Inspection on 10/07/07 for Oak Tree Manor

This inspection was carried out on 10th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oak Tree Manor 04/02/09

Oak Tree Manor 05/04/06

Oak Tree Manor 07/11/05

Oak Tree Manor 04/04/05

Oak Tree Manor 25/11/04

Oak Tree Manor 02/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Oak Tree Manor 2 Chene Drive Off Waverley Road St Albans Hertfordshire AL3 5QP Lead Inspector Jeffrey Orange Unannounced Inspection 10th July 2007 08:30 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 Manor DS0000019486.V345576.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 Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Tree Manor Address 2 Chene Drive Off Waverley Road St Albans Hertfordshire AL3 5QP 01727 832393 01727 866653 oak.care@virgin.net Oak.care@virgin.net Oak Care Limited 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) Sue Stacey Care Home 80 Category(ies) of Dementia - over 65 years of age (80), Old age, registration, with number not falling within any other category (80), of places Physical disability over 65 years of age (80) Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 5th April 2006 Brief Description of the Service: Oak Tree Manor provides non-nursing care services and accommodation for up to eighty older people who may also have a physical disability, or dementia. Detailed information about the services offered including the latest report by the Commission for Social Care Inspection is available in the home. Weekly fees for services range from £480 to £500 per week. Additional charges are made for newspapers, toiletries, chiropody and hairdressing services. (This information was correct at 10.07.07) The purpose built home is owned by Oak Care Ltd. and is situated in a residential area close to the city centre of St. Albans with its good transport links and extensive shopping and leisure facilities. The home has three floors served by a passenger lift. The bedrooms are on the ground and first floor and are all single occupancy with en-suite facilities. Each of the residential floors has a dining room, kitchenette, hairdressing room and lounges. The main kitchen and laundry are on the ground floor and the top floor provides living accommodation for staff. There is ample parking and the home has attractively laid out gardens to the rear of the building, with the recent addition of a covered pavilion area where residents can sit outside protected from the sun. Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report follows a visit to the home during which it was possible to talk to people living in the home, visitors, staff, visiting healthcare professionals, the manager and the proprietor. Key records were inspected, including those relating to care planning, staff recruitment and medication. This report also makes use of a number of questionnaires received from people who live in the home, information provided to the Commission for Social Care Inspection in the home’s Annual Quality Assurance Self Assessment, together with any concerns or other information received about the home since the last inspection in April 2006. What the service does well: What has improved since the last inspection? Care plan documentation now includes better information about the involvement of community healthcare professionals with people living in the home and the dietary needs of people living in the home are clearly set out and more accessible to staff. The home has joined the National Association for Providers of Activities for Older people. (NAPA) This should inform and enhance the future activities programme of the home, which will in turn benefit people living in the home.(See below) Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 6 What they could do better: 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 Manor DS0000019486.V345576.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 Manor DS0000019486.V345576.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): Standards 1 3 5 (Standard 6 does not apply to Oak Tree Manor). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The system of pre-admission assessment in place is thorough and comprehensive and should ensure that only those whose care needs can be appropriately met are admitted into Oak Tree Manor. The information provided for people considering Oak Tree Manor as a home either for themselves or for someone they are responsible for is sufficiently comprehensive and well presented to enable them to make a well-informed decision about the home. There is one minor amendment to the Service User’s Guide that is required to make sure it meets the revised Care Homes Regulations in full, this does not substantially detract from the overall good quality of the information that is provided. Staff are provided with the training they require giving them the basic knowledge and skills needed to satisfactorily identify and meet the care needs of people living in the home. As an increasing number of people living in the home experience some degree of dementia, additional specific dementia care training for staff, at an appropriate level, will need to be identified and provided for key staff to ensure that the care given is in line with current best practice and takes account of any future developments in the provision of high Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 9 quality dementia care for people living in the home who have dementia. EVIDENCE: “We chose Oak Tree manor because we did not like the other home we had been allocated”… “The friendly receptionist put me through to the manager, we made arrangements to go around the next day to see the home…we also checked on the CSCI website (www.csci.org.uk)” were some comments made to the CSCI. All of the survey returns received indicated that they felt they had sufficient information about the home to make an informed decision, unless the admission was an emergency one. Staff training files were seen and discussions held with staff about training received and planned for the near future. The basic training provided is good, however that for dementia care is rather more limited. This was discussed with the manager and proprietor and it is understood this will be addressed over the coming year and ongoing thereafter. Although the service user guide contains an impressive amount of information, in a very clear and accessible format, it does not yet fully meet the revised regulations that now apply. Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 10 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): Standards 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. The system for the administration of medication is essentially sound, provided all staff follow the home’s policies and procedures at all times. If this is done, people living in the home can be satisfied that their safety and well-being are protected in respect of their medication and how it is given to them. The standard of care planning is good and provides comprehensive information for staff to enable them to identify and meet the current and changing care needs of people living in the home. People living in the home have appropriate access to the community healthcare services they require. EVIDENCE: There was one instance where a particular liquid medication was being stored at temperatures in excess of that recommended for it and there was some Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 11 inconsistency in the records of medication that is prescribed on an “as required” basis. A Community nurse was visiting the home and reported positively on the home’s liaison with the community healthcare services, although some problems had been experienced at this and other homes due to delays on the part of the home’s pharmacy in providing prescribed dressings in a timely manner. “I know that my mother receives medical care when she needs it, has been sent to A&E when appropriate and has also seen an optician since entering the home” was one comment sent to the CSCI. The survey returns and conversations with people living in the home about the way that their care is provided were all very positive. “I have been particularly impressed with the caring and professional attitude of all the staff at Oak Tree Manor” was one typical comment made. Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 12 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): Standards 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 living in Oak Tree Manor are able to exercise a reasonable degree of choice in their daily lives and may vary their daily routines within reason so as to reflect their personal preference. A range of activities are available for people living in Oak Tree Manor, although the scope and scale of these could be improved and more use made of specialist advice on the provision of activities for people with dementia. EVIDENCE: Care staff were providing a limited programme of activities on the day of this visit, as the home’s activities organisers were both on leave. A concern about the frequency of activities recently available had been raised with the CSCI, this was discussed with the manager in a very positive and open way. In the information provided to the CSCI by the home it is indicated that it is proposed to increase the number of activities organisers and to recruit “Social Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 13 Carers” who can support activities organisers and provide an activities programme in the evenings. Since the last inspection the home has become a member of NAPA and a representative will be speaking at the next relatives’ forum. Copies of the menus available were seen and people living in the home confirmed that they always have choices offered and that alternatives to the main menu are always available. Several visitors to the home were spoken to and comments were also received from families of people living in the home by way of questionnaires sent to the CSCI. The overwhelming feedback received was positive. “I know my mother looks forward to going into the dining room at mealtimes” Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 14 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): Standards 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has comprehensive and well publicised complaints policy and procedures and these, together with staff training in safeguarding issues, including the recognition of abuse and the appropriate action to take if it is seen or suspected, should provide both people living in the home and those who care for them, confidence that they are protected and that any concerns or complaints will be dealt with appropriately. EVIDENCE: Staff training records seen and staff spoken too confirm that those working in the home are provided with the information, guidance and training they need in order to be able to recognise potential or actual abuse and to know what action they should take to ensure that people living in the home are protected. “The manager has an open door policy”…. “I know I can speak to the manager about anything” were two comments received from relatives of people living in the home. Relatives’ forums and residents’ meetings are held at which the views of those living in the home, including any concerns can be aired. Oak Tree Manor DS0000019486.V345576.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): Standards 19 20 24 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Oak Tree Manor provides a safe, comfortable and well-maintained environment for those living and working there. The rooms of people living in the home are well furnished and can be personalised with familiar items of furniture, pictures and ornaments to reflect their individual personality and taste. The communal areas, both inside and outside the home, provide a range of seating and activity areas for those living in Oak Tree Manor. EVIDENCE: Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 16 The survey returns sent to the CSCI were all very positive about the cleanliness of the home, as were comments made on the day of this visit by people living in the home and those visiting them. Those rooms seen, with the permission of the person living in the home, were well furnished and had various items in them that made them individual to them and reflective of their interests and life history. Maintenance staff were active in the home throughout this visit and the standard of décor seen was good, providing a pleasant home for people to live in. The addition of a “pavilion” in one of the home’s gardens helps those people living in the home who prefer sitting outside in the shade to do so. However, one resident said that ever since the pavilion has been in place it hasn’t stopped raining! Oak Tree Manor DS0000019486.V345576.