Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Oak Lodge Rest Home 1a Adams Road Shire Oak Brownhills West Midlands WS8 7AL The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Yvonne Allen
Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 34 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 34 Information about the care home
Name of care home: Address: Oak Lodge Rest Home 1a Adams Road Shire Oak Brownhills West Midlands WS8 7AL 01543372078 01543372078 pam@davidwilson6.wanadoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Pamela Mary Wilson Type of registration: Number of places registered: Mrs Pamela Mary Wilson,Mr David Alan Wilson care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 17 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the homeare within the following categories: Old age, not falling within any other category - Code OP 17 Dementia - Code DE 17 Date of last inspection Brief description of the care home Oak Lodge is a two storey detached property located in a quiet residential area of Brownhills. The building comprises of seventeen single bedrooms, many with en-suite facilities, a lounge, separate dining room, kitchen and laundry. There are parking facilities to the front of the property and a small, enclosed garden, with patio to the Care Homes for Older People
Page 4 of 34 Over 65 0 17 17 0 Brief description of the care home rear. The home is approximately one mile from the centre of Brownhills, close to bus routes to other towns, shops and other amenities. Oak Lodge is registered to provide care for up to seventeen older people of both sexes for the reason of old age. Over the past two years a number of improvements to the building have been made, including the installation of a passenger lift, improving facilities offered to the people who live there. Over the twelve months the home has also been granted registration to accommodate elderly people with dementia care needs. The weekly fees charged by this home range from 350 to 390 pounds. Care Homes for Older People Page 5 of 34 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. The inspection process commenced several weeks prior to the visit and the visit to the home was carried out by one inspector over one day. Prior to the inspection visit the Providers had completed a self-assessment tool, which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to undertake a self-assessment, which focuses on how well outcomes are met for people using the service. In this case the AQAA was completed well and gave us good information on how the service sees Care Homes for Older People
Page 6 of 34 itself. Several weeks prior to the inspection visit we sent a number of surveys to be completed by people who live in the home, relatives and staff members. Many of these were returned to us and comments from them have been included in this report. All of the Key Minimum Standards were assessed and for each outcome a judgment has been made, based on the evidence gathered. These judgments tell us what it is like for the people who live in this home. The ways in which we gathered evidence to make our judgments are as follows We looked at any information we had received about the home since the last inspection. We spoke with the people who live in the home. We spoke with the staff who work in the home. Discussions were held with the Registered Manager and Provider. We examined relevant records and documentation. We walked around the home and visited all bedrooms and communal areas. We observed care practices and staff interaction with the people in their care. At the end of the inspection visit we discussed our findings with the Registered Manager and Provider. As a result of this Key Inspection we have made 2 requirements and 2 recommendations. What the care home does well: The home provides people who live there with a clean comfortable environment which is domestic in character and adapted to meet their needs and physical limitations. Staff are carefully chosen to work at the home. New staff undergo a thorough induction training programme and people can be assured that staff have the necessary training to meet their needs. Staff have a good rapport with the people who live in the home. They are caring and attentive. The Manager and Provider run an open door policy and are approachable. The home is well run and managed in the best interests of the people who live there. People feel that they have a voice and that any concerns they might have are dealt with swiftly and effectively. Personal care needs are met with dignity and respect and people are encouraged to maintain their own Independence wherever possible. Individual health care needs are monitored and access to health care professional is facilitated and arranged where needed. There is an effective Quality Assurance system in place at the home and this helps to maintain and improve services. This is what people who live in the home and their relatives feel that the home does well Senior staff and management are very approachable. They act promptly and sympathetically to any concerns you might have. They keep you fully informed regarding any situations. The home has made my Aunt extremely welcome and looks after her every needs very well. Oak Lodge is always a very clean and friendly place. They do not discriminate and do their best to make their residents feel at home. All his needs are met, if he is not well they give him their care and attention at all times. They care for my mother in an excellent way. They treat residents as part of a large family but still cater for their individual needs. All staff are caring and friendly. Nothing is ever too much trouble for them, however busy they may be. Care Homes for Older People Page 8 of 34 Very efficient and caring friendly staff who are available at all times. Staff are always welcoming and friendly. My mother is quite deaf and partially sighted so we really appreciate being able to chat over a cup of tea in the privacy of her own room. I visited many homes before