CARE HOMES FOR OLDER PEOPLE
Oakmount Rest Home 2 Narrow Lane Poulner Ringwood Hampshire BN24 3EN Lead Inspector
Mrs Pat Trim Unannounced Inspection 15th September 2005 02:00 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 Oakmount Rest Home DS0000011855.V250376.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. Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Oakmount Rest Home Address 2 Narrow Lane Poulner Ringwood Hampshire BN24 3EN 01425 479492 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr 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 Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users in categories MD and DE must be at least 60 years of age. 12/04/05 Date of last inspection 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 own 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 7 have en suite facilities. Shared areas comprise a dining room, large lounge and conservatory. Upstairs rooms are reached by a stair lift. The ground floor does not have level access to all areas as there are a number of single steps to communal areas and some bedrooms. Because of this the home is unable to offer accommodation to residents who need to use a wheelchair. 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 Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of this visit was to carry out the second statutory inspection for the year 2005/2006. It was an unannounced inspection, completed by one inspector in four hours. During the inspection five of the twenty-one residents and two of the thirteen staff were spoken with. Time was also spent talking with Mr. M. Foot, one of the providers, and the acting manager. Core standards, not assessed on the last inspection, were covered in this inspection and compliance with the requirements from the last inspection was reviewed. One of these had not been met and was a requirement for the second time, following this inspection. A partial tour of the home took place and some care records were inspected. For an overview of how the home is meeting the core standards in 2005/2006, both reports should be read. What the service does well: What has improved since the last inspection? What they could do better:
Care plans are detailed and identify what residents are able to do and what help they need. Risk assessments minimise the risk in carrying out daily living activities such as bathing. However, several residents identified things they
Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 6 would like to do such as going for a walk alone or watch television in their rooms. These wishes should be recorded in the care plan and the resident and staff should work together to see if the wish can be safely achieved. During the inspection staff were observed assisting residents with their mobility. In some instances this was not done satisfactorily. Staff spoken to had not had recent moving and handling training. Some residents were becoming more frail and sometimes required a high level of assistance. Staff training should be reviewed to make sure all had received up to date instruction. 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. Oakmount Rest Home DS0000011855.V250376.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 Oakmount Rest Home DS0000011855.V250376.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): The core standards were assessed on the last inspection. EVIDENCE: Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – other core standards assessed on last inspection Comprehensive care plans ensure that individual personal care needs are met, but residents’ daily living can be restricted by the failure to include their wishes in care plans and to develop management strategies that enable them to take risks. EVIDENCE: Information about residents is recorded in their assessment and care plan. The care plan gives detailed guidance about what help residents need and what they can do for themselves. Risk assessments are completed for activities of daily living and give staff clear guidance on how to minimise risks. However, during the inspection a number of residents expressed wishes that are not recorded in the care plans. For example, one resident wished to be able to walk outside the grounds of the home. The acting manager explained that on admission the resident had been quite frail but was now able to go and walk in the garden. The risk assessment relating to mobility did not record his wish to go out alone or include an action plan for staff to follow to assess whether this wish could be achieved.
Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 10 The care plans should include resident’s wishes and staff should find ways of assessing whether these wishes can be achieved by the use of risk assessment and action plans. This would also evidence the resident’s involvement in the care planning process. Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 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 the following standard(s): These standards were assessed on the last inspection. EVIDENCE: Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 12 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 In house policies and procedures and staff training ensure that residents are protected against the risk of abuse. EVIDENCE: Residents spoken with confirmed they felt staff treated them with dignity and respect. They were aware of the complaints procedure and felt comfortable about taking any concerns to the acting manager. Staff spoken with were aware of their responsibility to report any incident of abuse and could name the home’s policy that required them to do so. One of the staff spoken with had received training about adult protection during the completion of her NVQ3. The home had a copy of Hampshire’s protection of vulnerable adults procedure. The home’s own policy and procedure, including a whistle blowing policy, had been completed with reference to the above guidance. The providers confirmed they do not hold any personal allowances for residents. Individual records are held of money given to the home by relatives to pay for any expenses incurred by residents, such as hairdressing or chiropody. Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 13 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 The other core standards were assessed on the previous inspection The providers act upon requirements and recommendations from with other agencies to ensure service users are able to live in a safe, well-maintained environment. EVIDENCE: The requirements made following an environmental health inspection on 11th April 2005 in respect of the kitchen had been met. A new kitchen floor had been fitted and the tiled areas re-grouted. During the inspection it was noted that a fire door in a resident’s bedroom had a small table placed in front of it. The acting manager opened the door but it was quite stiff to open. The acting manager and inspector discussed the possible risk this could present, bearing in mind there were a number of other fire exits from the ground floor. The home’s fire safety officer was visiting the home the following week so it was agreed he should be asked for guidance as to whether clear access was required to this door.
Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Residents are supported by a well-motivated and experienced staff team. The safety of residents who require assistance with moving and handling could be compromised by staff not having attended up to date training. EVIDENCE: Residents felt staff were well trained and able to meet their needs. They said they thought they were treated with dignity and respect. The daily routines of the home were observed throughout the inspection. Staff supported residents with personal care tasks at their own pace. The providers encourage staff to develop their skills and three staff have completed an NVQ3 in care. Three more are currently completing this course. Four staff had just received their food hygiene certificates and fire training for all staff had been arranged for the following week. Staff spoken to felt they were encouraged to attend training opportunities. They had a wide range of care experience and training. Since the last inspection a number of residents have become more frail, requiring assistance with moving and handling. One resident in particular required a high level of moving and handling assistance. The acting manager confirmed she had asked the doctor to refer the resident for an occupational therapy assessment.
Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 15 There were concerns about some moving and handling practice, as staff assisted residents to the meal table. The two staff interviewed had not had recent moving and handling training and the acting manager said that none had been arranged for the near future. A requirement was made that staff training in moving and handling should be reviewed and updated training given to staff who require it. At the last inspection a requirement was made that the hours used by care staff to cook the main meal should be recorded separately on the rota. This had not been done so the rota did not accurately reflect the number of care staff working in the home during the late morning. Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 16 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): These standards were assessed on the last inspection EVIDENCE: Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x 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 x x x x x x x STAFFING Standard No Score 27 2 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 27 Regulation 17 Requirement Care hours and cook hours must be separated on the rota. This is a repeat requirement from the inspection dated 12/4/05 Provide up to date training for all staff in moving and handling Timescale for action 01/12/05 2. 30 18 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakmount Rest Home DS0000011855.V250376.R01.S.doc Version 5.0 Page 19 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
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