Inspection on 18/01/06 for Oakdene

This inspection was carried out on 18th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oakdene 20/09/07

Oakdene 08/06/06

Oakdene 02/08/05

Oakdene 04/03/05

Oakdene 21/04/04

Oakdene 03/09/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Oakdene Oakdene 100 Tollemache Road Birkenhead Wirral CH41 ODL Lead Inspector Les Hill Announced Inspection 18th January 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 Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakdene Address Oakdene 100 Tollemache Road Birkenhead Wirral CH41 ODL 0151 653 7109 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) Mrs Irene Patricia Steele Mrs Irene Patricia Steele Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd August 2005 Brief Description of the Service: Oakdene is a detached property that was originally a vicarage and was adapted to provide residential care and support for 16 older people in 1981. The present owner took over the home in 1992. It is located in a residential area of Claughton, Birkenhead and is about half a mile from local shops and services. Buses stop outside the front gate. The home is approached via a sloping drive but the house and gardens are set on level ground. There is parking for two or three cars in the grounds and unrestricted parking on the main road. Accommodation is provided in 10 single and 3 double bedrooms. The home has a communal lounge, a conservatory, a separate dining room and a small smoking room. There are two bathrooms, one of which has a bath lift, and five WCs. The gardens are accessible to residents who need the use of a wheelchair. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Oakdene was undertaken on Wednesday 18th January 2006 over a period of 5 hours. It involved the examination of records, a tour of the building, discussions with the manager and deputy manager and meeting with residents. The inspector received six completed questionnaires from residents/their relatives. The inspection was undertaken as part of the Commission’s responsibility to visit and report on each registered care home on two occasions every year. What the service does well: What has improved since the last inspection? What they could do better: Requirements have been made to produce a Statement of Purpose and Service User Guide, to improve care plans and to ensure that staff recruitment practices conform to national minimum standards. An additional requirement has been made for the manager to spend more time in the home. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 6 Recommendations have been made to keep staffing levels under review, to ensure 50 of staff have an NVQ award, to ensure staff have regular formal supervision and to expect that the manager obtain an award at NVQ level 4 in management. A recommendation has also been made for the manager to explore alternative arrangements to the ones currently in place, for the management of resident’s personal money. 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. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3, 4, 5 and 6 Some additional work is required to ensure the statement of purpose and service user guide meet requirements. Improvements have been made to the assessment processes. EVIDENCE: The home’s statement of purpose is in need of some additional information to ensure that it includes all the matters identified in Schedule 1 of the National Minimum Standards, Care Homes for Older People. Once this is completed the service user guide should be updated to comply with Regulation 5 of the same standards documents. Residents have a contract/statement of terms and conditions of residency. Assessment documents were in place on the three resident’s files examined during the inspection. The home has copies of assessments undertaken by social workers from the placing authority that are kept separate from the homes own assessments. The files should be re-arranged so that all assessment documents are held together. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 9 Oakdene has been offering care and support to older people for approximately 24 years and the current owner has been responsible for the service during the past 13 years. From discussion with the manager and deputy manager and feedback from service users/their relatives, the inspector was able to ascertain that all of the residents are appropriately placed. The home will refer residents whose physical or mental health needs deteriorate to a level where they feel they can no longer cope, to the appropriate social worker for re-assessment. Prospective residents and their families are invited to visit the home and to spend some time there before making a decision to stay. The home is not contracted to provide Intermediate Care. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Care planning arrangements have improved and should be further developed to confirm good practice. Resident’s health care needs were being addressed and they were treated with dignity. EVIDENCE: Care plans had been improved to contain more detailed information for staff. Some structure to the care files would enable the manager to confirm whether all of the resident’s needs had been addressed, whether risks had been identified and whether the detail of care plans is sufficient to confirm appropriate actions. Staff are recording information about the health and wellbeing of residents and separate records are kept of visits by health care professionals. The home has links with a number of GP surgeries and the deputy manager told the inspector that they receive good support from the GP’s, district nurses, a local optician and dentists. A chiropodist visits the home on a regular basis though there is a small charge for this service. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 11 Medicines are administered through a monitored dosage system made up by the pharmacist on a weekly basis. The homes arrangements for managing the medicines were checked and found to be in good order. The pharmacist has provided training for staff in managing medicines. Observations during the inspection, discussion with residents and feedback from the CSCI questionnaires confirmed that residents are treated with dignity and respect. Movable screens are provided in shared bedrooms to ensure privacy. Residents can meet with visitors in any of the home’s lounge areas or in their own bedroom. Information is still to be gathered about the wishes of residents and their families at the time of death. The home promises to provide care and support in a dignified manner and appreciative messages had been sent by families to staff in the home, commending the good standards of care they had provided. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents are helped to exercise control over their own lives. EVIDENCE: The home has TV, video and music equipment and staff organise a bingo session each week. They also do some reminiscence activity, organise quizzes and take residents out for a walk (staffing levels permitting). Residents are taken out in taxis to a local pub for a meal and have also been taken shopping. A hairdresser visits the home each week. Some of the residents continue their attendance at a local day centre. Visitors are welcomed at the home at any time and visiting hours are unrestricted. Residents are encouraged to make decisions about their everyday lives, what time they get up or go to bed, what they wear and they have a choice of food at mealtimes. They are also encouraged to make decisions about how they will spend their day. The home’s menus confirm that a variety of food is provided. Residents who commented about the food were complimentary about the quality and variety Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 13 of meals served in Oakdene. Meals are usually served in the dining room but residents can choose to eat in their own bedrooms. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Appropriate complaint procedures were in place. Policies and procedures were in place to support actions following adult protection concerns but ongoing training for staff should be provided. EVIDENCE: The home has a complaints procedure in place that refers to the role of CSCI. No complaints have been made to CSCI or the home since the CSCI inspection in August 2005. Most of the residents have family visitors. However, all of them have information about the advice and advocacy services provided by Age Concern, Wirral. Residents are listed on the Electoral Register and have the opportunity to vote in local and national elections. Staff have been provided with information about adult protection procedures through induction training and through NVQ training. The home will be provided with a copy of Wirral’s revised procedures for reporting incidents of abuse and the homeowner should take the opportunity to update training in adult protection matters for all staff in Oakdene. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Residents live in a safe and well-maintained environment. EVIDENCE: On the day of this inspection the home was clean and free from any offensive odours. It is evident that a programme of on-going routine maintenance and redecoration is in place. All parts of the home are in good decorative order. Lounges and the home’s conservatory are well laid out with quality furnishings to create a homelike environment. Some of the residents had brought an armchair from home and have chosen to have it placed in the lounge for their use. The dining room has appropriate furniture and tables are laid out with cloths and place settings. All bedrooms have a wash hand-basin. An adapted bathroom is located on the ground floor and a second bathroom is available on the first floor. An adequate number of WC’s are available around the home. All of the WC and bathrooms were clean and well kept. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 16 The home has a mobile hoist and hand/grab rails are fitted at appropriate locations. A two-stage stair lift provides assisted access to the first floor bedrooms and there are ramp access points to the front and rear of the house. Bedrooms are individually decorated and residents are able to choose the colours and some furnishings for their room. All of the rooms have been personalised with small items of furniture and treasured possessions brought into Oakdene by the resident. Most bedrooms are single occupancy but residents who share a room are given the opportunity to move into a single room when there is a suitable vacancy. Radiator covers have been fitted into all of the bedrooms. Some bedrooms have opening windows that are not fitted with a restrictor. The homeowner should ensure that all windows to the first floor have restrictors to enable them to be opened for ventilation but cannot be opened far enough for a resident to climb through. Hot water delivered to resident’s bedrooms and bathrooms is thermostatically controlled but staff will also use a thermometer to confirm the temperature of bath water. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Recruitment practices must be strengthened. The home is yet to achieve the standard of 50 care staff with an award at NVQ level 2 or above. EVIDENCE: The staff rota identifies that three care staff are on duty each morning and two care staff are on duty each afternoon. At night there is one wakeful member of staff and one member of staff sleeping in. The inspector was satisfied that staffing levels are appropriate for the current level of need in the home however, the homeowner must keep them under review and provide additional help if residents become more dependent. Five of the home’s care staff have an award at NVQ level 2 or above. The homeowner told the inspector that she is experiencing some difficulty persuading other care staff to take up the formal training. The Commission expects that at least 50 of care staff will have an award at NVQ level 2 or above. The home has not recruited any new care staff since the CSCI inspection in August 2005. On that occasion concern was expressed about the level and quality of information provided to support an application for employment and to confirm (as far as possible) that staff are safe to provide personal care. Since the last CSCI inspection the homeowner has applied for CRB clearances on all staff that were without this confirmation and has received the majority of them back as clear. It was agreed