deciding on Oak Lodge. I have never regretted the decision as Oak Lodge provides a caring, family home and is happy to support both residents and their families. I recommended the home to a friend whose mother needed care and she is now happily settled at Oak Lodge. They look after my mother as good as is possible and they keep a very sick lady alive, comfortable, with dignity and to their best. I am totally satisfied. A visiting professional told us - Oak Lodge is one of the best residential homes within this area and offers a very friendly atmosphere to all. What has improved since the last inspection? The Providers tell us that this is how they have improved since the last inspection One carer now welcomes and assesses the visiting client. The assessment is discussed with managers in order to reach a decision and decide a future plan. This helps to ensure that people coming into the home settle in and feel welcome. The registration has been extended to include existing and new clients with mild dementia up to a number stated in the Statement Of Purpose. This document has been revised to reflect this. This information is provided to people considering coming into the home. Also more monitoring of professional visits takes place to help ensure that health care needs are met. The manager has attended a course in risk management and has cascaded this to other staff. Detailed risk assessments are now completed in respect of people with high risk needs. Again this helps to ensure that all needs are met and people are kept safe. The Providers now monitor and document personal choices in respect of activities of daily life in the home and more staff are provided at busy times to ensure that these needs and preferences can be met. No complaints have been made to us or the Providers over the last 12 months. The Providers have upgraded the security of the home as a result of extending their Care Homes for Older People Page 9 of 34 registration to accommodate people with dementia care needs. This helps to ensure that people are kept safe. They have also replaced some furniture - new dining chairs, new overbed tables and 4 new television sets. This has helped to improve the facilities and comfort offered to people who live in the home. Sit on scales have been purchased which will help to monitor the weight of people more effectively. More infection control procedures have been put into place including color coded mops and sanitation of these. More staff training in this area has been put into place. This helps ensure that infection control guidelines are adhered to and people are kept safe. An additional member of staff is provided from 6pm-9pm to make 3 in total so that peoples needs can be met more effectively. 61 of care staff are now trained to NVQ levels 2 and above, this helps to ensure that staff have the skills and training required to meet needs. Job application forms have been improved to include obtaining a 10 year employment history and exploring gaps in employment and risk assessments have been developed for new staff until their enhanced CRB is received. This helps to safeguard people who live in the home. The Providers have improved their quality monitoring system and this includes obtaining the views of the people who live in the home. This will help to maintain and improve all services offered to people in the home. What they could do better: The Provider should review the programme of activities to help ensure that peoples social and therapeutic needs are met. One person told us that they would like to have A wider choice of activities for people with mental and physical disability. Perhaps more sessions of Reminiscence Therapy. Another person said - I would like to go on more trips out. One person felt that the laundry was not always adequate They could take more care in sorting out the clothes after washing. Another person felt that having people with dementia care needs in the home had an Care Homes for Older People Page 10 of 34 impact on the other people who live there The ratio of dementia patients should be lower to allow a more normal environment for people who are only suffering from old age. This was discussed with the manager and she intends to monitor this ratio very carefully. One person told us Sometimes the staff seem stretched to the limits but I think this is due to illness rather than actual staff shortages. Discussions with staff and people who live at the home identified that this is not a regular occurrence. It was identified that wardrobes are not attached to the bedroom walls and the Providers will need to ensure that this is done in order to prevent wardrobes from toppling over. There is also a ripped carpet in one of the bedrooms and this poses a tripping hazard. This will need to be made safe. It was also identified that labels on prescribed creams and lotions do not contain specific instructions as to their use. This was identified at the last inspection and has not been resolved. The manager should address this in order to ensure the safe usage of these creams and lotions. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 11 of 34 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 12 of 34 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People undergo an assessment of their needs prior to being offered a place at the home. The people who live in this home can be assured that their assessed needs will be met. Evidence: The AQAA states that people are offered a day visit to come and view the home and meet the residents and staff prior to making a decision whether to come into the home. The Providers tell us that all needs, including dementia care needs are always assessed carefully prior to admission. The home has obtained registration for dementia care since the last Key Inspection. Before being offered a place at this home people have their needs assessed by the
