Inspection on 02/08/05 for Oakdene

This inspection was carried out on 2nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 18/01/06

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 100 Tollemache Road Birkenhead Wirral CH41 0DL Lead Inspector Mr Les Hill Unannounced 2 August 2005 9:10 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. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakdene Address 100 Tollemache Road Birkenhead Wirral CH41 0DL 0151 653 7109 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) Mrs Irene Patricia Steele Mrs Irene Patricia Steele CRH with PC 16 Category(ies) of OP 16 places registration, with number of places Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4 March 2005 Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 5 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 F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Oakdene took place on Wednesday 3rd August 2005 over a period of 3.5 hours. It involved the examination of some records, a tour of the building and discussions with six of the residents. The inspection was undertaken as part of the Commission’s requirement to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? Some training opportunities for staff have been introduced. Radiator covers have been provided in resident’s rooms. One radiator without a cover has a risk assessment to confirm it is safe. The deputy manager had made contact with Age Concern and they had visited to provide information about their advice and advocacy services. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 7 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. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 and 6. Some additional work is required to improve the statement of purpose and service users guide. Improvements have been made to the assessment processes. EVIDENCE: The homes statement of purpose has been upgraded but some additional work is required to ensure it contains all matters listed in Schedule 1 of the National Minimum Standards, Care Homes for Older People. The homes service users guide should also be amended to include all of the matters identified in standard 1.2 of the same document The CSCI inspection of 4th March 2005 confirmed that residents are provided with a contract/terms and conditions of residency. Assessment documents were in place on the three resident’s files sampled during the inspection. However they need to be brought together as one Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 10 document and the manager should ensure that all areas of potential need are covered. The home has been offering care and support to older people for approximately 24 years and the current owner has been responsible for the services provided for the past 12.5 years. Through discussion with the deputy manager and observations during the inspection, the inspector was able to confirm that all of the residents are appropriately placed and the home will refer residents whose physical or mental health deteriorates to a level where they feel that cannot cope, to the appropriate social workers for reassessment. 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 F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11. Care planning arrangements must be improved. Resident’s health care needs were being addressed and they were being treated with dignity and respect. EVIDENCE: Care plans seen during the inspection were incomplete and didn’t address all the needs identified for each resident. The inspector suggested a model of practice for the deputy manager to follow and the homeowner has linked with a consultancy that could assist the development of care planning in Oakdene. Once the care plans are in place, appropriate risk assessments should be completed to ensure staff and residents are aware of the support procedures to be followed. Staff are recording information about the health and wellbeing of the residents on the care files. None of the residents has a pressure sore. The home has links with a number of GP surgeries and the deputy manager told the inspector that the GP’s are very supportive. District nurses visit when necessary as do the optician and a private chiropodist. The residents are not listed with a dental practice although Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 12 the home has used local dentists when necessary. The deputy manager told the inspector she would contact a dentist surgery to register the residents for any future treatments. Medicines are administered through a monitored dosage system made up by the pharmacist on a weekly basis. The homes arrangements for managing medicines were checked and found to be in order. The pharmacist has also provided training for staff in the administration of medicines. Observations during the inspection and discussions with residents in the home confirmed that residents were treated with respect and their dignity was preserved when staff were undertaking personal care tasks. Movable screens are provided in double bedrooms. Residents can meet with visitors in any of the homes lounge areas or in their own bedrooms. During a tour of the building the deputy manager knocked on each bedroom door before entering. The deputy manager told the inspector that she had not yet approached residents and their families to ascertain what they would expect to happen at the time of their death. The home promises to provide care and support in a dignified manner and will use the support of specialist nurses as appropriate. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 13 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. Residents are helped to exercise control over their lives. EVIDENCE: The home has TV, video and music equipment and staff organise a Bingo session each week. They also organise quizzes and take residents out for a walk, staffing levels and work pressures permitting. Residents are taken in taxis to a local pub for a meal and have also been taken shopping. The home is planning to take up to 10 residents to the Grand Hotel in Llandudno for a long weekend, in late September or early October. A hairdresser visits the home each Thursday. Some of the residents go out to a local day centre once or twice each week. The home’s brochure states that visitors are welcome at any time and visiting hours are unrestricted. Residents are encouraged to make decisions about their everyday lives. What time they get up and go to bed; what to wear and have a choice at mealtimes. They are also encouraged to make decisions about how they will spend their day. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 14 The records of menus confirmed that a varied diet is provided. Residents told the inspector that the food served in the home is very good and their likes and dislikes are respected. Meals are usually served in the dining room but residents are able to take their meals in their own bedrooms. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 15 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, 17 and 18. Appropriate complaint procedures were in place. Staff have been trained in adult protection matters. EVIDENCE: The home has a complaints procedure in place that refers to the role of the CSCI. No complaints have been made to CSCI or to the home since the CSCI inspection in March 2005. Most of the residents have family visitors. However, all of them have been provided with information about the advice and advocacy services provided by Age Concern. Residents are listed on the Electoral register and have the opportunity to vote in national and local elections. Staff have been provided with information about adult protection procedures through induction training and through NVQ training. The deputy manager was unsure as to whether the homeowner has a copy of Wirral’s adult protection procedures. The inspector would advise the homeowner to ensure that a copy of Wirral’s procedures are maintained in the home and that all staff have access to them. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 16 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, 20, 21, 22, 23, 24, 25 and 26. Residents live in a safe and well-maintained environment. EVIDENCE: The home was clean and free from any offensive odours on the day of this inspection. It is evident that a programme of routine maintenance and redecoration is in place. All parts of the home are in good decorative order. Only one radiator on an upstairs corridor is without a cover but is protected by a table. The manager should record a risk assessment to confirm that it is safe. Hot water delivered to resident’s rooms is thermostatically controlled but staff also use a thermometer to check that bath water is safe. Lounges were well decorated and furnished. Some of the residents had brought their own armchair from home and had chosen to have it placed in the lounge. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 17 The dining room was laid out with small tables all of which had a cloth and placemats. All of the bedrooms have a wash hand-basin but none have an en-suite WC. However, there is an adapted bathroom on the ground floor and a second bathroom upstairs. A separate WC is available on the ground floor and there are four other WC’s on the first floor. All of them were clean and well kept. 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 and there are ramp access points at the front and rear of the house. Bedrooms are individually decorated and residents are able to choose the colour and some furnishings for their room. All of the rooms have been personalised with items of furniture and treasured possessions brought into Oakdene by the resident. Most of the bedrooms are for single occupancy but residents who share a room are given the opportunity to have a single room when one becomes available. Radiator covers have been fitted in all of the bedrooms. Some of the bedrooms have window openings that have not been fitted with restrictors. The homeowner should ensure that all windows to the first floor have restrictors fitted to ensure they can be opened for ventilation but cannot be opened far enough for a resident to climb through. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 18 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, 28, 29 and 30. Recruitment practices must be strengthened. A programme of staff development is in place but the home may not achieve the standard of 50 care staff with NVQ level 2 in care by the end of 2005. EVIDENCE: The staff rota identified 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 be able to provide additional help if residents become more dependent. Five of the home’s 16 care staff have completed the training for an award at NVQ level 3 but are awaiting final confirmation of their assessment. If the home is unable to ensure that another 3 staff will complete the award by the end of 2005 they will not be able to meet the standard of 50 trained staff as recommended by CSCI. The recruitment records of three members of staff were examined and did not contain evidence to confirm that appropriate checks had been carried out. References were not available for two of the staff and only one reference was in place for the third. The reference form did not identify the person from whom the reference had been requested although the reference provider had Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 19 written their name and address on the back. Confirmation of CRB and POVA checks was not provided. The homeowner had accepted a CRB check that was at least twelve months old for one member of staff but had sent off the appropriate POVA and CRB application. The CRB clearance had not been received. There was no confirmation of identity documents, no statements about health and fitness and no copy contract to confirm the start dates. The homeowner must ensure that the homes recruitment and selection procedures protect residents and are safe. A list of the documents required is included in Schedule 4.6 of the National Minimum Standards, Care Homes for Older People. A number of training initiatives have been introduced and staff are benefiting from induction programmes that include, first aid, moving and handling, food hygiene, fire precautions and adult protection. Staff have undertaken training in the management of medicines. Copies of certificates are kept in the home. The deputy manager was advised to draw up a training matrix to show what training had been provided to which staff so that training opportunities can be purchased more effectively. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 20 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, 32, 33 and 35. The home is run in the best interests of the residents. EVIDENCE: The homeowner is also the registered manager and has been in post for almost 12 years. The deputy manager is responsible for the day-to-day operation of the home and has recently been given time to ensure that care plans and other records are maintained. The deputy manager is awaiting the results from her NVQ level 3 training but the home’s manager has not yet begun the training for NVQ level 4. Residents told the inspector that they are happy in the home and appreciate the care and support provided by al the staff. Some of them said they would feel able to raise any concerns with the manager or her deputy. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 21 The manager has not yet introduced a quality assurance survey and this will be discussed further at the next announced inspection. The homeowner like many other homeowners, has experienced difficulty in opening bank accounts on behalf of residents who cannot get to the bank or building society to conduct their own affairs. An arrangement has been set up to permit one of the residents to hold a joint account and is protected by a contract that requires the resident’s signature and will close the account, identifying any balances to the placing local authority for inclusion in the resident’s estate, upon the death of the resident. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 22 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 2 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 3 2 x 2 x x x Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4&5 Requirement Timescale for action 30/09/05 2. OP7 15 3. OP29 18 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 30/09/05 that all residents have written care plans identifying how the residents needs are to be met. The care plans should also contain all relevant assessments of risk. The homeowner must ensure 31/08/05 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. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Refer to Good Practice Recommendations Version 1.30 Page 24 1. 2. 3. 4. 5. Standard OP3 OP11 OP27 OP28 OP31 The homes manager should ensure that assessments of residents are maintained and improved. The homes manager should ensure that the wishes of residents are recorded so that staff can respond appropriately after 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. Oakdene F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 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 F52_F02_s18919_Oakdene_v228692_020805_Stage 4.doc Version 1.30 Page 26 - 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. 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