Inspection on 08/06/06 for Oakdene

This inspection was carried out on 8th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oakdene 20/09/07

Oakdene 18/01/06

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 Key Unannounced Inspection 8th June 2006 09:00 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.V291507.R01.S.doc Version 5.1 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.V291507.R01.S.doc Version 5.1 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.V291507.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 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. The homeowner states that fees are set at Government allowance rates, currently £308 per week. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Oakdene Residential Care Home took place on Thursday 8th June 2006 over a period of 4.5 hours. It involved the examination of some records, discussions with the home’s owner/manager, talking with 6 meeting three members of staff and a tour of the building. Several weeks prior to the inspection the homeowner had completed a questionnaire giving information about the home, residents and staff. Residents who spoke with the inspector were complimentary about the care and support provided by staff at the home. They were also complimentary about the environment that is being maintained to a good standard and about the quality and variety of meals served. All of them said they were happy living in Oakdene. The inspection was undertaken as part of the Commission’s responsibility to visit and report on all registered care homes. What the service does well: What has improved since the last inspection? What they could do better: Requirements have been made to further improve care plans and reviewing arrangements at the home, to ensure levels of care staff are maintained Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 6 alongside appropriate cooking and domestic staff, to ensure staff recruitment and selection procedures are maintained in accordance with laid down standards and to ensure staff receive regular one-to-one supervision. Recommendations have been made to improve the level of staff with an NVQ award in care at level 2 or above, to ensure discuss with a social worker the need for external control over a residents personal affairs and to ensure all of the required records are maintained to a good standard. 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.V291507.R01.S.doc Version 5.1 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.V291507.R01.S.doc Version 5.1 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 Residents have the information they need to help them make a decision about the suitability of the home. EVIDENCE: The home’s statement of purpose has been improved since the CSCI inspection in January 2006 and now contains all of the matters identified in Schedule 1 of the National Minimum Standards, Care Homes for Older People. A contract/statement of terms and conditions of residence is provided and is kept separately to the main care file. The inspector examined three resident’s care files and a pre-admission assessment was located on each of them. One of the files also contained the assessment of need prepared by the placing authority. From discussion with the homeowner and from spending time with residents the inspector was satisfied that all of them are appropriately placed at Oakdene. The home will refer residents whose physical or mental health needs Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 9 change to a level where they cannot be adequately supported by staff, for reassessment by the appropriate social worker. 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.V291507.R01.S.doc Version 5.1 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 The recording of care plans and reviews is in need of further development. Residents are protected by the home’s polices and procedures for the management of medicines. EVIDENCE: Of the three care files seen during the inspection only two had a written care plan in place. The content of care plans has improved over the past twelve months but there is room for further development. The written plans could be presented more clearly and there should be evidence to confirm that they have been reviewed and amended, where necessary. The inspector advised the homeowner to work through all of the care plans in the home, to ensure they are relevant and up to date and to ensure they are presented clearly. In addition a system for recording reviews should be introduced. A separate record is kept on the file of visits and contact with health care professionals. The inspector was told that the home receives good support from GP’s and from the district nursing service. They also have links with domiciliary dental, optical and chiropody services. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 11 Medicines are administered through a “monitored dosage” system that is made up by the pharmacist on a weekly basis. The homes arrangements for managing the medicines was checked and found to be in good order. The pharmacist has provided training for staff in managing medicines. Residents told the inspector that they are treated with respect and that staff are “very kind”. The home has three shared bedrooms. A movable screen was available to be used in these rooms but at the time of this inspection was being stored in one of the toilet areas. Staff should ensure that the screen is used to protect the dignity of residents in their bedrooms. The homeowner told the inspector that she is gathering information from residents and their relatives to ensure the home can respond appropriately at the time of death. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 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 weekly Bingo session. They also do some reminiscence activity, organise quizzes and take residents out for a walk (staffing levels permitting). Residents have also been taken out in taxis to a local pub for lunch or on shopping trips. A hairdresser visits the home each week and attended during the course of this inspection. In conversation with the inspector residents said they would like to have more activities provided in the home. The homeowner should meet with the residents to explore their wishes and ideas for activities so that a more varied programme can be introduced. Three of the residents attend a local day centre on two days each week. 