Care Homes for Older People Page 13 of 34 Evidence: home manager. She ensures that only people whose needs can be met by the staff at the home are admitted. We saw records of pre-admission assessment of needs. The manager told us that she visits people either in hospital or in their own home and discusses the placement with the person and their family. People are encouraged to participate fully in the admission process and development of their plan of care. The manager also explained that people are encouraged to come and visit and stop for a meal in order to have a look around the home and to meet the staff and the other people who live there. People who have their care funded also receive an assessment of their needs by the people who are funding them such as Social Services. Since the last Key Inspection the home has been registered to accommodate elderly people with dementia care needs. At the time of the visit we were informed that there were three people who fell into this category of needs. Some people told us that they are concerned about this - Needs are met but the admittance of more dementia patients makes life difficult for those not affected by the illness. We were not aware of the degree of dementia care at Oak Lodge when choosing this care home and The ratio of dementia patients should be lower to allow a more normal environment for people who are only suffering from old age. Discussions with the manager identified that the home will remain primarily as a home for general elderly frail people, but that, should people develop dementia then their needs will continue to be met by the home. The manager explained that, people will be able to continue living at the home as long as the staff are able to meet their needs. However, sometimes, a person can develop dementia care needs which staff are unable to meet. In such circumstances the manager would seek an assessment of this persons needs with a view to finding an alternative placement. The manager commented that, with the above in mind, it is important to consider the well being of all the people who live in the home. The manager ensures that people who are planning to come into the home are made fully aware that the home is also registered to accommodate people with dementia care needs and she told us that this information is included in the Homes Statement Of Purpose. Care Homes for Older People Page 14 of 34 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care needs are planned and met and care is delivered with dignity and respect. Individual health care needs are monitored and access to health care professionals is facilitated. Evidence: The AQAA tells us that regular monitoring of peoples health by General Practitioners and district nurses takes place and is on going. Risk assessments are carried out for people wishing to self-medicate and people are always treated with privacy and respect by staff. We looked at a random selection of care plans and talked to people about the care they received in the home. All of the people we spoke to told us that they are happy with the care and attention afforded to them in the home and that their care needs are met very well. Care plans have been developed for each person according to their
Care Homes for Older People Page 15 of 34 Evidence: needs. Personal care is planned taking into account individual preferences and choices and people have a say in how their care is delivered. Health care needs are assessed and monitored by the staff and by outside professionals such as District Nurses and General Practitioners and people who live in the home are assisted to attend any outpatient and clinic appointments they might have. The following comments were received from people who live at the home and their representatives I do prefer to take my mom to hospital/doctors appointments and the home are fine with this. We have always been informed immediately when mum has needed to go into hospital. They have organized getting her there and accompanied her and stayed with her until we could get to the hospital ourselves. We found that care and attention is afforded to people to ensure that adequate fluids and diet are taken and weight gain or loss is monitored. People who are at risk of developing pressure ulcers are carefully monitored and specialist pressure relieving equipment is supplied for them. People are assisted to maintain their Independence wherever possible and are supplied with walking aids following an assessment of their needs. Where people need assistance to move, equipment is provided for the staff to use such as a hoist and handling belts. People and their relatives are also happy with the care shown to them I feel that we are kept well informed. We are more than satisfied with the care and attention mum receives. Everyone is very kind, mum is always treated with respect. All residents are treated with respect and there is a nice atmosphere in the home. They care for my mother in an excellent way. He is always well looked after and cared for, the care home always ring us to say what has happened to him even if it is only a visit to the doctors. All his needs are met, even if he is not well they give him the care and attention at all
Care Homes for Older People Page 16 of 34 Evidence: times. A visiting Health professional told us - I feel that the standard of care at Oak lodge is very high and staff are very knowledgeable. Two staff members also told us on surveys - The Home provides care and support to all residents at all times. All staff on duty and the owners are very caring and considerate to residents. This comes across very strongly. We found that people have the opportunity to manage their medication or have it managed and administered for them by the staff in the home. We observed a senior care assistant administering lunchtime medication. Only staff who have received appropriate training can administer medication and even those staff receive regular supervision carried out by the manager. There was one person managing his own medication at the time of our visit. Labels on creams and lotions came from the pharmacy with the instructions use as directed but there are no further