Inspection on 04/05/05 for Oakdene Care Home (Residential Unit)

This inspection was carried out on 4th May 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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakdene Care Home (Residential... 19/03/09

Oakdene Care Home (Residential... 05/04/06

Oakdene Care Home (Residential... 20/01/06

Oakdene Care Home (Residential... 28/02/05

Oakdene Care Home (Residential... 11/08/04

Oakdene Care Home (Residential... 23/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Oakdene Care Home (Residential Unit) 10 Woodborough Road St Anns Nottingham NG3 1AZ Lead Inspector Jeremy Cassidy Unannounced 4 May 2005 10:00am th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakdene Care Home (Residential Unit) Address 10 Woodborough Road St Anns Nottingham NG3 1AZ 0115 958 0172 0115 948 2700 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) Nottingham City Council 14 Hounds Gate Nottingham NG1 7BE Mrs Linda Sadler Care Home (CRH) 22 Category(ies) of Learning Disability (LD) 22 registration, with number of places Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 22 people with Learning Disabilities who are over 45 years of age 2. To include one named person aged 42 years and one named person aged 43 years 3. One named service user to be included between 16-23 September 2004 Date of last inspection 28-02-05 Brief Description of the Service: Oakdene provides care and support, including short-stays for up to twenty-two individuals with a learning disability. The home is situated on a busy road close to Nottingham City Centre and all the facilities it has to offer. The home was originally purpose built for people with physical difficulties and consequently there is good access throughout the building. There are three separate self-contained units, one situated on each of the three floors and a large communal dining room. All bedrooms are single occupancy. The home has a well-maintained, pleasant, enclosed garden. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first of two unannounced inspections to be carried out between April 2005 and March 2006. The inspection lasted for 6 hours and included inspection of care and other records, a discussion with two service users, and with the staff on duty. What the service does well: What has improved since the last inspection? What they could do better: Staff Criminal Records bureau checks must be evidenced on files. There are several outstanding building repairs and upgrades that have not been addressed. Staff should have more regular supervision. Care plans, risk assessments and policies and procedures need to be reviewed and updated. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 6 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 Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3, and 5 Information about the service is provided, work needs to be undertaken to review care plans as required. EVIDENCE: A service user guide contains detailed information about the services and support that service users may expect. Some files examined had care assessments on. Service users over the age of 65 should have their care plans reviewed on a monthly basis. There is an outstanding recommendation to add the room number to the Terms and Conditions of Residence; this has not yet been addressed. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,8,9 and 10 Care plans and risk assessments still need developing. EVIDENCE: Four care plans were inspected during this visit. Information on service user files still needs improvement to ensure that service users needs are understood and met. Care plans should be dated and reviewed as required. The outstanding requirement to ensure that service users have care plans relating to their finances has not been met on all files. Service user meetings have taken place and there was evidence of some consultation with regards matters that affect the running of the home. The registered manager remains the appointee for most of the service users. Risk assessments within the care plans were inspected, there remains insufficient guidance offered to staff on how to manage risks. One service user had recently returned from hospital, But there was no risk assessment to support her return to the home. There is a confidentiality policy which all staff have signed up to say that they have understood. Notices which name individuals and guide how staff work with them should not be displayed in public areas. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,15 and 17 Structured, planned and appropriate day- time activities are not available to all service users. EVIDENCE: Independent living skills were not assessed as an area of need within the care plans seen and it is recommended that this area be addressed with all service users. Some service users attend structured day-care in an annexe attached to the main building. Staff interviewed said they try to ensure that all of the service users get a fair chance to access the community, but this depends on staffing levels. Service users at home during the course of the inspection were not observed participating in organised and appropriate activities. Service users are able to have visitors and invite friends or family for tea. Staff interviewed stated that service users could make their own tea, coffee and help themselves to juice. Service users interviewed said they like the food and menus were seen displayed and alternatives are offered following consultation. There is also an outstanding recommendation to provide pictorial versions of the menu to facilitate choice for service users who cannot read. This has not yet been addressed. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 and 21 The Physical, Emotional and Healthcare needs of service users are met. EVIDENCE: Files examined evidenced appropriate support is provided to meet health needs, with referrals made where required. Physical and Emotional needs appear to be met. The Monitored Dosage System is used to administer medication and the medication administration record sheets were well recorded with no gaps evident. Service user preferences were recorded where possible with regards to ageing, illness and death. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The complaints procedures need to be developed. All staff need to undertake protection of Vulnerable adults training. EVIDENCE: Complaints are recorded in a book and this was inspected. There was no formal acknowledgement or concluding response to complaints. There was some evidence of actions taken to investigate the complaint. There was evidence of appropriate procedures followed with regards the vulnerable adults policy. Some staff have undertaken some training in this area, and those spoken with during the inspection have understanding of their roles and responsibilities. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,29 and 30 The building is not meeting service user needs. EVIDENCE: There remains an outstanding requirement in respect of the poor condition of the windows throughout the building. This makes the home appear old and institutionalised, and poses a real security risk to service users. The issue has now been outstanding for an unacceptably long period of time, and if this is not addressed by the timescale given in the previous inspection, enforcement action will be taken. The handyman currently employed has supported service users to redecorate their rooms to individual tastes. The handyman post has supported the manager with key health and safety issues in and around the building. There are concerns over the continued presence of Legionella spores in some parts of the water system, this has meant that some bathrooms are not available to service users. Some windows can be opened wider than regulations permit. Some of the stair rails have gaps wider than is permitted. Two fire doors had latch bolts fitted, this must be cleared by the fire brigade. There is an outstanding recommendation to fit thermostatic controls to the radiators in service users’ bedrooms which has not been addressed. Laundry is not undertaken on an individual basis. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,35 and 36 Staff training has increased, policies and procedures with regards staff recruitment do not meet standards. EVIDENCE: 2 staff files were inspected during this inspection, there was no evidence of Criminal Records Bureau checks on the files. Staff files must contain the information and documentation specified in Schedule 4. Staff interviewed had completed NVQ 2 in care and the manager was completing her NVQ 4 in management. Staff reported that they were happy with the range and level of training provided. Staff stated that `the management were approachable and supportive of the staff team and service users. There were some supervision notes on staff files but this was not undertaken as recommended. Staff should receive supervision at least six times in any one calendar year. The manager reported that it was hoped at least 50 of staff would have achieved a minimum of NVQ 2 in care by the end of 2005. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,40,41 and 42 Quality assurance visits have taken place as required. Policies and procedures are in place, but still need reviewing as per previous inspection. EVIDENCE: Quality assurance visits were evidenced to have taken place as required. The manager remains acting as appointee for some service users which is not considered appropriate. Legionella remains within the water system but work was underway to address this. The records were generally well kept and up to date. Policies and procedures have not yet been reviewed as required in previous inspection. Accident reports must be held on individuals concerned files. An action plan and risk assessment needs to be written with regards the works ongoing to eradicate the latest legionella outbreak. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 1 x 3 2 Standard No 11 12 13 14 15 16 17 2 3 x x 3 2 3 Standard No 31 32 33 34 35 36 Score x 3 x 1 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakdene Care Home (Residential Unit) Score x 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x 3 2 2 2 x C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 17 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. 2. 3. 4. 5. Standard YA 6 YA 9 YA 11 YA16 YA22 Regulation 24 (1) 13.4 (b) 12 (a) 12 (b) 22(1, 2, 6(a & b) Requirement Ensure that service user care plans are reviewed as required. Maintain risk assessments on service user files. Include independent living skills assessments in care plans. Ensure day care routines and options are recorded on care plans. The complaints procedure must be amended to say “The Commission for Social Care Inspection” and all service users must be given a copy (or otherwise made aware) of their right to complain and the process involved. Review restraint policy. (Timescale of 30/10/04 not met.) Timescale for action 30-06-05 30-06-05 30-06-05 30-06-05 25/5/05 (from previous inspection) 6. YA23 13(6) 7. YA24 23 (2)(b) 8. YA27 23 (2) (j) It is required that the remedial work is carried out to improve the state of the windows. Timescales of 8/8/04 and 8/12/04 not met.) The registered provider is required to address this matter within the timescale indicated if further action is to be avoided. Ensure that work is undertaken 30-06-05 Version 1.30 28/5/05 (from previous inspection) 28/7/05 (from previous inspection) Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Page 18 9. 10. YA30 YA34 16 (f) 19(1)(b) 11. 12. YA40 YA41 17.3 (a and b). 17(1)(a & b) 23 4 (b) 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. YA 42 to return to communal use bathrooms currently unavailable to service users. Make arrangements for service users to have their laundry wahed on an individual basis. Ensure staff files comply with schedule 4 of the care homes regulations 2001. Timescale of 31/09/04 not met). Review policies and procedures with regards restraint. Accident records in respect of service users must be stored in their files to preserve confidentiality. Consult with Fire Authority on locks placed on fire doors. 31-08-05 28/5/05 (from previous inspection) 31-08-05 25/5/05 (from previous inspection) 30-06-05 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. Refer to Standard YA5 YA6 Good Practice Recommendations Insert room number into the terms and conditions of residence. It is recommended that care plans are written in the first person and that those relating to service users who are over 65 be reviewed monthly in line with the Older Persons’ Standards. C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 19 Oakdene Care Home (Residential Unit) 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. YA9 YA11 YA12 YA14 YA17 YA23 YA26 YA36 YA41 YA41 Risk assessments should be considerably more detailed and reviewed at the same time as care plans. Care plans should assess service users needs in respect of independent living skills It is recommended that alternative day time activities are explored for service-users Activities provided in house should be displayed to facilitate choice Include pictorial references into menus and include alternatives to the main menu on the display copy to facilitate choice All staff should have training regarding abuse It is recommended that thermostatic controls are put in place to enable service-users to control the temperature in their own room Care staff should be supervised a minimum of six times a year The registered providers should review the arrangements for entering the building to ensure the safety of service users, visitors and staff. It is recommended that staff accidents be stored on their files. Oakdene Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Care Home (Residential Unit) C53 C03 S37916 Oakdene V225067 040505 Stage 4.doc Version 1.30 Page 21 - 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!