Inspection on 12/04/05 for Oak Mount Rest Home

This inspection was carried out on 12th April 2005.

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 Mount Rest Home 16/08/07

Oak Mount Rest Home 11/07/06

Oak Mount Rest Home 15/09/05

Oak Mount Rest Home 15/12/04

Oak Mount Rest Home 10/08/04

Oak Mount Rest Home 13/02/04

Oak Mount Rest Home 27/03/03

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech 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 Oakmount 2 Narrow Lane Poulner Ringwood Hampshire BN24 3EN Lead Inspector Pat Trim Unannounced 12 April 2005, 8:30 th 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 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. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Oakmount Rest Home Address 2 Narrow Road Poulner Ringwood Hampshire BN24 3EN 01425 479492 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr M J Foot, Mrs H A Foot Care Home 21 Category(ies) of Dementia (21), Dementia - over 65 years of age registration, with number (21), Mental disorder, excluding learning of places disability or dementia (21), Mental Disorder, excluding learning disability or dementia - over 65 years of age (21), Old age, not falling within any other category (21) Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Service users in categories MD and DE must be at least 60 years of age. Date of last inspection 15/12/2004 Brief Description of the Service: Oakmount provides accommodation and care for 21 residents in the categories Old Age, Old Age with dementia and Old Age with mental disorder. Residents in the categories Dementia and Mental Disorder may not be admitted under the age of 60 years. The home is owned and managed by Mr. M. and Mrs. H. Foot. An acting manager is responsible for the day to day running of the home. The owners also have a second home in Southampton. The property is a large family home that has been extended to provide accommodation on two floors. All bedrooms are single and seven have en suite facilities. Shared areas comprise a dining room, large lounge and conservatory. Upstairs rooms are accessed by a stair lift. The ground floor does not have level access to all areas. Because of this the home is unable to offer accommodation to residents who are wheel chair bound. The home is situated at the end of a quiet residential road, close to local shops amenities and public transport. The town of Ringwood is a couple of miles away. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection for the year 2005/2006 and was unannounced. The inspection took 5.5 hours and during it there was an opportunity to speak with four residents, a visiting district nurse and one of the staff, as well as the providers and acting manager. The daily routines of the home were observed. A partial tour of the premises was completed and three residents were case tracked to assess care provision. The one requirement made following the last inspection had been met by the provision of a sluice facility. What the service does well: What has improved since the last inspection? The acting manager has spent time reviewing the day-to-day running of the home. She has divided up routine work such as putting away laundry so that responsibility is shared between the different shifts. This has resulted in staff on each shift being expected to spend time with residents, chatting or playing games and providing mental stimulation. Residents said they enjoyed spending time with staff and thought this was an improvement on previous practice. Following a discussion with staff, the acting manager has also introduced the practice of permitting residents to have breakfast in their rooms if they do not wish to get dressed to come down for breakfast. At present this is only for residents who are going to have a bath after breakfast and do not wish to get dressed twice. A sluice has been fitted on the first floor to provide an effective method of disinfecting commode pans. Staff said how much more efficient and hygienic this system was than the previous practice of cleaning them in the downstairs laundry. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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 standard(s) 3. Standard 6 does not apply. Prospective residents have an assessment of need completed prior to admission to ensuring the home is able to provide the level of care they require. EVIDENCE: Three residents had moved into the home since the last inspection. All three said they had been given information about the service and had a signed contract. During the inspection two residents were observed being asked to sign a contract provided by the Social Services Department. The files of the three new residents contained information gathered prior to admission. Two residents had been admitted as an emergency. The acting manager had obtained copies of the Social Services Department assessment prior to their admission. Further information had been gathered during their visit to the home. The third resident had been visited by the acting manager so her needs could be discussed prior to admission. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Each resident has a care plan that ensures their individual needs are met and that their rights to privacy and dignity are respected. Residents’ health care needs are monitored and referrals made to health care professionals to ensure good health care delivery. The home has a medication procedure that ensures the safe management of medication. EVIDENCE: Each of the three new residents had a care plan that identified what they could do and what aspects of their care they needed assistance with. Risks relating to individual aspects of the care needs, such as mobility, were clearly identified and action plans put in place to promote independence and minimise risks. The bathing policy stated that no resident should be left alone in the bath. The practice of the acting manager was to base the judgement on whether a resident could be left alone in the bath on the risk assessment. This was used to identify how the resident could have some privacy during their bath no matter how frail or confused they were. It was agreed that this was good practice and ensured that the residents’ rights to privacy and dignity were upheld whilst maintaining their safety. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 10 Residents confirmed that staff were aware of the help they required and that support was given. However, there was no evidence that residents had been involved in the care planning process. This was discussed and it was agreed that staff should be encouraged to review care plans with residents. Staff were observed dispensing medication after breakfast and lunch. Individual residents were offered their medication with a drink and each record signed to confirm the medication had been given. This followed good practice guidance in the Royal Pharmaceutical Guidelines. One resident had selfmedicated until her admission to the home. She confirmed she had asked staff to take over this task for her, as she did not feel well enough to manage it at the time of her admission. The plan was for this resident to return home shortly. As this could mean she would need to manage her own medication again, the need to support her to take back this responsibility was discussed with the acting manager. Residents said they were able to see a doctor when they felt unwell. During the inspection a district nurse called to see three residents. She confirmed the practice had a good working relationship with the home and provided nursing support when needed. Residents said items like hearing aids and glasses were regularly checked by staff to ensure they were working properly and had been cleaned. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 11 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 standard(s) 12, 13 14 and 15 Residents are offered suitable activities to provide mental stimulation. Residents would be able to exercise more choice over how they spent their time if some practices in the home were more flexible. Although a balanced diet is provided, residents would benefit from being offered more choice. EVIDENCE: During the inspection, six residents joined in a craft activity provided by a local college. There were photographs of many items made during this course and residents said how much they enjoyed the activities. The home also provides a weekly exercise class and regular entertainment. The acting manager said she had rearranged staff work schedules to ensure all staff had time to spend chatting to residents and helping them with activities throughout the day. Residents said they enjoyed knitting, reading and doing crosswords as well as board and card games. The acting manager had introduced the practice of residents being able to have breakfast in their rooms, if they were having a bath after breakfast and did not want to get dressed. This practice should be expanded to enable any resident to have breakfast in their rooms if they wish. The provider commented that if Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 12 a resident expressed a wish to have their breakfast in their room, staff would try and accommodate this request. It was felt by the providers that residents should be encouraged to walk to the breakfast table and to use the opportunity to socialise. Residents spoken with expressed their satisfaction with the meals provided, but confirmed only one choice of main meal was routinely offered. Staff confirmed they prepared an alternative if they knew the meal was something a resident did not like. The provider confirmed residents would be offered an alternative if they requested it. To promote this flexibility residents should be informed in advance what the main meal of the day is to give them an opportunity to request something else. Care staff are responsible for cooking the main meal of the day, which is prepared in advance by night staff or the providers. The need to separate the time spent on cooking from care hours is discussed in the section entitled “Staffing”. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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 standard(s) 16 Residents are aware of the complaints procedure and are confident their concerns will be investigated thoroughly. EVIDENCE: A copy of the complaints procedure is displayed in the entrance hall and residents are given a copy on admission. The complaints procedure states in plain English, that a copy of any complaint will be kept and that residents will be informed in writing of the outcome of any investigation. Residents confirmed that they were able to take any concerns to the acting manager. Examples were given of the acting manager investigating complaints and telling the resident of the outcome. The acting manager confirmed no recent formal complaints had been received. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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 standard(s) 19, 21, 23 and 26 Recent investment has improved the facilities available for residents, creating a more suitable environment for the client group. EVIDENCE: The addition of a conservatory to provide a second lounge area, and a walk in shower on the first floor and assisted bath on the ground floor greatly improved the facilities available to residents. The installation of a sluice facility on the first floor has provided a better method for the disinfecting of commode pans and reduced the risk of infection. The Environmental Health Officer had visited the home on 11th April 2005 and made a number of requirements relating to the kitchen. These included the renovation of the kitchen floor and work surfaces. This should be a priority to ensure residents are protected against the risk of infection. Five bedrooms were viewed. These were comfortably furnished and incorporated the resident’s own belongings to personalise the rooms. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 15 Residents said were able to lock their doors to ensure their privacy. All bedrooms had individual alarm pull cords to summon assistance when required. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Residents’ safety was being compromised by the failure of the providers to follow Department of Health guidance in respect of Criminal Records Bureau Disclosures and Protection of Vulnerable Adults procedure. Staff are not deployed appropriately during the late morning to appropriately assist residents. EVIDENCE: The appointment of new staff is shared between the acting managers of both the providers’ homes. The acting manager confirmed she had appointed two new members of staff since the last inspection. One of these had begun as a cleaner in the home in January 2005 but had transferred to care staff. She was starting to work in the home as a supernummery member of staff and was going on an induction training day next week. The need to obtain a Criminal Records Bureau Disclosure for each new employee was discussed at the last inspection, however, two new appointments had been made without this being done and without a referral being made to the Protection of Vulnerable Adults list. The acting manager was again advised to refer to the Department of Health guidance. Residents said they felt sometimes staff were very busy but they responded quickly to requests for assistance. The acting manager said she felt routines were sometimes inflexible because of the way staff hours were used. She was hoping to review this. On the day of the inspection two staff and the acting Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 17 manager were on duty. Mr. and Mrs. Foot visited the home during the inspection but were not on the rota as working. The rota confirmed that normal staffing levels were three staff including the manager on during the day and two waking staff on at night. Care hours are reduced during the day when the care staff has to cook the main meal. The rota must show the hours lost in this way by identifying which staff is cooking and for how long she is unable to provide care. The care staff on duty on the day of the inspection were experienced and had completed a number of training courses. One staff was completing an NVQ3 and said she had found this helpful in developing her skills. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35 and 38 The acting manager has the skills to manage the home and to uphold residents’ rights. The home is maintained to promote the health, safety and welfare of residents and staff. EVIDENCE: The acting manager is completing her NVQ4 and will be applying to the Commission for Social Care Inspection for registration. There was evidence she continued to develop her practice and had recently attended training in respect of working with dementia. At present the role of registered manager is shared between the acting manager, the acting manager of the Southampton home and the providers. It was agreed these roles needed to be clarified before appointing a registered manager and it was suggested a job description for the registered manager role should be completed. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 19 Residents and staff said they felt the acting manager promoted their best interests and was trying to ensure residents’ rights were upheld. Staff felt they were able to make suggestions about practice in the home. Residents confirmed they managed their own money if they were able or asked a relative or friend to be responsible. The acting manager confirmed she did not collect anyone’s pension or hold any money for them. The providers invoiced residents’ representatives for any expenditure. During this inspection a number of records were seen that evidenced equipment was regularly serviced. The acting manager had just taken over responsibility for completing fire safety tests and recorded these appropriately. Staff had an outside trainer to give fire safety training annually and in house training was also given. Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 3 x 3 x 3 x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 3 x 3 x x 3 Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 21 NO Are there any outstanding requirements from the last inspection? 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 29 Regulation 19 Requirement No staff may work in the home until a Criminal Records Bureau Disclosure has been applied for and a POVA first check been completed. You must obtain a copy of Department of Health Guidance in respect of Criminal Record Bureau and POVA guidance issued 26/7/04. Care hours and cook hours must be separated on the rota. Timescale for action 12/4/05 2. 29 19 1/5/05 3. 27 17 1/5/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Hampshire Area 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 Oakmount H54 S11855 Oakmount Rest Home V221214 120405 Stage 4.doc Version 1.20 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. 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