directions for staff to refer to. This was highlighted at the last Key Inspection and should be addressed so that staff know specifically how to use the cream. Creams and lotions prescribed to people still do not contain specific instructions and only say use as directed. This was identified at the last Key Inspection and it is recommended that more specific instructions are printed on labels relating to cream and lotions to ensure that these are administered safely and to avoid overuse. Staff were observed to be polite and respectful toward the people who live in the home. People feel that they are treated with dignity and respect. Care Homes for Older People Page 17 of 34 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily life in the home is made flexible and varied and personal autonomy is promoted. The programme of activities should be further developed to help ensure that individual social and therapeutic needs are catered for. Evidence: The AQAA tells us that the home encourages people to mix socially with people with similar interests. There are visits from the local clergy regularly. Mealtimes are flexible if people are not feeling hungry. They offer well balanced meals. They have improved on the activities on offer. Personal phone calls from relatives are always put through to people. Regular feedback is obtained from our questionnaires. We found that there is a planned programme of activities and entertainment displayed in the home. People are encouraged to join in activities but are also supported to continue with any hobbies and interests of their own which they might have. Care Homes for Older People Page 18 of 34 Evidence: People are supported to maintain links with families and friends and the local community. Trips out are arranged to local venues and places of interest. We spoke with some of the people who live in the home about activities and entertainment. They told us that this takes place - something on every day and that they go on trips out. They told us that they had been to Walsall lights, Chase water, Safari park and other trips out. The Manager said that they use ring-a -ride for these trips. Also there is a school located directly behind the home and people went to the concert held at the school last year. People told us that they had enjoyed this very much. We found that visitors are welcome at any reasonable time and can visit their relatives in private. Individual autonomy is promoted and people have choices in respect of the daily life in the home. People told us that they are encouraged to exercise these choices. Choices and preferences are documented in individual care plans. Church services are held regularly in the home and representatives of the Clergy visit people by arrangement. We received some mixed comments from people who live in the home and their relatives about the provision of activities and entertainment as follows Residents seem happy and enjoy activities and days out when offered. Wider choice of activities for residents with mental and physical disability is needed -perhaps more sessions of reminiscence therapy. Would appreciate more choice of activities. Yes we enjoy days out and activities indoors with carers. Mum is encouraged to take part in trips and activities which she enjoys. We could do with more activities. People have choices and their preferences and privacy are upheld - My relative is allowed to come and go as he pleases, or just sit in his room to watch television and listen to his radio. Care Homes for Older People Page 19 of 34 Evidence: Mum doesnt always choose to participate but the staff do try and encourage her to be involved in the activities. We identified that activities are assessed regularly as part of the Quality Assurance programme and action is taken to improve the service where highlighted. It is recommended that the activity programme be reviewed to take into account the individual wishes and abilities of people who live at the home. We looked at the provision of meals in the home. The menus are rotational and provide alternative dishes at each mealtime. This is what some of the people told us about the meals served in the home Mum doesnt always realize that there is a back up menu if the choices of the day are not to her liking. However, mostly there is something on the menu that she does like. Residents have had a meeting with Pam and David to ask if they can have more variety in meals. We spoke to a number of people in the dining room and they told us that they liked the meals in the home and that there is always a choice available to them. The lunchtime meal we observed looked appetizing. The manager carries out audits on the meals and we saw documents relating to action taken to improve meals following a meeting with the residents. One lady told us - when I wake up early they make me a cup of tea and I can have a drink and snack any time. Care Homes for Older People Page 20 of 34 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that any concerns they might have about the home will be listened to, taken seriously, and, where required, action will be taken to address concerns. People who live in the home are safeguarded from harm. Evidence: The AQAA tells us that the home has a robust complaints procedure and that they listen to people and their relatives about any concerns they might have. They tell us that they make available advocacy contact for anyone who needs it. Staff are issued with policies for safeguarding and there is a whistle blowing policy in place. Their knowledge of this is tested during supervision sessions. The providers tell us that they have an open door policy in place and that they have not received any complaints over the last 12 months. We found that there is a complaints procedure displayed within the home which is both clear and accessible. At the time of the inspection visit the manager told us that she had not received any concerns or complaints since the last inspection. Care Homes for Older People Page 21 of 34 Evidence: We, the