during the inspection that the homeowner Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 18 and manager would obtain confirmation of current staff identity and would reorganise their files to ensure all information about individual employees is kept together. Any new member of staff must be recruited in an appropriate manner and all of the matters identified in Schedule 4 (Section 6) of the National Minimum Standards, including confirmation of identity, CRB and POVA clearance, two references and a copy of the contract, must be held on file. A number of training initiatives have been introduced and staff have benefited from induction programmes that include, first aid, moving and handling, food hygiene and fire precautions. Training has also been provided in the management of medicines. Copies of certificates gained by staff are kept in the home. The deputy manager has drawn up a training matrix to identify training completed by staff and training required. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38 The home is run in the best interests of residents but the homeowner/manager must spend more time in Oakdene or appoint someone to manage the home. EVIDENCE: The homeowner is also registered as the manager and has been in post for approximately 12 years. She spends one day each week in Oakdene but undertakes some administration work connected to the running of the home on others. National Minimum Standards require a homeowner to appoint someone to manage the home where he/she does not intend to be in full-time day-today charge of the care home. In this respect, the homeowner for Oakdene must either, take responsibility for managing the home full-time, or appoint someone to manage the home on her behalf. The deputy manager has been responsible for the day-to day management of the home and has been working to improve the documentation referred to Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 20 earlier in this report. The working arrangements between the manager and the deputy will need to be worked out to ensure residents are supported with consistency of direction and that accountability for keeping specific records is clearly defined. Residents told the inspector that they are happy in the home and appreciate the care and support that is provided by all the staff. All of the completed questionnaires confirmed that residents/their families would know whom they should speak to if they had any concerns. Discussions with the homeowner and manager, talking with residents and feed back from questionnaires confirmed that residents in Oakdene are well cared for and are able to make choices about their everyday life. The main focus of discussion was the needs of individual residents and the atmosphere in the home was warm and friendly. The Commission is not aware of any matters that would affect the continued operation of Oakdene. The homeowner is considering the appointment of a “bookkeeper” to assist the financial accountancy processes involved in managing a care home. Difficulties have been experienced by all care homes attempting to open bank accounts for residents who are unable to attend the bank in person. The homeowner at Oakdene has an agreed procedure in place to support one resident with banking but was advised to contact the social worker to consider Court of Protection or Power of Attorney arrangements. Policies and procedures prepared by Mulberry House have been introduced to replace the ones currently in place at Oakdene. The homeowner was advised to confirm that each of the procedures is relevant and appropriate for the home and to destroy the current policies as new ones are accepted. All staff should familiarise themselves with the new procedures. As reported earlier in this report record keeping must be improved to confirm the work being undertaken in the home. Fire safety checks, fire alarm tests and hot water checks are undertaken as required. The cooks also check and record the temperatures of fridges and freezers. Fire safety procedures are updated for staff with the use of video training. The homeowner confirmed that all other health and safety checks have been carried out within required timescales. Contracts are in place for the maintenance of the stair lift, moving and handling equipment and fire protection equipment. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 2 2 2 3 Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 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 OP1OP37 Regulation 4&5 Requirement Timescale for action 31/03/06 2. OP7OP37 15 3. OP29OP37 18 4. OP31 8 The homeowner must produce a statement of purpose and a service users guide for the home that contains all matters listed in Schedule 1 of the National Minimum Standards, Care Homes for Older People. The homeowner must ensure 31/03/06 that residents care plans contain all areas of need and identify how the needs are to be met. The care plans should also contain all relevant assessments of risk. The homeowner must ensure 31/03/06 that staff recruitment and selection procedures are safe and must maintain the records identified in Schedule 4 Section 6 of the National Minimum Standards, Care Homes for Older People. The registered manager must be 18/01/06 in full-time day-to-day charge of the home. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP11 OP27 OP28 OP31 OP35 OP36 Good Practice Recommendations The homes manager should ensure that the wishes of residents are recorded so that staff can respond appropriately at the time of their death. The homeowner should ensure that staffing levels at the home are kept under review to meet the changing needs of residents. The homeowner should ensure that at least 50 of the homes care staff have an award at NVQ level 2 or above by the end of 2005. The homes manager should be qualified to NVQ level 4 in care by the end of 2005. The responsible person should discuss the possibility of alternative arrangements for the management of resident’s personal money. The home’s manager should ensure that all staff are provided with formal supervision on six occasions each year. Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Oakdene DS0000018919.V272635.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!