CARE HOMES FOR OLDER PEOPLE
Oakdene Ringwood Road Three Legged Cross Wimborne Dorset BH21 6RB Lead Inspector
Amanda Porter Unannounced 21 September 2005 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 D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Oakdene Address Ringwood Road Three Legged Cross Wimborne Dorset BH21 6RB 01202 813722 01202 828346 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) Dorset Health Care Limited Mrs Jennifer Church CRH N - Care Home With Nursing 45 Category(ies) of OP Old age (45) registration, with number of places Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To accommodate one person over the age of 65, as known to the CSCI, with mental health needs. Date of last inspection 24 February 2005 Brief Description of the Service: Oakdene is a purpose built care home registered with the Commission for Social Care Inspection to accommodate a maximum of 45 older people requiring nursing and personal care. The home is situated in a small village close to local amenities including a shop, post office and garden centre. Accommodation is provided in 44 rooms one of which is a shared room, 41 of the rooms have en-suite facilities. These are situated on the ground and first floor and two passenger lifts provide access between the floors. There is communal lounge and dining room space on the ground floor and a smaller lounge is situated on the first floor. The ground floor houses the home’s kitchen and office areas. A laundry is sited on the first floor. There is easy access to the attractive and well maintained garden, which surrounds the home. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the late morning and early afternoon of the 21st September 2005 and took a total of three hours. The registered manager, Mrs Jennifer Church, and the head of care were on hand throughout to aid the inspection process. The purpose of the inspection was to review the requirement and recommendations made in the last report and to assess outstanding key standards. Four residents, two visitors and four members of staff were spoken with and asked their views on the services provided at Oakdene. Comments included: “I heard good things about this home before I came to live here”. “I would recommend this home to anyone”. “The staff are very good”. “Food is excellent. There is lots of choice”. “I love working here”. Some documentation was reviewed, including care files, policies and procedures. A tour of the premises was undertaken. What the service does well:
Staff have developed good relationships with the residents and this results in a supportive and caring environment in which the residents feel secure and comfortable. Residents said that they liked living in the home and staff treated them with kindness and respect. The home carries out thorough assessments prior to residents moving in and assurances are given that individual needs can be met. The home ensures access to health care services to meet assessed needs and liaises with a variety of health care professionals. Residents said that generally the lifestyle experienced in the home matches their expectations and preferences. The catering is of a high standard and the food was very much enjoyed. The home protects the residents from abuse by ensuring robust policies and procedures are in place The home is kept clean and smells pleasant. An efficient laundry service ensures that there are always sufficient amounts of clean linen available and residents personal items are returned to them clean within a reasonable time frame.
Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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 D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 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 Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 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. Standard 6 is not applicable as the home does not provide intermediate care. New residents move into the home having had their needs assessed and been assured that these needs will be met. EVIDENCE: Four care files were reviewed and all of them contained information gained through assessment prior to admission. The assessments were thorough and contained sufficient information from which a care plan could be drawn up. Residents spoken with said that consultation had taken place with themselves, family members and the manager of the home and assurances had been given that needs could be met. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 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 & 10. The care planning system in place is not sufficiently thorough to adequately provide staff with the information they need to satisfactorily meet resident’s needs. However the health needs of residents are well met with evidence of good support from community professionals such as GPs, district nurses, MacMillan services, opticians and chiropodists. Residents felt that staff were kind and caring, treated them with respect and upheld their right to privacy. EVIDENCE: Four care files were reviewed and each contained care plans and general risk assessments. Where the risk of developing a pressure sore was high action was taken and the equipment necessary for the promotion of tissue viability and prevention or treatment of pressure sores was readily available. Visits from GP, district nurse, MacMillan services, chiropodist and optician were recorded in the residents care file. Residents said that their healthcare
Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 10 needs were well met. Residents confirmed that they felt involved in planning their care with staff although this was not documented in care files. Care plans gave general rather than specific instructions to care staff as to how needs were to be met and did not fully reflect the care needed by each individual. Although talking to residents and staff it was apparent that needs were well met. Some files lacked manual handling care plans for individuals. Residents confirmed that they were treated with respect and kindness and their right to privacy was upheld. Comments from visitors included “Staff are very attentive and check on my relative regularly as she is unable to use the call bell”. “I am very happy with this home”. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 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. The social, cultural and recreational activities provided at Oakdene generally meet the expectations of residents. However the lack of individual social care plans cannot guarantee that activities are organised in response to assessed needs. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: The home employs two activities coordinators, who work between Monday and Friday. A variety of activities are available and include: • Games • Music • A church service every two weeks as well as other visits from members of the clergy • Gentle exercise classes • Outings such as to the Beach Hut at Poole and trips out on the Dolphin boat Residents said that they were free to choose if they wanted to participate in any of the organised activities and they could spend their time as they wished. Some people preferred to spend time on their own in their rooms.
Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 12 There was no documentation available relating to activities at the time of inspection and individual care plans indicating how social needs were to be met were not held in care files. The Registered Manager said that she intends to ensure that each resident receives a weekly activities programme and a copy of the weekly menu. This will be reviewed at the next inspection. Oakdene has a four weekly menu, which is changed seasonally. It offers a choice of appetising food. Residents confirmed that they liked the food and were very happy with the choice of menu. During the inspection lunch was served. Residents were free to choose where they ate their meal, either in the dining room, lounge or bedroom. The lunch menu was: Homemade Soup of the Day Roast Pork or Chicken, roast potatoes and vegetables or Vegetable Frittata Apple Crumble and custard or Fruit Salad. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 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) 18. Procedures for responding to suspicions of abuse are held in accordance with Department of Health guidance therefore any allegations of abuse can be managed effectively and protection of service users can be guaranteed. EVIDENCE: The home had a robust policy and procedure to respond to suspicion or evidence of abuse or neglect, which refers to the Department of Health guidance “No Secrets”. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 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) 26. The home is kept clean and smells pleasant thereby making daily life for all in the home more pleasurable. EVIDENCE: All areas of the home were clean and there were no unpleasant odours. Hand washing facilities are sited in appropriate areas throughout the home for staff to use to prevent spread of infection. The laundry is done within the home and designated staff are employed during the mornings to undertake these duties. Adequate supplies of clean linen were seen to be available. The laundry is situated on the first floor and has two commercial style washing machines and two tumble driers. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 15 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) 30. The shortfalls in training may result in care staff not being fully competent to do their jobs properly. EVIDENCE: Since the head of care had taken up her post in May she had started to build a more robust training programme. However there was little evidence, through talking to the registered manager and the head of care and reviewing training records that, as yet, all care staff had received foundation training, which meets National Training Organisation (NTO) workforce training targets. This standard will be reviewed at the next inspection. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 16 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) These standards were not assessed during this inspection. EVIDENCE: Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x x x x Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 18 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 OP12 Regulation 14(1) Requirement Timescale for action 21/12/05 2. OP30 18 Social and leisure care plans must be individualised and based on preferred interests and activities in order that residents can be assured that the appropriate activities are provided. All care staff must receive 21/12/05 foundation training to NTO specification within the first six months of appointment. 3. 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 OP7 Good Practice Recommendations Care plans should be more specific and and set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the resident are met. Care plans should be drawn up with the involvement of the resident, recorded in a style accessible to the resident; agreed and signed by the resident whenever capable and/or representative (if any). Each resident should be provided with a copy of the
D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 19 2. OP7 3.
Oakdene OP12 activities programme and the menu on a regular basis. Oakdene D55 S20448 Oakdene V245384 210905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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