Inspection on 13/05/05 for Oakapple Care Home

This inspection was carried out on 13th May 2005.

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

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

Other inspections for this house

Oakapple Care Home 30/09/08

Oakapple Care Home 06/12/07

Oakapple Care Home 23/05/07

Oakapple Care Home 25/10/05

Oakapple Care Home 16/12/04

Oakapple Care Home 25/05/04

Oakapple Care Home 03/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Oakapple Care Home Debdale Hall Bungalow Debdale Lane, Mansfield Woodhouse Mansfield Nottinghamshire NG19 7EZ Lead Inspector Stephen Benson Unannounced 13 May 2005 9:30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakapple Care Home Address Debdale Hall Bungalow Debdale Lane Mansfield Woodhouse Mansfield Nottinghamshire NG19 7EZ 01623 622 588 01623 631 959 ngyinkwong@aol.com Mrs Wendy Mary NG Yin Kwong, Oakapple/ Debdale Hall Bungalow, Debdale Lane, Mansfield Woodhouse, Notts NG19 7EZ Mrs Wendy Mary NG Yin Kwong Care Home (CRH) 10 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Old age, not falling within any other category registration, with number (OP) 10 of places Dementia (DE) 1 Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 16/12/04 Brief Description of the Service: Oakapple is a care home providing personal care and accommodation for 10 older people. The home provides long term care and will accept emergency admissions. The home is owned by Mrs Wendy Mary NG Yin Kwong, which is run as a family business. The home is located in the grounds of Debdale Hall between Mansfield and Mansfield Woodhouse about a mile from shops, pubs, the post office and other amenities. The home was opened in 1987 and consists of an extended bungalow. 6 of the home’s bedrooms are single, and 3 of the bedrooms have en-suite facilities. The home has large gardens that are well maintained and easily accessible. There is car parking available for 6 cars Since the last inspection the home has carried out a programme of redecoration. The home does not have a website but further information can be obtained from the manager. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first of two unannounced inspections to be carried out between April 2005 and March 2006. The inspection lasted for 6 ½ hours and the main method of inspection used was called case tracking which involved selecting 3 residents and tracking the care they receive through the checking of their records and discussing this with them. Other residents were spoken with and additional records were seen. A discussion was had with the manager, both of the care staff on duty were spoken with and care practices were observed. Other residents, friends and relatives were spoken with but there were no visiting professionals seen during the inspection. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the service does well: What has improved since the last inspection? There is a new system for planning the care each resident needs replacing the previous one and a resident said she has told staff what help she wants. A system is being prepared so that any resident who wants to be responsible for their own medication can be as long as they are safe doing so. Some parts of the home have been decorated and furniture moved around to let residents have a different view. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 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. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Any new resident will have been assessed before moving into the home. EVIDENCE: Community Care Assessments are provided for all prospective residents referred through care management arrangements and these were seen in records. Residents who are privately funded are assessed by staff from the home using a pre prepared assessment form, which assess the key areas needed. These assessments are then used to start the care planning programme. There have not been any recent admissions as the home has been fully occupied so this standard could not be assessed in any greater detail. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8,. 9,. 10 and 11 There are good arrangements in place for meeting the health and social needs of residents. EVIDENCE: The care planning system is in the process of being changed. This meant that there are 2 systems in operation. The new system is in the form of a published book, which includes various assessment systems, including nutritional, tissue viability, falls and psychological healthy. The new system includes a reviewing and updating process. There was however limited space for preparing the actual care plans and the management are currently considering the best way to ensure that they have the level of detail they require in the care plans. A relative spoken with said he had seen his relative’s care plan and had been able to contribute to this. A resident spoken with said that she was able to say what support she wanted but did not recall seeing a care plan. The new system includes a section for residents to record their views. The change of care planning system should not be allowed to drag on so it is recommended that a target date is set by which the change should be complete. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 10 A record is made of every medical appointment attended by a resident. A relative spoken with said that when his relative developed a rash staff had intervened well and ensured that she received the medical treatment she required. The relative also said that he felt the standard of personal care was excellent and he was impressed at how clean his relative is kept. He also said that he felt that continence management was good. Records showed that one resident has got a pressure sore and that this is being monitored and attended to using appropriate equipment. There are activities provided that encourage movement and in good weather walks around the grounds are encouraged. Resident’s have access to other health care services including district nurses, optician, dentist and chiropodist. A resident said that the doctor came to see her this week and a member of staff was present to help her. The home has a policy on the receipt, recording, storage, handling and administration of medicines and uses a monitored dosage system. A process for assessing whether a resident is able to self medicate is currently being prepared. The administration of lunchtime medicines was observed and correct practices followed. The Medicine Administration Records were fully completed, although there were two different methods being used for recording when paracetamol was given PRN and it is recommended that only one be used. The controlled drugs register did show several errors, which had been corrected at a later date and some entries only had one signature. One resident had her dosage reduced at her request. A dosage should only be changed at the discretion of a doctor. A resident said that she always gets her medication when she needs it. Residents said that they were happy with the arrangements for their personal care and one said that she praised their sensitivity. Information about respecting privacy and dignity is included in the staff induction programme and the keyworker system used is intended to promote this. One resident has bedrails fitted to her bed, but there is no assessment for this. Also approval should be given that the rails in use are of the correct type for the bed and fitted correctly. Residents wishes for funeral arrangements are included within the care plans and staff described appropriate arrangements to enable appropriate care and comfort to be provided to anyone who is terminally ill. There is access to bereavement counselling if required. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Efforts are made to provide flexibility to residents and to promote choice although this could be increased with some thought and planning. Residents were happy with the food provided. EVIDENCE: The routines can be adjusted to suit the day-to-day arrangements. Residents described the routines as flexible and said they are able to chose what they do. Residents are able to help around the home if they wish and some do share in domestic duties. A variety of games are played and a bingo session was played during this inspection. There is an activities programme displayed in the staff room, this would be better displayed where residents could see it. Visitors were present during the inspection and spoke positively about the home. They said that they are made welcome when they visit and were seen talking with staff and residents. Residents spoken with said that they can have visitors at any time. Staff spoken with described promoting choice for residents, however it was observed that there were areas where more autonomy and choice could be promoted, in particular at meal times. Staff were seen pouring drinks and passing round bread and butter. Condiments were used by staff rather than Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 12 being on the table. There were some instances observed where residents were being offered a choice that was not meant, an example being one resident was asked “are you ready to come for your dinner?” and when replied “no” she was taken through to the dining room anyhow. Where able residents retain control of their finances and relatives manage these when the resident cannot. One resident said that she had been able to bring in her own three piece suite and chest of drawers. A new menu is prepared each week. Lunch on the day of inspection was fish in parsley sauce, chips an d mushy peas. Both residents and visitors to the home said that the food was good. One resident requires a soft diet and does not have the same level of variety and freshly prepared food as other residents. This was not clearly recorded in her care plan and there was not any monitoring of her nutritional intake. There were good stocks of food Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents and relatives feel that any concerns they have would be listened to and they feel safe within the home EVIDENCE: The complaints procedure is displayed in the hall but does not contain up to date information on the inspecting authority. There is a complaints book on the hall table for anyone to add a comment in, however this has not been used. A discussion was held on how to make better use of this procedure. A resident said that she had no complaints at all but would not hesitate to tell staff is she was unhappy about something and a relative said that he had been given a copy of the procedure and he always questioned things with staff from curiosity. There have not been any reported incidents of abuse to the Commission for Social Care Inspection and staff said there have not been any. A resident said that she had been there for 6 years and never seen anything like that. A relative said that he visits regularly and had never witnessed any conduct that was detrimental to any resident’s welfare. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home provides comfortable well maintained accommodation suitable to the needs of the residents EVIDENCE: The home is an extended bungalow making it accessible to those with mobility problems. The home and grounds are well maintained and a gardener was tending the grounds on the day of this inspection. A resident said that she enjoys sitting in the garden in the summer with the sun umbrellas up. There has been some recent redecoration and movement of furniture. Those residents who prefer to use a particular chair are able to have it moved periodically so that they can enjoy a differing view of the gardens. The home was clean, tidy and fresh at the inspection and a resident said just look around it’s kept lovely. A relative said that it is always clean and free from any unpleasant odour when he visits. Staff described a regular cleaning schedule to ensure all areas of the home are cleaned thoroughly in rotation. There are infection control procedures in place and the laundry is well Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 15 organised, although there were some cleaning materials which should be in a locked cupboard. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Records in use do not accurately show that there are sufficient staff on duty or what training has been undertaken. EVIDENCE: The rota did not show that there was adequate cover provided, however this was explained that there were some working hours that have not been recorded. Residents spoken with said that the staffing levels always seem to be adequate. There is a recruitment procedure, which ensures that the necessary checks are carried out. The partner of the proprietor lives on the premises and sometimes helps in the home. He must therefore be subject to the same recruitment checks as anyone else working in the home and references and Criminal Records Bureau checks must be carried out. A record of staff training undertaken is made although this did not easily show the training undertaken by each member of staff. Mandatory training is provided with some courses being studied through distance learning. A relative said that he felt that staff training was an inherent part of the home and residents said that they felt that staff were able to do their job. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, and 33 There are suitable management arrangements in place, which plan for the future management of the home. The views of residents are sought. EVIDENCE: The current manager and provider have not got NVQ level 4 or an equivalent qualification, however her daughter works in the home as a senior care and is studying for her NVQ level 4. It is intended that she will apply to be the registered manager in due course. A copy of the last inspection report is displayed in the hall. A questionnaire has been prepared for seeking views of residents and their relatives on services provided. These have not yet been fully completed by all, but one relative said that he had completed one. It is intended once these have been completed they will be gone through to see if any suggestions have been made. One resident said that she is able to comment on anything she wants to. Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 18 Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 x 3 x x x x x Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 9 9 Regulation 13 13 Requirement Ensure that doses of medication should only be altered by the appriopriate medical practitioner Ensure that the correct procedures are followed when recording in the Controlled Drug register Bedrails should only be used following an assessment and approval is given that they are correct for the bed and fitted properly by an OT Monitor the nutritional intake for any resident on a soft diet Update the complaints procedure Timescale for action 1st July 2005 1st July 2005 1st July 2005 3. 10 12 4. 5. 6. 7. 15 16 26 27 16 22 12 17 8. 29 18 Ensure all cleaning products are kept in a locked cupboard The rota must be an accurate reflection of the staff cover provided and training records training undertaken Then partner of the provider 1st August must supply two references and 2005 obtain a Criminal Records Bureau check 1st July 2005 1st August 2005 1st July 2005 1st July 2005 Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 21 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. 4. 5. Refer to Standard 7 8 12 14 16 Good Practice Recommendations Set a target date to complete the change of care planning systems Use one system for recording when PRN doses of paracetamol are administered Display the activities programme where residents can see it Find ways of increasing choice and autonomy for residents Promote the use of complaints procdure Oakapple Care Home C53 C03 S8724 Oakapple V226410 130505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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