Inspection on 13/06/07 for Oakdale Residential Home

This inspection was carried out on 13th June 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

Oakdale Residential Home 23/05/06

Oakdale Residential Home 31/10/05

Oakdale Residential Home 12/05/05

Oakdale Residential Home 14/12/04

Oakdale Residential Home 03/06/04

Oakdale Residential Home 02/12/03

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

CARE HOMES FOR OLDER PEOPLE Oakdale Residential Home 123 Kiln Road Benfleet Essex SS7 1TG Lead Inspector Brian Bailey Unannounced Inspection 13th June 2007 10:20 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 Oakdale Residential Home DS0000018087.V342377.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. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakdale Residential Home Address 123 Kiln Road Benfleet Essex SS7 1TG 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) 01702 553734 01702 556836 oakdale@1stchoicecarehomes.com Mr Kanagaratnam Rajamenon Mr Kanagaratnam Rajaseelan Manager post vacant Care Home 27 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (27) of places Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided to no more than 27 people over the age of 65 years (OP). Number of service users to whom personal care is to be provided shall not exceed 27 (27). Personal care to be provided to 15 service users over the age of 65 years with Dementia. 23rd May 2006 Date of last inspection Brief Description of the Service: Oakdale is a large, detached, private care home situated in a residential area of Thundersley. It is relatively close to the main shopping areas of Southend, Rayleigh and Benfleet. Bus routes are close to the home. The property has been adapted to provide accommodation that consists of twenty-three single bedrooms and two shared bedrooms. Ten of the single bedrooms have en-suite WC facilities. There are two lounges, one with a dining area; a passenger lift that provides access to the first floor. The home has a small number of off road parking facilities to the rear of the building. There is also a large well-maintained rear garden, although access is too difficult for many of the people living at the home. The current weekly charge for a room ranges from £430 to £525 per week. Extra charges are made for chiropody, toiletries and hairdressing. Previous inspection reports are available from the home and from our website www.csci.org.uk Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection looking at the core standards for the care of older people. This report is based on a range of information that has been accumulated from our inspection records, a site visit to the home that took place on 13th June 2007 at 10.20am, a tour of the property, discussions with the acting manager, the deputy, staff, people that live at the home, relatives, questionnaires issued by CSCI and the records kept at the home. The home is registered to provide accommodation and care to twenty-seven older people. At the time of the site visit, there were twenty-six people in residence. People living at the home spoke of being cared for by kind and attentive staff. Staff spoken with were happy working at the home and considered people were well cared for. An acting manager was appointed to run the home on 1st January 07. Together with the deputy manager, much work had been done in that time to meet the National Minimum Standards and in particular the requirements made at the last inspection in 2006. Thirteen questionnaires returned to us by relatives and people at the home also confirmed the view that improvements had been made. There was a warm and lively atmosphere at the home where everyone seemed to be involved. What the service does well: What has improved since the last inspection? Relatives considered that communication between staff and families had improved. People at the home welcomed the introduction of an easy to read newsletter. The manager has introduced formal staff supervision sessions and is in the process of improving the way care plans are recorded. The system for Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 6 recording money held for safe keeping has improved and files of staff and people at the home have been brought up to date. Changes to the environment have included the redecoration of bedrooms and the provision of new furniture and the dining area being made more welcoming. The creation of a fund for developing activities for people at the home. 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. Oakdale Residential Home DS0000018087.V342377.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 Oakdale Residential Home DS0000018087.V342377.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): 1, 3 and 5. Quality in this outcome area is good. People are provided with good information about the home to help them decide whether Oakdale would be a suitable place to live. Senior staff obtain assessments of peoples’ care needs prior to admission so that they can determine whether the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service User Guide had been amended since the last inspection. These are detailed and considered to now meet the required standards and provide people with a good range of information about the facilities and service provided. Copies of these documents were available in the bedrooms. Evidence was available to show that senior staff obtain detailed assessments of people prior to their admission to the home. Information obtained was sufficient to enable the senior staff to be confident that the staff would be able Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 9 to provide the care needed and the environment would be safe. The home was in the process of admitting a person at the time of the inspection visit. The manager and a relative confirmed that there had been opportunities to visit the home and that the manager had also visited the person in their own setting. The person was made welcome and the relative was not left feeling excluded from the process. The acting manager was able to demonstrate that there was a system in place to ensure that the needs of the person were adequately recorded and how the needs were to be met. Oakdale Residential Home DS0000018087.V342377.