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): Standards 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. There are sufficient care staff, administrative support staff and management with the necessary skills, experience, training and support to ensure that Oak Tree Manor operates safely and efficiently at all time. This promotes and safeguards the essential well being of people living in the home. This level of performance would be further enhanced by the recruitment of additional activities staff and by the provision of additional training specific to the care of people with dementia. There are robust recruitment policies in place, which should ensure that only those suitable to do so provide personal care to people living in the home. EVIDENCE: “I have been impressed by the standard of care my Mother receives, the carers are very understanding” was one of a series of very positive comments received about the quality and performance of care staff. Positive feedback was also received from people living in the home, relatives and visitors to the home about the management and administrative staff and also the good standard achieved by the domestic support staff. Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 18 Training records were seen and discussions were held with staff about the training and supervision support they receive. This process confirmed that appropriate basic training is provided and that staff receive the supervision and support they need to satisfactorily meet the care needs of people living in the home. Approximately 50 of permanent care staff hold NVQ level 2 in care. (Information provided to the CSCI in the home’s annual quality assurance selfassessment) Several of the staff team spoken to have registered on an NVQ course starting in September 2007. Recruitment files for recently recruited members of staff were seen to include the required evidence of checks and enquiries made about them. This can give confidence to people living in the home and to those who are responsible for them, that their safety and well being is protected by the home’s recruitment practice. Oak Tree Manor DS0000019486.V345576.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): Standards 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. The home is well managed. The proprietor and manager give strong and clear leadership and direction to the home and there is a robust system of quality assurance in place to monitor the performance of the home. This means that people living in the home benefit from efficient, safe and effective practices and routines in the day-to-day operation of the home. EVIDENCE: The manager hold the Registered Managers Award. Very thorough and detailed monthly reports on the operation of the home are available to the CSCI. Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 20 People living in the home, staff and visitors were all positive about the manager, proprietor and the administrative and support team. The standard of record keeping, including those for the maintenance of facilities and equipment is good. The home does not act as appointee for any resident and does not directly administer resident’s finances. Oak Tree Manor DS0000019486.V345576.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 2 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 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 Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 22 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 OP1 Regulation 5 Requirement The home’s Service User Guide must be reviewed and revised so that it meets all the requirements of the revised Care Homes Regulations. The storage temperature of medication must be within the recommended range for it in every case. (This was carried forward from the previous inspection. It is understood that since the site visit action has been taken to meet it in future and this will be monitored.) All medication prescribed on an “as required” (PRN) basis must be reviewed to ensure that the current prescription agrees with the actual administration and recording practice taking place. Where it does not, appropriate action must be taken to ensure that at all times medication is administered accurately in line with the prescription. Where medication is prescribed with variable dosages, the exact dose administered on each DS0000019486.V345576.R01.S.doc Timescale for action 31/08/07 2. OP9 13(2) 10/07/07 3. OP9 13 31/07/07 4. OP9 13 10/07/07 Oak Tree Manor Version 5.2 Page 23 occasion must always be recorded. 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 OP9 Good Practice Recommendations The home should seek advice from their pharmacy on the storage temperature of Lactulose and whether alternative formulations or products are available with a higher permitted storage temperature than that currently specified. This should then be discussed with the general practitioner prescribing the medication. The activities programme for those people living in the home that have dementia should draw on resources and advice available from specialists in the provision of activities for people with dementia. (E.g. NAPA and the Alzheimer’s Society). Activities staff should receive specific training at an appropriate level to assist them to provide meaningful activities for people with dementia. 2. OP12 Oak Tree Manor DS0000019486.V345576.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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