lodge Nursing Home 13/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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 Rectory Road Oakley Basingstoke Hampshire RG23 7EL Lead Inspector Marilyn Lewis Unannounced Inspection 09:30 4 January 2006 th 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 DS0000011655.V266467.R01.S.doc Version 5.0 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 DS0000011655.V266467.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oak Lodge Nursing Home Address Rectory Road Oakley Basingstoke Hampshire RG23 7EL 01256 780222 01962 782377 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) Forest Care Limited Mrs Sarah Maureen McColl Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability over 65 years of age of places (10) Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: Oak Lodge is a care home providing nursing care for forty one persons over sixty five years of age and those of that age who have physical disabilities. The home is one of two homes owned and operated by Forest Care Limited. Oak Lodge was opened in 1995 and the establishment forms part of a large Georgian Manor House with conference facilities. It stands in extensive grounds in Oakley, on the outskirts of Basingstoke, Hampshire. Residents are accommodated in thirty five single rooms and three double rooms sited over three floors. Two passenger lifts and stairs allow access to all areas of the home, including a large lounge, small lounge for smokers and a conservatory. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 4th January 2005. The inspector met with eight of the forty-one residents during a tour of the home, the registered manager, the administrator, two trained nurses and three carers. Care plans were sampled for six residents. The home’s policies and procedures were seen and the home’s policies and procedures were assessed. This was the second unannounced inspection for the home in the year 2005/2006. Information on the first inspection can be found in the inspection report dated 30th June 2005. What the service does well: On the day of the inspection the home looked very clean and welcoming and there was a relaxed atmosphere. The home provides prospective residents with good information about life at the home and they are able to visit the home before making a decision about living there. A full care needs assessment is carried out for all prospective residents, to ensure the home can meet their needs, before a place at the home is offered. The full assessment forms the basis for individual care plans. Care plans seen were detailed and provide staff with the information they require to support the residents. The health care needs of the residents are met and they are protected by the home’s clear procedures for dealing with medicines. Residents are treated with respect and sensitivity throughout their stay at the home. Residents are protected by staff awareness of abuse issues and their willingness to act on any concerns. The home provides residents with a clean, safe environment, with cheerful communal rooms and resident’s bedrooms that are homely and contain many Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 6 personal items such as small pieces of furniture, photographs and ornaments. Sufficient bathroom and toilet facilities are available and specialist equipment is provided as required. The home stands in extensive grounds and many of the rooms in the home provide pleasant views over the surrounding grounds and countryside. The number and skill mix of staff employed at the home meets residents’ needs. The registered manager runs the home well and residents and staff benefit from her open approach to management. Residents’ health, safety and welfare are promoted and protected by staff who receive regular supervision and the safe working practices in operation at the home. What has improved since the last inspection? 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 DS0000011655.V266467.R01.S.doc Version 5.0 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 DS0000011655.V266467.R01.S.doc Version 5.0 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): 1, 2, 3, 4 and 5 No one is admitted to the home without a full care needs assessment to ensure the home can meet their assessed needs and prospective residents are provided with good information and are able to visit the home before making a decision about living there. EVIDENCE: Since the last inspection the home’s Service User Guide has been reviewed to now provide prospective residents with improved information on life at the home. The document contains details of the registered manager’s qualifications and experience, an outline of the organisation responsible for the home, information on the number and size of resident rooms and the services provided. Staff qualifications are included but are vague, giving an indication of qualifications to be held and not the actual qualifications held. The registered manager said that she would arrange for the qualifications held by staff to be listed, to make it easier to understand. Each resident is provided with a written contract giving details of the terms and conditions for living at the home. The contract includes the room number Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 9 to be occupied, the services and facilities available and covered by the fees and gives an outline of additional services that are available at additional cost such as hairdressing and newspapers. Prior to admission a full care needs assessment is carried out before a prospective resident is offered a place at the home. The matron or deputy matron completes the care needs assessment. Assessments seen for three residents contained information on all aspects of care including personal and social care needs. Relevant information from relatives, care managers and health professionals was included in the completed assessment. The registered manager is a trained nurse and has the experience and qualifications required to run the home. Staff receive training in all aspects of care provision including infection control and wound care. Care plans seen indicate that advice is sought from GPs and other health professionals such as physiotherapists and dieticians as required. The registered manager said that prospective residents and their relatives are encouraged to visit the home before making a decision about living there. Following admission a trial period of four to six weeks is offered to ensure the home is the right place for them to live. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 10 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 and 11 Care plans provide staff with the information they require to meet the assessed needs of the residents, who are treated with sensitivity and respect throughout their stay at the home and who are protected by the home’s clear procedures for dealing with medicines. EVIDENCE: Care plans were seen for three residents who had recently been admitted to the home. The care plans covered all aspects of care needs including personal care, nutrition, pressure areas and mobility. Risks assessments had been undertaken on admission but had not been reviewed and updated even though the plans indicated that changes had taken place in the resident’s abilities. The residents had been admitted to the home at a very busy time and staff spoken to said that this was why the documents were not up to date. Although the documents had not been updated, staff spoken to, knew about the current needs of the residents and the actions required to meet those needs. Three care plans sampled for people who had been resident at the home for some time, indicated that the plans were reviewed regularly. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 11 The registered manager contacted the commission following the inspection to confirm that the care plans for the new residents had been reviewed and updated. Care plans seen indicated that residents were able to receive advice and support from GPs and other health professionals as required. GPs visit weekly and on request and physiotherapists and occupational therapist visit on referral from the GP. A dietician has provided staff with advice on specialist diets. Residents who wish are able to visit their dentist or optician in the community or receive consultations at the home. The home has clear procedures in place for dealing with medicines. All medicines brought into the home are recorded. The trained nurse responsible for the administration of medicines at the time of the inspection said that a new system was in place for the disposal of unwanted medicines. The nurse said that the home was arranging to keep a record of medicines placed in the disposal containers. Individual medication charts seen had been completed appropriately. Records for medicines stored in the controlled medicines cupboard were up to date and the records matched the amount held. The minimum and maximum temperature of the fridge used to store some medicines, such as eye drops, was being monitored and recorded. The nurse said that the temperature of the room where some medicines were stored, which could become very warm, was also being monitored to ensure medicines were being kept at the required temperature. During the inspection staff were seen to attend to residents in a caring, friendly manner. Four residents spoken to during the visit said that staff always treated them with respect. The registered manager said that residents were able to stay at the home when dying, if at all possible. Relatives are able to spend as much time as they wish at the home. The residents or their relatives provided funeral arrangement details that were recorded in their care plans. The registered manager said that some residents or relatives found discussing this issue difficult and wishes were sought in a sensitive manner. The home has procedures in place to ensure residents cultural and religious needs at this time were followed. Some staff have received bereavement support training. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 12 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): EVIDENCE: These standards were met when assessed at the last inspection. Information can be found in the inspection report dated 30th June 2005. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 13 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): 18 Resident’s safety is protected by staff awareness of abuse issues and the procedures to be followed should abuse be suspected. EVIDENCE: The home has procedures in place to be followed should abuse be suspected. The procedures were very detailed and the registered manager said that she was arranging for an easy to follow guide to be available for staff. Three staff members spoken to during the inspection were aware of the procedures and indicated that they would act on any suspicions of abuse. Staff receive training on abuse awareness during induction. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 14 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 and 26 Oak Lodge provides a clean, safe environment with cheerful communal rooms, suitable personalised bedrooms, sufficient bathroom and toilet facilities, pleasant gardens and specialist equipment as required. EVIDENCE: Oak Lodge is part of a large Georgian Manor House that stands in extensive grounds. The other part of the property is run as a conference and entertainment centre. Visitors to the conference centre are not able to access the nursing home without entering via the main nursing home door. Notices in the nursing home indicated that large entertainment events were due to take place at the conference centre in the summer of 2006. The registered manager said that residents of the home and their relatives were able to participate in the events and an action plan was being developed to ensure that any disruption to the home was kept to a minimum. All visitors to the home are required to complete the visitor record book when entering and leaving the property. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 15 At the time of the inspection the home looked very clean and welcoming. Accommodation is situated on three floors. Two lifts and staircases provide residents with access to all areas of the home that includes a large lounge, a small lounge for smokers, a conservatory and a separate dining room. Small sitting areas are provided on each floor of the home. Residents are accommodated in thirty-five single rooms and three double rooms. The rooms seen looked clean and homely and contained many personal items such as pictures, photographs, plants and ornaments. Five residents spoken to during the tour of the home said that they liked their rooms. Many of the rooms have pleasant views over the home and conference centre’s extensive grounds. All bedrooms in the home are fitted with an en-suite wash hand basin and toilet facilities and sufficient separate bathroom and toilet facilities are provided on each floor of the home. Specialist equipment such as hoists and pressure relieving mattresses, are provided for residents who are assessed as requiring them and grab rails and ramps are fitted where required to maximise the resident’s independence. The home stands in extensive grounds and residents have access to a patio area to the rear of the lounge, a garden to the side of the property and a central partially covered courtyard. A variety of seating is provided in all areas. All areas of the home looked very clean and in good order. Staff receive training in infection control and disposable gloves and aprons were readily available. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 16 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 and 29 The number and skill mix of staff employed at the home meets residents’ needs but their safety could be put at risk by the lack of robust recruitment procedures. EVIDENCE: The home employs the registered manager, a deputy matron, five trained nurses, seven trained nurses who work as ‘bank nurses’ and twenty carers. Separate staff are employed for administration, activities, catering and domestic duties. The registered manager said that staffing levels were flexible to meet the changing needs of the residents with additional staff employed when the resident’s dependency levels were high. Two care staff members are currently undertaking training for NVQ level 3 and two more for level 2. At present no carer holds the qualification. However twelve of the carers, who are from overseas, have qualified as nurses or physiotherapists in their home country but accreditation for the equivalent NVQ has not yet been obtained. The registered manager is aware of the requirement for fifty percent of care staff to hold level 2 or above or is in the process of obtaining the qualifications. The deputy manager and a senior nurse are due to start training to be assessors later this month. Recruitment records were seen for two staff members who have recently started work at the home. The records contained proof of identity and two Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 17 written references. One of the staff members is a trained nurse but the Personal Identification Number (PIN) had not been confirmed with the Nursing and Midwifery Council to ensure it was still valid. The registered manager is to confirm with the commission that the number has been checked. Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks had also not been completed for the staff member. An application for the checks had been completed and sent to the department. The home’s administrator telephoned the department while the inspector was present for an update on the process. A requirement has been made that POVA checks at least must be obtained before staff start work at the home. Since the inspection the registered manager has informed the commission that checks have confirmed the validity of the trained nurse’s PIN and a satisfactory POVA check has been received. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 18 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, 36, 37 and 38 The registered manager runs the home well and her open approach to management benefits the residents and the staff. Residents are protected by the regular supervision of staff and the safe working practises in operation at the home. EVIDENCE: The registered manager is a trained nurse with many years experience in providing care in a residential setting. She is currently undertaking NVQ level 4 in management. Four staff members spoken to during the inspection commented on the support received from the registered manager. The registered manager operates an open door approach to management. It was evident during the inspection that she had a good rapport with residents and staff. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 19 Resident meetings are held regularly. Records are kept of the discussions and copies are made available for residents who were unable to attend. The registered manager said that residents also have the opportunity to give their views on the quality of care provided at the home when she speaks to each one on a daily basis. Staff meetings are held every four months. Records seen for the last meeting indicated that all aspects of care provision were discussed including confidentiality, team working and care plan documentation. A system is in place for all staff members to receive regular supervision. The registered manager supervises the trained nurses who then supervise the care staff. Supervision meetings are held at a time suitable for both parties and records are kept. The home has procedures in place for all aspects of care provision including health and safety, manual handling, staff recruitment and visitors to the home. The documents showed evidence of regular review and the registered manager said that the procedures were reviewed on an annual basis or more frequently if required. At the time of the last inspection it was noted during a tour of the home that some fire doors were wedged open. On this occasion no doors were wedged open. Hazardous substances such as cleaning fluids were stored safely and information regarding substances in use at the home was available for staff. Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 21 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 The registered person must ensure that a Protection of Vulnerable Adults check is completed for all staff members before they commence work at the home. Timescale for action 05/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oak Lodge Nursing Home DS0000011655.V266467.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000011655.V266467.R01.S.doc Version 5.0 Page 23 - 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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