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): 7, 8, 9, 10. Quality in this outcome area is good. People at the home could be confident that their care plans will be sufficiently detailed to ensure staff met their needs. People are better-protected following improvements to the training, administration and storage of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records sampled showed that the home was in the process of changing the format to ensure that more detailed information is available to staff. The care plans of eleven people have now been transferred to a new system. Care plans covered a wide range of needs with clear guidance for staff as to how the identified needs were to be met. Care plans were not being reviewed frequently enough although the manager had introduced a system to record reviews and for these to be monitored. Risk assessments had been completed and clear information was available to show that health care professionals attend on a regular basis. The daily records were seen although some of these contained only a very brief account. Relatives spoken with said they felt confident with care provided and felt reassured when they left the building. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 11 Visitors have commented on feeling that they know more now that the home has a new acting manager. People at the home said they considered staff to very patient and kind and that they respected their right to privacy. Staff were always ready to assist and to offer support. Changes to the medication system had been made since the last inspection visit and the various requirements made at that time have been implemented. The security of medication is improved with all medication in a locked trolley and kept within a locked cupboard. The medication was well organised and evidence was available to show that controlled drugs are recorded appropriately and the medicine administration record (MAR) sheets were up to date with no gaps of signatures. A senior has been trained to advanced level to administer medication and ensures that other staff are appropriately trained and competent. The manager and deputy also intend to undertake this training. Oakdale Residential Home DS0000018087.V342377.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): 12, 13, 14 & 15. Quality in this outcome area is good. Many people at the home enjoy the provision of a good range of stimulating activities on a regular basis, although these may not include everyone. The provision of an appealing and balanced diet is beneficial to all people at the home although for some people, having to remain in their armchair to eat a meal would not be welcomed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following recommendations made by people at the home, the new acting manager had made some improvements to the dining room to make it more welcoming. New tablecloths and flowers improved the appearance and the tables were nicely laid out ready for meals. The home was very busy during this site visit with several visitors coming and going. People at the home appeared to enjoy the lively atmosphere and to interact well with staff throughout the day. People were observed sitting in the lounges, bedrooms and the entrance area. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 13 During the afternoon the activities coordinator reorganised the dining tables so that people at the home could sit in a group and enjoy activities. They started the afternoon with a quiz. For those that chose not to participate, they appeared to enjoy the change and the company. Several people are able to pursue their interests and hobbies. One person commented on a survey form retuned to us, “I have many interests and hobbies in which I can indulge” and “I am comfortable, well fed and have clean clothes, I do my hobbies and read – and I have not washed up for three years – what more could I want”. One person spoken with said they preferred to remain in their room where they were very comfortable, but liked the door open so they could see the staff come and go. The home did have a good variety of activities and materials available. From observation, during the afternoon activities session, people with dementia were actively involved. Good food stocks were available in the kitchen. A choice of lunch was available; the meal was nicely presented and staff were observed to assist people appropriately. Records of food presented were available. Fresh fruit was available. None of the people at the home that were spoken with had any complaints about the food. As reported elsewhere in the report, the lack of dining room space means a lack of choice, as it’s not possible for everyone to sit at a dining table. Some people at the home would welcome consideration being given as to how this situation could be improved. Oakdale Residential Home DS0000018087.V342377.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): 16 and 18. Quality in this outcome area is good. People at the home benefit from having a good complaints procedure and procedures in place to protect them from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy is displayed in the home and included in the statement of purpose. Of the thirteen survey forms returned to us, all were aware of the complaints procedure. The complaints log at the home was not checked. The home had a policy and procedure on the protection of vulnerable adults from abuse (POVA). All but some recently appointed staff had been provided with training on this topic. For some staff that were last trained in January 2004, a refresher course on POVA is required to ensure there understanding of issues is up to date. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24, 25 and 26. Quality in this outcome area is adequate. People at the home benefit from living in a safe, well-maintained environment that is clean, pleasant and hygienic although some improvements to the garden at the rear of the house are necessary to ensure people can use the facility. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Oakdale is a large detached house that has been adapted and extended to meet the needs of older people. The entrance hall is homely and welcoming in appearance. A tour of the building included a check of some of the bedrooms in the main house and the newer extension, bathrooms, toilets, laundry, kitchen, dining area and lounges and garden. All areas were clean and tidy. Many bedrooms had been personalised and all were comfortable and homely in appearance. They were in general suitably furnished and decorated. There Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 16 were no odour control problems. The call bell system was readily available to people in their bedrooms and was in working order. Corridors in the extension were wider than in the main house and had rails to assist any person who was unsteady in walking. The communal lounges were furnished with comfortable chairs and the décor was attractive. The amount of dining space per person is limited and therefore a number of people have little choice but to have their meals on a table in front of their armchair. All bedrooms rooms seen had reasonable outlooks although a few overlooked a boundary fence but were light and airy. The laundry, which had a keypad entry restriction for safety reasons, was seen and was clean. The manager was advised that there was no hand washing facilities in the laundry with soap and towels for staff to use. The kitchen was well equipped, clean and tidy; a step in the kitchen leading to a door requires a warning notice to minimize the risk of an accident. A passenger lift provides access to the first floor. The front door has a keypad to exit to ensure people do not walk out to the busy road outside. A very large private well maintained garden is available at the back of the house. Few people are able to make use of it owing to the distance of the garden from the house and the path is uneven. . Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. People are protected by the home’s recruitment procedures and are cared for by an experienced and caring team of staff that work well together. People would benefit however if more staff were trained to qualification standards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff files examined were very well organised and comprehensive. All recruitment requirements were met and of those files sampled further information about past experience and training was evident. Evidence was available to show that Criminal Records Bureau disclosure checks are obtained for staff. A training log was made available that showed all the training courses staff had attended during past few years. This showed clearly that training is provided on all matters relating to Health and Safety, National Vocational Qualifications, POVA, understanding dementia and other courses that relate specifically to the care of older people. Training had been booked for a course on falls management. The home has not managed to meet the recommended level of 50 of care staff having a NVQ although there are currently five staff currently taking the qualification at levels 2 and 3. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 18 Records showed that staff recently employed had received the home’s initial induction training but there was no evidence that these staff had been offered or will undertake the Skills for Care induction package. Staff spoken with said they enjoyed working at the home; they were knowledgeable about people’s needs, willing to work flexibly according to need, worked very well as a team and from observation provided good level of support to people at the home. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 37 and 38. Quality in this outcome area is good. People at the home benefit from living in a home that is well managed by a team of experienced senior staff. Health and safety matters are addressed to ensure people live in a safe environment. Peoples’ personal money was held safely on their behalf. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager has the relevant experience to run the home and has achieved the Registered Managers Award. An application for registration as manager needs to be submitted to CSCI. The home also has an experienced person as deputy manager; they seem to work well as a team having made many changes in the way the home is run that are of benefit to people living at the home. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 20 The home has improved compliance with health and safety matters by addressing the issues raised at the last inspection such as fire drills. Evidence was available to show that services and equipment had been serviced and were up to date. Staff had been provided with training on a range of health and safety topics including food hygiene, moving and handling and first aid. The home’s insurance liability insurance certificate was seen and the expiry date is 2/8/07. Staff spoken with confirmed they had attended these courses and certificates were available. Accident reports were being kept on one file and these should be separated onto each person’s file to ensure confidentiality is maintained. The arrangements for the safekeeping of small amounts of peoples’ money were checked. Their relatives usually deposit money. Well-maintained records were being kept and the two accounts checked were accurate and up to date. Expenditure was in accordance with those items considered as extra to the fees. The home has a Quality Assurance system in place and a survey of people was carried out in April and May and so far, fourteen responses had been returned for the manager to summarise. Thirteen survey forms issued by CSCI were returned to us from relatives, people living at the home and health care professionals. Positive views about the home and of the way it is managed now were expressed. A few people commented on how communication between the home and relatives had improved. A relative commented, “The carers are very patient and kind and try to make everyone feel at home”. Oakdale Residential Home DS0000018087.V342377.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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 X 2 X 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X 3 3 Oakdale Residential Home DS0000018087.V342377.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 OP7 Regulation 15 (2) b Requirement A regular review of care plans must be carried out to ensure they are up to date and accurately reflect the needs of the people at the home. Consideration must be given as to how the dining room facilities can be expanded to provide adequate space so that all people at the home can choose where they take their meals. Access to the garden must be improved to enable people at the home to access the area safely. A wash hand basin must be provided in the laundry for staff to use so that they do not place people at risk from cross infection. All new staff must be provided with Skills for Care induction training to ensure they have the necessary skills and knowledge to care for people at the home. Timescale for action 01/09/07 2 OP20 23 (2) g 01/11/07 3 OP23 OP26 23 (2) o 23 (2) J 01/10/07 4 OP30 18 (1) © i 01/10/07 Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations Continue to consider how the decoration of the building can be made to help people with dementia find their way around the building more easily. Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Oakdale Residential Home DS0000018087.V342377.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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