Inspection on 11/09/07 for Oakdene Rest Home

This inspection was carried out on 11th September 2007.

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 Rest Home 21/11/06

Oakdene Rest Home 20/12/05

Oakdene Rest Home 08/08/05

Oakdene Rest Home 27/09/04

Oakdene Rest Home 05/05/04

Oakdene Rest Home 30/03/04

Oakdene Rest Home 04/01/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Oakdene Rest Home 165 Minster Road Minster On Sea Sheerness Kent ME12 3LH Lead Inspector Sue McGrath Key Unannounced Inspection 11th September 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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 Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakdene Rest Home Address 165 Minster Road Minster On Sea Sheerness Kent ME12 3LH 01795 874985 01795 871704 Tracey.Gobbi@btinternet.com 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 Tracey Melanie Gobbi Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2006 Brief Description of the Service: Oakdene is a large detached property providing accommodation on two floors. Oakdene is a residential service provider, providing care and support for up to 26 Older People. The owner manages the home, and she employs two deputy managers, 4 senior carers, 5-day care staff, and 5 nights care staff. In addition to this the home employs two cooks, 2 kitchen assistants, a housekeeper and a cleaner. The Registered Owner/Manager, Mrs Tracy Gobbi has several years experience as a manager and owner of residential care home’s for the elderly. Mrs Gobbi manages the home herself and deals with the day-to-day running of the establishment. The home is located on the main road in Sheerness (Minster on Sea). It is within walking distance of public transport, (bus) and has local shops and facilities nearby. The fees range from £326.33 to £420.00 per week. The quality of the service provided is good. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place on 11th September 2007 and was conducted by Sue McGrath, Regulation Inspector for the Commission for Social Care Inspection. The key inspections for care home services are part of the new methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Some judgements have been made through observation only. The requirements made at the last inspection had been complied with. Overall this was a positive inspection with generally good outcomes for service users. What the service does well: The home had a relaxed atmosphere and most parts were clean and tidy and there were no offensive odours. Service users appeared contented and relaxed. The bedrooms were well personalised and looked comfortable. One visitor complimented the staff on how well they cared for her mother who was currently unwell. The home was well maintained and comfortable. The lounges and dining areas were well presented. Staff retention was high which offered a continuity of service to the service users. The home exceeded the 50 requirement of staff with NVQ level two or above. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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 Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with the information they need to make an informed choice about moving into the home. Service users benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Service users and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: The home’s Statement of Purpose is available to all prospective service users and gives the details of the care that is on offer at the home. This document does not appear to have been updated since October 2003, the date on the Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 9 front of the copy given to the inspector. It is recommended that when the document is updated the home should emphasis they are not registered for nursing or dementia care. The manager confirmed that each service users has a contract or terms and conditions with the home and some were seen on the relevant files. The home carried out a comprehensive assessment on each service user prior to admission to ensure the home can meet their needs. Samples of these assessments were seen on residents’ files. The manager explained that normally herself and or the deputy manager would visit the prospective service user in their current setting, be it at home or in hospital, to gather the relevant information. Relatives are asked to provide details of the life history of the service user to enable a full picture to be drawn up, however sometimes this information is difficult to obtain. Part of the assessment process takes into account and identifies any social or cultural requirements and equality and diversity is part of the review process. Each prospective service user in encouraged to visit the home prior to admission and to join the home in a meal. Four weeks after admission a review is usually held to ensure all parties are happy for the service user to remain. If the service user is funded by Social Services their care manager will be involved with the process. The assessment that is completed at this stage covers risk and is used as the basis for the care plan. The care staff appeared to have a good understanding of the service users needs and the evidence seen indicated that the home is meeting their needs appropriately. The home does not offer intermediate care. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and service users benefit from having full access to all professional health care services as required. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Each service user has a comprehensive care plan which details and gives guidance to staff on all aspects of health, personal and social care needs. These appear to be in depth and confirmed that all service users are registered with a local GP and receive support from other health professionals as Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 11 required. Discussion took place around the difficulty of accessing dental care from the local Community Dentist Department, with service users having to wait nine to ten months for an appointment. To this end the home uses the services of a local dental technician for any problems with dentures. Chiropody is available at a cost to the service users. A local optician is also available. Records seen on the care plans indicate that all medical needs are met and that records are well maintained. Daily records contain details of how staff support service users with their personal hygiene, giving encouragement to remain independent where possible. Care plans indicate that service users’ wishes regarding illness and death are recorded and acted upon when necessary. The only point of concern was that the service users themselves appeared unaware that care plans are drawn up and several stated they had not been consulted or involved with the drawing up or reviewing of the plans. It is recommended that, where possible, service users are involved and those that are able to, sign to say they have agreed the plans. Evidence was seen that staff regularly update and review these plans. Several service users spoken with stated they were happy with the level of care they received. One stated ‘they look after me very well and I am very happy here’ One relative who was visiting her mother said ‘ the staff have always looked after Mum very well but since she has become very poorly the level of care has been exceptional. I feel confident they look after mum when I am not here and that has helped me’ Another relative stated in a returned comment card that the staff treat clients as individuals and give them as much dignity as possible. The purchase of a new medical trolley improves the security of the medication held within the home. Medication was seen to be administered correctly during the inspection. The medication is only administered by trained staff but a more detailed training course is recommended. This was discussed with the owner during the inspection. It is noted that some staff have completed this course and that one more place is booked. The home has recently installed some overhead tracking to assist in the moving and handling of some residents. The owner stated that it was her intention to have more tracking installed as soon as feasible. Six full depth pressure mattresses have also been purchased by the home because they feel these provide maximum comfort and support when service Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 12 users needs are greatest. Staff are fully aware of good tissue viability care and, if needed, good support is offered from the local District Nurses. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users’ social and recreational interest and needs are not well provided for. Service users benefit from the flexible routines in the home, they are able to exercise choice in relation to routines of daily living. Service users are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. EVIDENCE: The current levels of social activities in the home are fairly low, but most of the residents appear happy with this. The home does have an activities list but this is not always adhered to. Some service users did say they would like to do more and sometimes do get bored. Arts and crafts seem to be the main activities offered as well as some musical session. The service may wish to Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 14 look to employing a dedicated activities co-ordinator to ensure service users find the lifestyle in the home matches their expectations. The daily routines in the home are fairly flexible and service users say they can get up when they want and go to bed when they want, they mostly prefer to retire early. Families and friends are actively encouraged to maintain contact with their relatives and to be involved with their care where possible. During the inspection it was noted that staff mainly respected dignity and gave choices over daily living. However, some of the less able service users were not always given the same choices with regard to assistance with eating or moving and handling. It is advised that staff continue to interact with all service users at all times. One service user in particular was approached from behind when an apron was fitted and she appeared very confused over this. When giving assistance to feed it is strongly advised that staff continue to communicate well. The meals seen on the day looked very appetising and all the service users spoken with were happy with the food. All said drinks were freely available and fresh fruit and vegetables were used where possible. Specialist diets could be catered for. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by a robust complaints system and service users and relatives feel their views are listened to and acted upon. The home has robust adult protection policies and procedures to ensure that service users are protected from abuse. EVIDENCE: The service has a comprehensive complaints procedure in place that ensures service users are protected at all times. The owner stated that she would be proactive when dealing with any minor issues before the escalated to any formal complaints. The home has not received any formal complaints since the last inspection. Families spoken with confirmed they felt and issued would be dealt with promptly by the management team. The service also has a comprehensive Adult Abuse policy in place and staff on duty were able to explain their understanding of the procedure. It could not be evidenced that formal Adult Protection training had been undertaken within the last year. Some challenging behaviour training had taken place. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a mainly clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. Service users are encouraged to maximise their independence by having access to the range of specialist equipment supplied by the home. EVIDENCE: Several bedrooms were viewed and are comfortable and well decorated. Many have a range of personal items in to ensure the service users have their own belongings around them. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 17 Some of the bedrooms and toilets could have been cleaner. Some of the bedrooms were dusty. This was discussed with the owner who agreed to monitor the cleanliness more vigorously. Some cleaning materials were seen left in toilets and these need to be more secure and stored in a secure cupboard. All of the service users spoken with were happy with their rooms and with the living areas. The home has a conservatory that doubles as a second dining area and a large lounge giving service users ample communal space to compliment their private area. The provider may wish to consider having dining chairs with arms as several service users were seen having some difficulty get up form the table. The service users have access to specialist equipment to assist with increased independence such as walking aids, wheelchairs, grab rails, hoists and stair lift. The home has purchased several specialist mattresses recently. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure service users’ needs are met by a mix of qualified and care staff. The service cannot efficiently monitor the training needs of staff because staff training is not well recorded. Service users are protected by the home’s robust recruitment procedures. EVIDENCE: From discussion with the provider, staff, some residents and one visitor and observation made during the day, it was evidenced that the staffing arrangements are appropriate to meet the needs of the current service users. Several of the service users are becoming very frail and may need more help in the future. Rotas indicate that the service employs three carers and one deputy every morning and three staff and sometimes the deputy in the afternoon. Night staffing is adequate. The home’s recruitment procedure is robust and does protect service users. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 19 Staff training was difficult to assess because the management does not have a training matrix that evidences what training has been giving. There was some confusion over what has been completed and what has been booked. The provider will be required to evidence what training has occurred in the last twelve months. Figures given in the Annual Quality Assurance Assessment indicates that the home has ten members of staff who have completed NVQ level 2 or above and one member currently working towards their award. This indicated that the home has over 50 per cent of staff with the required NVQ qualification. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from having a manager who is supported well by senior staff in providing clear leadership throughout the home and by staff who demonstrate an awareness of their roles and responsibilities. Sound financial procedures protect service users. Current arrangements were sufficient to protect the health, safety and welfare of residents and staff. EVIDENCE: The provider/manager has the necessary experience and qualification to run the service appropriately. Discussion took place regarding the management of Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 21 the owner’s sister home and it was later confirmed by the registration team at CSCI the she needed to apply to be the registered manager at that home. Discussion took place regarding what information would be required to enable the owner to be the registered manager for both home’s. Both home’s have experienced and well qualified deputy managers in post. Evidence gathered at this inspection indicates that the management approach is creating an open, positive atmosphere and staff say they feel well supported in the home. The owner normally carries out yearly quality assurance exercise and this is due soon. Some of the service users said they missed having regular resident meetings and would like them reinstated. The owner said she would take this into consideration. The system for dealing with service users personal monies was accurate with records of monies received, expenditure, dates and signatures. Several accounts were checked and all balanced. Environmental risk assessments have not been updated and not all radiators are guarded. This could put some service users at risk from burns, particularly if they fell against them. It is strongly advised that radiator covers be fitted or a robust risk assessment put in place that give concise and clear details of the action staff need to take to prevent service users suffering any burns. