Inspection on 11/10/06 for Oak Tree Lodge

This inspection was carried out on 11th October 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oak Tree Lodge 09/12/08

Oak Tree Lodge 14/12/07

Oak Tree Lodge 28/10/05

Oak Tree Lodge 27/06/05

Oak Tree Lodge 24/11/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Oak Tree Lodge 12 Jesmond Road Clevedon North Somerset BS21 7RZ Lead Inspector Catherine Hill Key Unannounced Inspection 12th October 2006 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 Lodge DS0000061676.V315995.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 Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Tree Lodge Address 12 Jesmond Road Clevedon North Somerset BS21 7RZ 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) 01275 873171 Oaktree (Clevedon) Ltd Ms June Keating Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th October 2005 Brief Description of the Service: Oak Tree Lodge is set on a hill in a residential area close to local amenities and the town centre. It provides residential care for up to 34 elderly residents in a homely environment. Plenty of in-house activities and entertainment are provided as well as regular local outings for which there is no charge. The home emphasizes the importance of staff and families getting to know each other well so that residents can be offered the best possible service. The home is on four floors and there is a passenger lift to all levels. Thirty of the bedrooms are single, eleven of them have an en suite bathroom and seven have an en suite toilet. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out during the course of one day, from 9:30 a.m. to 5:30 p.m. The inspector spent the first part of the visit talking with residents, visitors and staff, and spent the last part of the day looking at records and discussing with the owner-manager and her deputy ways in which the service can be developed. The owner-manager had not received the pre-inspection questionnaire that CSCI had sent to her, so the inspector had not been returned the contact details of relatives and external professionals, and was unable to contact them for their views on the home. However, she spoke in depth with about half a dozen residents, with three visiting relatives, and with several of the staff who were on duty during this inspection. During the course of these conversations, the inspector saw most communal areas of the home and several residents bedrooms. She also spent some time in the lounge while the poetry club was going on. She sampled residents care records, medications records, policies and procedures, fire precautions records, accident records, menu records, staff rotas, and the complaints record. What the service does well: Residents and visitors levels of satisfaction were generally very high. Everybody the inspector spoke with commented on how very helpful and willing staff are, and how exceptionally high the standard of care is. One person said I have several real friends among the staff … an affection grows up between you. Another person said that the staff are tip-top - most attentive, very helpful. A relative commented that the home is very understanding about the residents problems, and works very co-operatively with the family. The home offers an exceptional range of activities. In-house group activities are offered at least once a day, and residents also have plenty of opportunities for activities in the wider community. Some residents also get a lot of one-toone time with staff, and it is hoped to extend this once the key worker system is fully underway. Activities include the poetry club, whose output is often published in the homes newsletter, a pub club, and a gardening club, bingo and quizzes, and the home is about to introduce painting sessions. The owner-manager regularly spends time with residents, and is seen as very, very helpful. Many people commented on how clean the home always is. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 6 Staff described a very happy working atmosphere, a sense of being part of a team, and high job satisfaction. Many staff undertake more than one role within the home, which makes their jobs more interesting. Staff have plenty of room to be creative and try out their own ideas, but described really effective support from the management team. What has improved since the last inspection? What they could do better: The pre-admission assessment format in current use does not prompt staff to gather very much useful information, particularly about mental orientation and the needs that have led the person to seek residential care. A couple of people raised concerns about the behaviour of some residents who are being admitted to the home. The level of dementia of these people is outside the range of needs for which the home can cater, and their behaviour has had an impact on other residents quality of life. The inspector reminded the owner-manager that the home is not registered to provide specialist dementia care and that care needs to be taken to admit only people whose needs are within the homes registered categories. Residents are still not as involved as they could be in planning their own care. The care manager has drafted a letter to the relatives of those residents who might not be able to express their own views, inviting them to come to sixmonthly review meetings. However, a senior member of staff does all residents monthly reviews on her own. The inspector suggested that key workers could use their regular chats with residents to get their feedback on how their care needs are being met or could be met in future, and then pass this on to seniors for consideration in the monthly reviews. Care plans need to be updated promptly as soon as there has been any significant change in the persons needs. A requirement was made at the last inspection about the storage of controlled drugs. The home took action to meet this requirement by bolting a lockable box to the interior of the medications cabinet, but when the lock of this box broke, controlled drugs were stored in a removable box. The inspector advised Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 