commission, had not received any complaints or safeguarding referrals about this home since the last inspection. The manager told us that she likes to address any concerns which people might have about the home on a one to one basis. This was observed during the inspection, when we heard someone who lives in the home thanking the manager for addressing a concern she had. People we spoke with confirmed the above and the following are some of the comments we received I would speak to my family or carers. We have never had any problems but know without doubt Oak Lodge staff have their service users welfare at heart and would not fail them. I would speak to any of the staff. If a senior member is not available, a note is made in the diary and a phone call made as soon as possible. Any problem or request is dealt with efficiently. I do know how to make a complaint but I have not had cause to. Procedure is prominently displayed. We found that the home has a policy on the safeguarding of people who live there. Staff are aware of this policy and are given training and instruction in the Protection Of Vulnerable Adults (POVA). The home also has a Whistle blowing Policy in place of which staff are also aware. Care Homes for Older People Page 22 of 34 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable, homely environment which has been adapted to meet the needs of the people who live there. Evidence: The AQAA tells us that the home has a rigorous cleaning routine which keeps the home clean and fresh. There is an infection control policy in place and this is given to all new staff. Sanitation of mops policy is now in place. Manual sluice and commode liners are in use. They tell us that they have upgraded the security of the home in line with the change of registration having more people with more dementia needs. The Providers tell us that the home is fresh and clean and provides a homely environment for the people who live there. They also say that the decor and furnishings are domestic in character. We walked around the home and looked in all of the bedrooms and communal areas, the kitchen and laundry room. Bedrooms have been individualized and adapted to meet the personal needs and preferences of the people living there. People are able to bring in personal effects and items from home with the agreement
Care Homes for Older People Page 23 of 34 Evidence: of the manager. Since the last inspection the Providers have purchased new dining chairs, new sit-on scales, new overbed tables and 4 new flat screen television sets, providing 2 in each lounge. This gives an excellent range of viewing from all areas of the lounges. In bedroom 5 there is a requirement to make the carpet safe in this room or replace it - as there is a rip in the carpet caused by the door guard unit. Locks on bedroom doors are provided so that people can have a key if they wish to. None of the wardrobes are secured to the walls and there is a requirement for this to be done in order to help prevent wardrobes toppling over onto people. This is what some of the people who live in the home told us about their environment Oak Lodge is always clean They could take more care in sorting out the clothes after washing. My relative has her name on her label but she still ends up with other peoples. Lounge area sometimes a little cluttered. As a walking stick user - can find it difficult to negotiate objects at times In reference to the above comment it was noted that in one of the lounges, (facing the road), materials (board games etc) used for activities were stored on the floor behind an easy chair. It is recommended that these be stored away for safety reasons. Since the last key inspection a system has been adopted for appropriate storage and sanitizing of mop heads. We also saw color coded mops stored appropriately in accordance with infection control guidelines. The laundry and kitchen were both maintained in accordance with infection control guidelines. There are sufficient accessible and adapted toilets and bathrooms provided. All bedrooms have a sink and some rooms have en suite facilities. There is a pleasant garden area which is accessible to the people who live in the home including wheelchair users. We noted that staff have undergone infection control training. These staff also told us
Care Homes for Older People Page 24 of 34 Evidence: that they have regular updates of of this training. There are facilities for staff to wash their hands and hand gel is provided. The Provider has had an Infection control audit completed since the last Key inspection. Care Homes for Older People Page 25 of 34 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home are cared for by a skilled and competent staff team who are trained to meet their needs. Evidence: The AQAA tells us that a high proportion of staff are trained to National Vocational Qualification (NVQ) status. They say that Dementia Awareness training has been given to most of the staff. Medication training is also a high priority to ensure that there are enough staff to assist with and administer medication. The Providers say that there is an annual training needs plan is in place at the home and that individual training and development needs assessment are carried out. A new employee application form is in place including a standard risk assessments for staff awaiting Criminal Record Bureau (CRB) checks. At the time of the inspection visit there were 14 people accommodated in the home plus one person receiving respite care. Three people had dementia care needs and the other people required personal care with varying degrees of limited physical mobility. The manager was on duty together with 3 care assistants, one of whom is a senior care assistant. During the afternoon/evening period this number dropped to 2 care staff and at night there are 2 waking care staff on duty. The manager confirmed that
