Inspection on 01/05/07 for Oak Tree House

This inspection was carried out on 1st May 2007.

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 Tree House 31/05/06

Oak Tree House 30/11/05

Oak Tree House 18/05/05

Oak Tree House 19/10/04

Oak Tree House 17/06/04

Similar services:

Ravensworth Lodge

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Oak Tree House Oak Tree Estate Station Road Preston East Yorkshire HU12 8UX Lead Inspector George Skinn Key Unannounced Inspection 1st May 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Tree House Address Oak Tree Estate Station Road Preston East Yorkshire HU12 8UX 01482 899169 01482 891419 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) www.pwccare.co.uk PWC Care Limited Mrs Pamela Joy Cawkwell Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st May 2006 Brief Description of the Service: Oak Tree House is a private residential home. The home is registered for 23 people over the age of 65 years of either sex. It also provides for those service users who may have dementia. The home is situated in the village of Preston within easy access of local facilities and being close to the city of Hull. It is located a short distance from the main road where public transport may be accessed. There are bedrooms on the ground and first floor with a stair lift for those service users who are less mobile. There are five shared rooms one which is used as a single room and fourteen single rooms; seven have en-suite facilities. The home has two lounges and a separate dining room all located on the ground floor. To the rear of the premises is a small car parking area and a garden area that is accessible to service users. Information is available about the service through the statement of purpose and service user guide. The current homes fees range from £291.00 to £375 per week; items not covered by the fee are chiropody £8.00, manicure £4.00 and hairdresser £2.50 to £15.00. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over 5 hours. Prior to the inspection surveys were sent to the home for all the service users to complete and for all staff to complete. 15-service users surveys were received back and 8 staff surveys. The site visit included speaking with the service users, staff and any visitors. The environment and some records were looked at. What the service does well: What has improved since the last inspection? What they could do better: The owner needs to make sure that the records kept about the service users include more information on their past lives as this helps the staff form a better picture and could help explain why some things happen now. The owner needs to make sure that all the staff have completed basic training to help ensure the safety of the service users. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 6 The owner needs to make sure that the staff record any confidential information about the service users in the right place to ensure the confidentiality of that information. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good quality outcomes in this area Service users needs are assessed prior to moving into the home. EVIDENCE: Four care plans were looked at this included a service user recently admitted to the home; all had evidence of assessments being undertaken prior to the service users moving into the home. A plan of care is generated form these assessments. The home does not admit service users for intermediate care. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good quality outcomes in this area. Service users health, personal and social care needs are set out in an individual plan of care. Service users can make decisions about their lives with assistance if needed. Service users are protected by the homes policies and procedures for dealing with medication. Service users feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Four service users files were examined and all had a plan of care. For service users referred through the local authority care management route, the plan of care is generated from the community care assessment. This provides the basis for the care to be delivered. The plan of care has been changed from the last inspection. This documentation contains a comprehensive assessment of service users needs and how staff are to meet these and are agreed with the Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 10 service users or their representative. The documentation contains basic factual information about the service users likes dislikes and information about any past experiences; this should be further developed in to a full life history which would contain detailed information which is important to the service users about past achievements and aspects of their lives which now have an impact on current behaviour. There is a book which the staff use to reporting and record the service users health and general well being; vigilance should be shown, if this system is to be used, that confidential information is not reported communally but in individual reports and an indication in the communal report that this information is available elsewhere. The service users’ plans are reviewed every month in the home and yearly by the care management team. Service users’ health care needs are monitored. Health professional visits are recorded and the district nurse visits regularly. Advice is given on the prevention of pressure sores and the promotion of continence. The home monitor the service users’ psychological health and recorded evidence on service users files indicated that community psychiatric nurses (CPN) are involved when required. The service users files indicated that they have access to chiropody, dental and optical services. Even though the home consult with and gain the input of the relevant health care professional there needs to be clearer evidence in the care plans that any multi agency meetings have been undertaken and any therapeutic intervention is based on current good practise guidelines. The service users’ medication is held in a lockable metal trolley; the home would support any one who wanted to self medicate, none of the service user have taken up this option. The medication is provided by a local pharmacist and the home use a monitored dosage system. Controlled drugs are stored and recorded separately; evidence seen during the site visit indicated the controlled drugs are not stored in accordance with relevant legislation the registered person should review the storage of any controlled drugs to ensure this is in line with relevant legislation. Records kept at the home indicated that the staff who administer medication have received some in house and external training; observation during the site visit indicated that they understood the importance of good practise when dealing with service user users medication. It was not clear if the training the staff had received was accredited training. The staff were observed using the service users’ preferred form of address and this is recorded on individual service users files. Staff were observed knocking on service users doors ensuring their privacy. During discussion with the Service users they confirmed that staff treat them with dignity. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good quality outcomes in this area Service users social cultural and religious needs are met. Service users maintain contact with relatives and friends. Service users are helped to exercise control over their lives Service users receive a wholesome and well balanced diet. EVIDENCE: Family and friends are welcome to visit the home there is no restriction on visiting times and those visiting commented on being made to feel welcome. The service users’ files inspected had likes and dislikes recorded; however as mentioned previously more information on past history would be beneficial. There is now a record of daily activities. The record was basic and did not explain of what benefit the activity has for the service user. The home has some outside entertainment and in house activities were observed during the site visit. Some service users especially those with dementia were sat for long periods of time either sleeping or not engaging in a Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 12 meaningful way with the staff; when the staff did engage it was very task orientated. Local church representatives do not visit the home on regular basis but documentation provided in both the statement of purpose and the service user guide indicated that this would be organised if the service user request this. Service user files indicted that all service users are asked when initially admitted about arrangements for their religious observation. Service users can handle their own money for as long as they wish. Service users have information on how to contact advocates who will act in their interests. The lunch time meal was observed, it was well presented and service users commented on the quality of the food comments included “the foods not fancy just as I like it” I’m fussy and the food suits me” there are no problems with the food its very good”. Staff practise was observed when helping service users with any personal tasks it was evident that the service user set the pace and the staff member was sensitive to the service users needs. Any encouragement was done quietly and calmly. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good quality outcomes in this area. Service users knew whom to complaint to and were confident that this would be taken seriously. Service users are protected from abuse. EVIDENCE: The home has a clear complaints procedure which is displayed around the home and provided in both the statement of purpose and the service user guide. Service users spoken to were aware how to make a complaint and said any concerns would be listened to and acted upon, one service user commented that he would “see the boss” if he had any complaints. Service user surveys indicated that they knew the home had a complaints procedure. There have been no complaints made to the home or via CSCI since the last inspection. The home has a Hull and East Riding Protection of Vulnerable Adults procedure. The provider/manager has developed in house procedures on the protection of vulnerable adults and whistle blowing, staff were aware of how to make a safeguarding adults referral and their responsibility to protect vulnerable service users. Staff surveys indicated that they had a good understanding of the term POVA and had confidence that the manager would deal with any allegations made effectively. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 14 There are policies and procedures on service users’ money and financial affairs; these protect the service user interest. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People experience good quality outcomes in this area. Service users live in a home which is well maintained and clean. EVIDENCE: The home is set in its own grounds, which are well kept. There is a gardener/ maintenance person employed and work is continuing to ensure service users can access the gardens. There is a programme of routine maintenance available. All recommendations made by the fire officer and the environmental health officer have been actioned, there are plans for a complete refurbishment of the kitchen. Service users have access to all parts of the building; the first floor is accessed via a stair lift. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 16 There have been continued improvements in the decoration of the home and the registered provider has applied for a grant to re-carpet the home. Toilets are appropriately sited on each floor; the toilet on the first floor has no hand washing facilities. Two bathrooms are accessible to service users, both bathrooms are now equipped with a hoist and documentary evidence indicate that these have been serviced. The review of the three ground floor toilets is still ongoing and may be included along with the refurbishment of the kitchen. This needs to be prioritised as the layout of the toilets makes manoeuvring of wheelchairs very difficult so posing a hazard to both service users and staff. The premises are clean and offensive odours are kept to a minimum. There is a large laundry that includes a washing machine that can be programmed to meet disinfection standards. All service and facilities comply with the Water Supply (Water Fittings) regulations 1999. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good quality outcomes in this area. Service users needs are met by the numbers and skill mix of the staff. Service users are in safe hands at all times. Service users are protected by the homes recruitment policies and practise. EVIDENCE: The homes rotas indicate that there enough staff on duty to meet the needs of the service users the home now employs dedicated laundry/cleaning staff; this has freed the care staff from these duties there enabling them to spent more time meeting the needs. A sample of staff recruitment files were looked at; these contained evidence of application forms being completed by all staff, relevant references being sought and evidence of Criminal Records Bureau checks (CRB) being undertaken prior to staff commencing work at the home. Various training courses have been completed and the registered person is committed to ensuring the staff attend relevant training courses. Records kept indicate that the staff have undertaken some of the relevant mandatory training and this is updated as required; however some staff surveys indicated that not all of the mandatory training has been competed. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 18 Service users commented positively on the quality of the care staff and the level of practise, comments included “the girls are very good” “ they can’t do enough for you and they’re always smiling”. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good quality outcomes in this area. Service users live in a home which is run in their best interests. Service user financial interests are safeguarded. The safety and welfare of service users and staff are promoted and protected. EVIDENCE: The manager is also the registered provider and has 26 years experience as a qualified nurse; she has retained her Professional Identification Number (PIN) up to date. She undertakes training with staff to update her skills and knowledge. The local authority has a quality system for care homes that is awarded in two parts. The home has undertaken this assessment and has achieved part 1 and Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 20 part 2 and has developed an in house quality assurance system; this now seeks the views of other stakeholders for example GP’s, district nurses and care coordinators. The service users manage their own money for as long as they wish, or families are responsible. The provider/manager is an appointee for 3 service users and this has been agreed with the families. There is a safe available to securely store money and valuables. The inspector examined two service users’ records; the records are up to date and kept on computer which has limited access available only to the manager and deputy manager, receipts are kept and the money balanced with the records. There were maintenance records available for gas, electrical installations and portable appliance testing. Fire checks were completed. The home are now notifying the CSCI of any events which are required by virtue of regulation 37 of the care homes regulation 2001. Service users have risk assessments on individual files, these are now regularly reviewed and updated. The Control of Substances Hazardous to Health (COSHH) risk assessments were in place. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15 Requirement Timescale for action 30/08/07 2 3 4 OP9 OP9 OP14 5 OP21 Any therapeutic intervention must be based on current good practise guidelines. This must be better evidenced in the service users plan. 13, 18 & Controlled drugs must be stored 19 in accordance with relevant legislation. 13, 18 & The owner must demonstrate 19 that the medication training is accredited 12, 15, 17 The owner must ensure that staff & 20 have the time to spend with service users undertaking meaningful activities especially with those service users with dementia. 23 The owner must ensure that there are adequate hand washing facilities fitted in the first floor toilet to prevent the risk of cross infection. 30/08/07 30/08/07 30/08/07 30/08/07 Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 23 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 2 3 Refer to Standard OP7 OP7 OP14 Good Practice Recommendations The care plan should include a full life history; this will give a better picture of the individual service users. Confidential information should be recorded in the service users files only. The record of daily activities should be more detailed, this would give a clearer picture of activities undertaken with the service users. Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oak Tree House DS0000047696.V338158.R01.S.doc Version 5.2 Page 25 - 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!