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 and go to bed, what they wear, where they will spend their Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 13 time during the day, and can request alternative foods if they do not like what is being served at mealtimes. During the course of the inspection staff approached one of the residents and offered an alternative meal, as they were aware that she did not like the one that was being prepared. Sample menus provided prior to the inspection identify that a varied diet is provided. Residents who commented upon the food were complimentary about the quality and variety of meals served in Oakdene. Meals are usually taken in the dining room but residents can choose to take them in their own room. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 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 are in place. Procedures on adult protection are being supported through staff training. EVIDENCE: The home has a complaints procedure in place that refers to the role of CSCI. No formal complaints have been made to the home or to the Commission in the past twelve months. 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 contact with Wirral’s, Induction Training Programme. The homeowner told the inspector that three staff have been registered to attend a one-day training event organised by Wirral’s Adult Protection Team on 15th June 2006. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 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: Oakdene is situated in a residential area of Birkenhead. The home is an adapted building that provides a safe and comfortable environment. There is a conservatory and pleasant outside garden areas where residents can sit on warm days. All parts of the home are in good decorative order. Lounges and the conservatory are well laid out with quality furnishings to create a homelike environment. Some of the residents have 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 with cloths and place settings. All bedrooms have a wash hand-basin. An adapted bathroom is located on the ground floor and the homeowner told the inspector that she is considering the conversion of the first floor bathroom to a walk in shower room. An adequate Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 16 number of WC’s are available around the home. All of the WC and bathrooms are clean and well kept. The home has a mobile hoist and hand/grab rails are fitted at appropriate locations. A two-stage stair lift provided assisted access to the first floor bedrooms and there is ramp access to the front and rear of the building. Bedrooms are individually decorated and residents are able to choose the colours and some furnishings for their rooms. 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 are given the opportunity of moving into a single room when one becomes vacant. Radiator covers have been provided in all of the bedrooms. Some of the first floor bedrooms have opening windows that are not fitted with a restrictor. The homeowner should ensure that these windows are fitted with a restrictor that enables them to be opened for ventilation but would not allow a residents to climb through. The homeowner has fitted new floor covering in the kitchen, bathroom and outside the dining room. One of the bedrooms has also had new floor covering. Some redecoration has taken place in the hallway and staircase. 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. It is evident that an ongoing programme of redecoration is in place and the home is well presented. On the day of this inspection the home was clean and free from any offensive odours. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 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 Staffing levels, recruitment practices and staff training opportunities do not meet the standards required. EVIDENCE: Residents who spoke with the inspector were complimentary about the ways in which they are supported by staff in the home. The inspector was also impressed by the ways in which staff on duty interacted with and supported residents in the home. Therefore, any criticism of practice identified in this section to the inspection report on Oakdene is not intended to reflect on the commitment of current employees but is rather aimed at improving professional procedures and practices. Although the home’s staff rota’s provided to the inspector showed that two (sometimes three) carers were on duty in the home, at the time of this inspection only one carer was working directly with residents, one person was in the kitchen and one was working as a domestic. The homeowner/manager told the inspector that the person working in the kitchen is a cook/carer. The home is registered to support 16 residents and at the time of this inspection there were 15 older people living at Oakdene. With minimum staffing levels of 1:8 (staffing levels must be increased if levels of dependency amongst the residents is high) the Commission expects that a minimum of two care staff will be deployed solely to provide personal care. Staffing levels are important to ensure the safety of both residents and staff and to ensure that Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 18 time is available to encourage and support activities in the home, a point made by residents and referred to earlier in this report. Additionally from a health and hygiene perspective it is inadvisable for someone to provide personal care and prepare food without all of the necessary changes of protective clothing and thorough cleansing. National Minimum Standard 27.7 expects that domestic staff “Are employed in sufficient numbers to ensure standards relating to food meals and nutrition are fully met and that the home is maintained in a clean and hygienic state, free from germs and unpleasant odours”. Only six of the home’s 18 care staff have an award at NVQ level 2 or above. The standard set by the Commission is for 50 of care staff to have an award at this level in care. The homeowner told the inspector that she is currently seeking funding opportunities to support more of her staff to gain an appropriate NVQ award. The inspector examined the files for three staff in the home. One had an application form and two references (although one was from a close relative), CRB clearance but no confirmation of identity documents. The other two had an application form, two references and confirmation of identity documents but CRB clearances, although undertaken in the past six months, were from a previous employment. The homeowner must ensure that staff recruitment procedures in the home protect, as far as possible, the safety of residents. That references are sought from people who are not related to applicants and that CRB clearance is obtained each time a new employee commences work, no matter how long it has been since a previous check was carried out. Staff files should contain all of the documents identified in Schedule 4 (Section 6) of the National Minimum Standards, Care Homes for Older People. The home uses Wirral Social Services induction training programme for new members of staff. The pharmacist has provided training in managing medicines and three staff have been nominated to attend an adult protection awareness course. At the previous inspection the deputy manager told the inspector that she was arranging various courses for staff. Copies of some training certificates were located on the staff files. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 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 to provide a comfortable and friendly environment for older people. Improvements to the paperwork and record keeping would give greater assurance that all procedures are safe. EVIDENCE: The homeowner is also registered as the manager of the home and has been in post for over 12 years. At the CSCI inspection in January 2006 she agreed to work on five days each week to fulfil the requirement that a manager must be in full-time, day-to-day charge of the home. Oakdene’s rota stated that she works in the home on five days each week and she told the inspector that she is now in full-time, day-to-day charge of the home. Residents who spoke with the inspector were complimentary about the home and the ways in which they are supported. They said they are comfortable and nothing is too much trouble for the staff. There was a relaxed atmosphere and residents said they would feel able to complain if a complaint was necessary. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 20 Accounting and financial procedures were not examined during the inspection but the Commission is not aware of any financial matters that would affect the ongoing management of the home. At the inspection in January 2006 the homeowner agreed to contact the social worker to discuss Court of Protection or Power of Attorney arrangements for one of the residents who was unable to manage their own financial affairs. The homeowner told the inspector that she had not yet managed to follow that decision through but would do so as soon as possible. A system of one-to-one professional supervision for staff has not yet been put in place. The inspector discussed with the homeowner, ways in which this might be achieved. The inspector is satisfied that residents are treated with respect and that their individuality is acknowledged and preserved. They live in a comfortable environment that is maintained to a good standard and are given the opportunity to make everyday decisions for themselves. Policies and procedures adopted by the home have been professionally prepared and approved. However, as identified throughout this report, standards of record keeping need to be improved to ensure that all of the systems in place to support residents are safe. The fire record book identified that a weekly check of the home’s fire alarm system is being carried out. The home also has a fire safety awareness video for staff training purposes. The homeowner confirmed in the pre-inspection questionnaire that all of the required systems are in place for the maintenance of lifts, hoists, fire equipment, gas safety and electric wiring safety. Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 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 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 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 2 2 2 3 Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP7OP Regulation 15 Requirement The Registered Person must ensure that residents care plans contain all areas of need, identify how the needs are to be met, contain all relevant assessments of risk and include evidence that they have been reviewed. Timescale for action 31/08/06 2. OP27 19 3. OP29 18 The Registered Person must 30/06/06 ensure that at all times suitable qualified competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the residents. The Registered Person must 30/06/06 ensure 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 Person must ensure that staff working at the home are appropriately supervised. DS0000018919.V291507.R01.S.doc 4. OP36 18(2) 31/07/06 Oakdene Version 5.1 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 OP11 Good Practice Recommendations The Registered Person should ensure that the wishes of residents are recorded so that staff can respond appropriately at the time of their death. The Registered Person 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 Registered Person should follow through discussions with the social worker to make appropriate arrangements for the management of the identified residents personal finances. The Registered Person should ensure that all of the records specified in Schedule 4 of the National Minimum Standards, Care Homes for Older People are maintained and contain detailed information, to support the work undertaken by staff. 2. OP28 3. OP35 4. OP37 Oakdene DS0000018919.V291507.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Liverpool Local 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. 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