Care Homes for Older People Page 26 of 34 Evidence: there is always someone senior on call and that this is usually herself. There is a good skill mix at the home with a senior carer on each shift. There is a good staff training and development programme in place at the home and staff told us that they feel very well supported with their training needs. Examination of their staff files confirmed that training is on going and training sessions are geared around meeting the needs of people who live in the home. There is a strong commitment to NVQ Training in Care and senior care staff have completed levels 2,3 and some have done level 4 in this. As well as the Registered Manager, 2 of the senior carers have also completed the Registered Managers Award (RMA). Staff are receiving training in dementia awareness on a rolling programme, as the home is registered to accommodate people with these needs. Mandatory training is on going and staff receive regular update training sessions in Moving and Handling, Infection Control, First Aid, Fire Safety and others. The recruitment procedure is robust and staff are carefully selected to work at the home. Staff are only employed following satisfactory references, CRB and Protection Of Vulnerable Adults (POVA) checks. There is a very thorough induction training in place at the home. This is called the Common Induction Standards, Social Care Workers Induction. A senior care assistant confirmed that this induction training takes place and that new staff work for about 1 month alongside a mentor who supervises them until they have been deemed competent. We met with a student who is completing the Apprenticeship in Health and Social care with Age Concern and is working at the home on a Work Placement agreement. The manager confirmed that this is working very well and the student herself told us that she is very supported at the home and is enjoying her work placement there. Care Homes for Older People Page 27 of 34 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and is managed in the best interests of the people who live there. People live in a safe environment. Evidence: In the AQAA the Providers tell us that management of the home is good with good quality reviews in place reflecting views of the people who live there and their relatives. They tell us that safety is well managed ensuring a safe environment for people. We found that the home is well managed and that people who live and work at the home are kept safe. The manager has the necessary qualifications to run the home and has been in the role of manager for 10 years. She possesses the necessary experience and
Care Homes for Older People Page 28 of 34 Evidence: qualifications, including the Registered Managers Award (RMA), in order to run the home competently. We received positive comments about the manager and owner. People told us that the manager and owner are very good and supportive. People also told us that the manager is approachable and will sort things out if there is a concern. There is an effective Quality Assurance programme in place at the home where all the services area reviewed regularly. Areas needing improvement are highlighted and action is taken to address this. Also regular meetings are held where people who live in the home are encouraged to make suggestions for improvement and talk about any concerns they might have. People we spoke with confirmed that these meetings take place. We looked at the management and maintenance of personal allowances in the home. The manager told us that people are encouraged to manage this for themselves wherever possible and in some instances family members do this. For those people who like the manager to oversee this the home provides a secure facility in which to keep small amounts of monies. We examined this process and looked at relevant records, receipts and monies. We found this to be maintained in accordance with minimum standards. The process is transparent, safe and allows for an audit trail if required. We looked at how the Health and Safety of the people who live and work at the home is promoted. There is a Health and Safety Policy statement in place at the home. Generic and individual risk assessments are undertaken and updated regularly. Equipment used in the home is maintained and serviced in accordance with requirements. Fire safety is risk assessed and necessary precautions taken to help prevent and detect fires. Staff receive regular fire safety training sessions and drills. Examination of records and observation of practices identified that the home is maintained in accordance with infection control recommendations and guidelines and that staff are given training in this area. Staff also receive regular update training sessions in all aspects of Health and Safety.
Care Homes for Older People Page 29 of 34 Evidence: Care Homes for Older People Page 30 of 34 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 31 of 34 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 19 13 The rip in the carpet in bedroom number 5 must be repaired and made safe This presents a tripping hazard for the person living in this bedroom 19/02/2009 2 19 13 Wardrobes in bedrooms must be secured to the bedroom walls and made safe. This is in order to prevent the wardrobe from toppling over and injuring people. 19/02/2009 3 19 13 In bedroom 5 there was a rip in the carpet and this must be repaired or the carpet replaced. This is in order to prevent people tripping over and injuring themselves. 19/02/2009 Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Older People Page 32 of 34 No. Refer to Standard Good Practice Recommendations 1 9 It is recommended that more specific instructions are printed on labels relating to cream and lotions to ensure that these are administered safely. It is recommended that the activity programme be reviewed to take into account the individual wishes and abilities of people who live at the home. This is to ensure that individual social and therapeutic needs are met. 2 12 Care Homes for Older People Page 33 of 34 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 34 of 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