7 that the home discusses arrangements for the storage of controlled drugs with the supplying pharmacist, and that these drugs must be stored in compliance with recognised guidelines. It was a requirement of the last inspection that the home has a policy for the protection of vulnerable adults from abuse and that it is kept available to staff. The only policy that could be found by management staff at todays inspection did not give information on what kind of event should trigger staff to suspect abuse, nor on what staff in charge of the home should do if they suspect abuse or if allegations are reported to them. Staff in charge of the home were not aware of what procedure they should follow. A full policy is needed, and staff must have abuse awareness training. The only records of any untoward incidents are the Regulation 37 reports that the home has sent to the CSCI. These will cover most of the untoward incidents that a home might experience, but there may be other incidents that the home should be recording but might not be obliged to report to CSCI. The home needs a system for recording all untoward incidents, as advised at the last inspection. Training sessions are regularly offered to staff, but not everybody takes advantage of this and some staff are not having the required levels of statutory training. 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 Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 8 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 Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 9 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): 1, 3, 4, 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents get plenty of information before making a decision to move in. A more thorough pre-admission assessment may help the home to only admit people whose needs it can meet. EVIDENCE: The current range of fees is between £350 and £450 per week. The home’s Statement of Purpose, Service User’s Guide, and a copy of the latest inspection report are kept in the entrance hall. Copies are given to enquirers and to new residents. An ‘A to Z of the Home’ gives additional valuable information about services provided and routines in the home. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 10 Where practicable, senior staff from the home visit prospective residents to do a pre-admission assessment. Where this is not possible, information is gathered from placing social workers, GPs, or families before a decision is made to admit the person. Some people have been admitted whose needs fall outside the homes remit. The home is registered to cater for older people, not those whose needs require a more specialised service, such as people with significant dementia and challenging behaviours. On occasions this has been because the home was not given sufficient information prior to admission, and the management staff have taken prompt steps to help the person find a more suitable placement. However, other admissions have been made which fall outside the homes registered categories, and on occasions the behaviour of these people has had a negative impact on the quality of life of other residents. The pre-admission assessment document currently in use does not prompt staff to ask in-depth questions about the persons care needs, about their reasons for seeking residential care, about their mental health nor about their mental orientation. A more detailed checklist may help to ensure that only appropriate admissions are made in future. Residents and their relatives are encouraged to visit as often as they like before making a decision to have a trial stay at the home. The home does not provide intermediate care. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 11 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, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care needs are well documented and well met. Staff are familiar with their individual preferences but residents are not properly consulted at present about the way their care needs are met. EVIDENCE: Many aspects of care at Oak Tree Lodge are excellent, but there are a few issues that detract from the overall quality. The residents and visitors with whom the inspector spoke said that they were highly satisfied with the standards of care. Everybody said that staff are very helpful, willing and pleasant. One person said I have several real friends among the staff … an affection grows up between you. Another person said that the staff are tip-top - most attentive, very helpful. A relative Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 12 commented that the home is very understanding about the residents problems, and works very co-operatively with the family. Relatives felt that they are kept well informed of any significant issues, and that their involvement is welcomed. One resident said that, while staff try to be nice about it, they sometimes seem under pressure and hurried. This person gave an example of an essential aspect of personal care being omitted. Although staffing levels are not as high as they used to be, staff rotas show a satisfactory number of staff on duty throughout the day, given the number and level of need of the current resident group. The inspector and owner-manager explored possible underlying reasons for staff seeming hurried at certain times of day: it may be due to staff trying to complete tasks within set timescales; for example, trying to ensure that all residents are up and dressed before morning coffee. This evidently meets the preferences of some residents, but there are other people who prefer a more leisurely start to the morning, and it could be that both residents and staff would benefit from a review of morning routines. The ownermanager is encouraging staff to move away from a task-oriented approach towards a person-centred approach, focusing more on individual needs than on completing task lists. This will hopefully further improve residents experience as well as making the job even more satisfying for staff. Care plans give a clear picture of each persons needs but there is no evidence at present that residents or their relatives are consulted about how care is given. The deputy manager has drafted a letter to go out to the relatives of those residents who cannot make their own views plain, inviting them to attend six-monthly review meetings in future. A senior member of staff reviews each care plan on a monthly basis, but at present does this on her own. The inspector suggested that key workers could use their regular chats with residents to get their feedback on how their care needs are being met or could be met in future, and then pass this on to seniors for consideration in the monthly reviews. Any significant changes in a persons care needs are promptly passed on to staff during handover. At present, though, senior staff wait for the monthly review to come round before updating the persons care plan. The inspector advised that this sort of essential guidance to staff needs to be put into writing at the earliest opportunity. While residents needs and the actions staff need to take to meet them are clearly described, there is little in the care plan about the persons preferences. However, staff complete a fairly detailed preferences checklist when the resident is newly admitted, and staff also tend to work at the home for a long time and to get to know residents very well. There was some evidence, though, that different staff may follow slightly different routines with individual residents, so including information in the care plan about how the resident themselves would like the routine to be done will help to promote consistency. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 13 At present, the names of those residents who have had a bath and the temperature of the water are recorded on one document, which is kept in the staff office for reasons of confidentiality. This means that staff need to test the water temperature and remember it until they are able to complete the record. The inspector suggested that a more reliable system might be to have a small notebook in each bathroom that records the time, date and temperature of each bath, but not the name of the person having the bath. The inspector at the last inspection advised that written risk assessments need to be drawn up for any residents who are self-medicating. The care manager confirmed that this had been done but that no residents are currently selfmedicating. Residents are encouraged to retain control of their own medicines, if this is practicable and they wish to. The home has been very flexible about offering various degrees of support to enable the person to continue being independent for as long as possible. MARS (Medication Administration Record Sheets) records were in good order but the inspector suggested that using coloured highlighters to draw attention to the times of day that each dose should be given, to medicines that are only given out as required, and to medicines that are self-administered by the resident might make the records easier to follow. The easier these records are to follow, the less likelihood there is of a serious medication error happening. The inspector at the last inspection also advised that controlled drugs must be stored in a cupboard which meets legal requirements and is secured to a solid wall. The home took action to meet this, following that inspection, by bolting a lockable box to the wall of the bolted medicines cabinet. However, the lock on this box broke, and controlled drugs were then stored in a lockable box that was loose within the medicines cabinet. This arrangement did not comply with the legal requirements for storage of controlled drugs. The inspector today advised that the home consults its supplying pharmacist regarding the arrangements for storing controlled drugs, and ensures that from now on they can be stored in line with the recognised guidance. Staff approached residents with friendliness and respect, and consideration of their point of view. Residents and relatives told the inspector that this is always the case. The team did an excellent job recently of managing the care of a dying resident. Clear plans were drawn up in liaison with the district nursing team and the persons relatives. The relatives later sent a thank you card to the team, which made it clear how successful the teams efforts had been. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents are offered an exceptional range of activities and lots of opportunities to influence the way the home is run. Relatives are made welcome, and the atmosphere is friendly and respectful. Residents get a good choice of home-cooked meals. EVIDENCE: The home offers an unusual range of activities. In-house group activities are offered at least once a day, and residents also have plenty of opportunities for activities in the wider community. Some residents also get a lot of one-to-one time with staff, and it is hoped to extend this once the key worker system is fully underway. Activities include a poetry club, whose output is often published in the homes newsletter, a pub club, a tea club, and a gardening club, and the home is about to introduce painting sessions. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 15 The schedule of regular weekly activities is posted on the residents noticeboard, along with the latest copy of the newsletter. The newsletter is also sent out to residents and their relatives individually. Residents meetings are now being held monthly, and several of the residents mentioned these to the inspector. These are evidently proving an effective way of letting people air their views. The week’s menus are posted on the noticeboard. This issue is always on the agenda at residents meetings, and their ideas and comments have been taken into account at the recent review of menus. Although a couple of residents had grumbles about specific dishes, most comments showed that people are generally very pleased with the variety and quality of meals. Main menus offer a couple of choices but other alternatives are always available. Residents likes and dislikes are well-known to the catering staff, and residents said that the cooks always give them something else if there is something on the main menu that they dislike. A high tea is offered every day except Sundays and Wednesdays, when there is a roast dinner or the tea club is held. Almost all dishes are home-made, including desserts and cakes, and at least two of the vegetables every day are fresh. Most desserts are diabetic-friendly, so that people need not feel singled out. If food needs to be mashed or liquidised for residents, each portion is done separately so that the person is presented with a variety of textures, colours and flavours. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 16 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 adequate. This judgement has been made using available evidence including a visit to this service. The home is very open to constructive criticism: any concerns are taken seriously and addressed promptly. There is no written guidance for staff on how to spot potential abuse nor what to do about it, and very few staff have had training in this area. EVIDENCE: No complaints have been received by the CSCI or the home over the past year. A couple of people had raised concerns with management staff, and described a really positive response that had made them feel their comments were welcomed. Staff had taken prompt action to try and address their concerns. One resident said little irritations crop up from time to time but they do their very best. The owner-manager regularly spends time with residents, and is seen as very, very helpful. It was a requirement of the last inspection that the home has its own written policy for the protection of vulnerable adults from abuse, and that this is kept available to staff. The only policy that could be found by management staff at todays inspection was information on the PoVA register and a whistle-blowing policy. There was no guidance on what kind of event should trigger staff to Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 17 suspect abuse, nor on what staff in charge of the home should do if they suspect abuse or if allegations are reported to them. The senior in charge of the home at the time of this inspection was not fully aware of current adult protection procedures. Abuse awareness training was offered to all staff last month, but only three people attended. This is a vital area of care, and staff cannot afford to become complacent about it as this makes it easier for abuse to occur undetected or unreported. The inspector therefore made it a requirement of today’s inspection that all staff must have abuse awareness training. The home has arranged a further training session for January 2007. The inspector advised that all staff must have had this training by the end of that month. The inspector also suggested that it may be helpful to supplement a written policy, once it is drawn up, with an easy-to-follow flow chart for quick reference. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 18 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, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is clean, well maintained, and well-suited to the needs of older people. EVIDENCE: The home is on four floors, the lowest of which houses the kitchen, laundry and offices as well as a couple of bedrooms. There is a passenger lift and plenty of signs around the home to indicate where the lift is. The environment is well maintained and well-suited to residents’ needs. The home is decorated and furnished to a standard that creates a comfortable and homely ambience, and there is an ongoing programme of redecoration and refurbishment. There are some attractive and unusual original features still in place. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 19 There is a small but pleasant patio garden to the rear of the building with level access and raised flower borders. There is a very large lounge and two smaller dining rooms on the first-floor. A fish tank has been fitted in the lounge, creating an extra point of colour and interest. Furniture in the lounge has been arranged to create two separate sitting areas, so that not all residents feel obliged to join in with the group activities going on in one half of this room. New dining room chairs are on order, some of which have specially designed feet to slide across the floor more easily, making it easier for the person to sit up to the table. There are two communal toilets and two communal bathrooms on each floor. Eleven bedrooms have an en suite bathroom and seven have an en suite toilet. 30 bedrooms are single, and 2 may be used as doubles. All single bedrooms are at least 10 m squared and the doubles are at least 16 m squared. The housekeeper checks each bedroom on a regular basis to ensure that it is as pleasant and comfortable for its occupant as possible. Any necessary repairs or improvements are quickly picked up in this way. New residents bedrooms are given a thorough cleaning before the person is admitted, two sets of new bedding are provided, and a vase of flowers is placed in the room to welcome the person. This is a good example of the degree of consideration staff give to how residents experience of the home can be made as nice as possible. Window restrictors are fitted throughout, radiators are fitted with low surface temperature covers, and the hot water outlets that are accessible to residents are fitted with temperature regulators. Staff responsible for the laundry described a well thought out system for ensuring that residents clothing is returned to them in good condition, and for ensuring that good infection control practices are followed. All areas of the homes seen were thoroughly cleaned. Three cleaners are normally on duty each day, one for each of the residential floors. Many people commented on how clean the home always is. Records of the times each toilet is cleaned or checked are now being kept on the back of each toilet door so that people can see how often these rooms are checked for cleanliness. Toilets on some floors are being cleaned first thing in the morning, so that the floors are dry and safe before residents are likely to be using them, but toilets on the main floor had just been cleaned before coffee time, when residents were most likely to want to use them. The owner-manager intends to talk with domestic staff about the timing of their cleaning schedules. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 20 Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels and a good programme of vocational training help to ensure that residents needs are well met. EVIDENCE: Rotas showed that 3 care staff are on every morning at the weekend, 4 care staff are on every weekday morning, and there are 2 or 3 care staff on every afternoon. These levels are supplemented by 2 additional staff every afternoon who prepare the evening meal and do some clearing up. 2 waking night staff are always on duty at night. A cook is on duty every morning, supported by a kitchen assistant. There are usually 3 domestic staff on duty each day, and either the housekeeper or a laundry assistant. The ownermanager is in the home most days, and the administrator works most weekday mornings. The staff the inspector spoke with were really enthusiastic about their work, and said how much they love their jobs. A small percentage of staff are not doing NVQ 2 but the vast majority are, and most of these have almost completed the course. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 22 Staff training and recruitment practices were not checked today due to lack of time. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 23 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, 32, 33, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run, and residents interests are at the heart of decisionmaking. EVIDENCE: June Keating, the registered provider, is also the registered manager and is studying for the Registered Manager’s award. She has delegated responsibility for day-to-day management of care issues to her deputy and senior care staff but is always available to offer advice and support. Staff described a very happy working atmosphere, a sense of being part of a team, and high job satisfaction. Many staff undertake more than one role Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 24 within the home, which they feel makes their jobs more interesting. Staff have plenty of room to be creative and try out their own ideas, but described really effective support from the management team. A programme of formal staff supervision is in place, and either Mrs Keating or her deputy carry this out. An accident book has been brought into use since the last inspection. The only form of incident recording is on the reports that the home sends to CSCI, however. There may be some incidents that the home does not have to report to CSCI but which it would want to keep a record of, so the inspector suggested ways this might usefully be done. The handyman accompanies the housekeeper on her weekly checks of residents bedrooms, and makes sure that any health and safety issues are promptly addressed. All call bells are checked during these weekly tours, as are all the lights in residents rooms, and wiring is checked to ensure that it is not loose or creating a trip hazard. At some points of the day, the corridor near the office smelt very strongly of cigarette smoke. There are two residents rooms in this area of the home, as well as the staff room and staff work areas. The inspector recommended that the home reviews its smoking policy, especially in light of the new legal requirements that will be coming into force soon. The fire precautions logbook showed that all equipment is being regularly checked and that fire drills are being held very frequently. These drills are used as an opportunity for giving staff brief refresher training. A qualified professional visits the home once a year to do a formal fire training session for all staff. However, not all staff attend his sessions, and the times of the drills indicate that night staff have not been involved in these. The manager confirmed that none of the staff names recorded at fire drills belong to night staff. It is a requirement that staff covering night-time duties receive fire instruction at least every three months. The inspector suggested that ways of giving this training to night staff are explored with the visiting trainer. Although sessions have been arranged for other statutory training - such as manual handling, first aid, and abuse awareness - not all those staff who undertook to attend actually turned up. Some training is mandatory for certain groups of staff, and the inspector advised that the provider may benefit from inserting a clause in staff contracts to this effect. Hazardous chemicals are kept safely. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 2 Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 26 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 OP3 Regulation 14 Requirement Only those residents whose needs fall within the homes registered categories may be admitted. Prospective residents needs must be adequately assessed before they are admitted to the home. Residents must be involved in reviewing their care needs whenever possible. This requirement was first made at the inspection of 28/10/05 Controlled drugs storage must meet recognised guidelines. This requirement was first made at the inspection of 28/10/05 A policy for the protection of vulnerable adults from abuse must be available to staff. This requirement was first made at the inspection of 28/10/05 All staff must have abuse awareness training and other mandatory training. Any incident must be recorded in DS0000061676.V315995.R01.S.doc Timescale for action 11/10/06 2. OP3 14 11/11/06 3. OP7 15 11/10/06 4. OP9 13 18/10/06 5. OP18 13 18/10/06 6. 7. OP18 OP37 13 17(2) 31/01/07 11/10/06 Page 27 Oak Tree Lodge Version 5.2 8. OP38 23 detail. Staff covering night-time duties must have fire training at least once every three months. 11/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP38 Good Practice Recommendations The home should review its smoking policy. Oak Tree Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Lodge DS0000061676.V315995.R01.S.doc Version 5.2 Page 29 - 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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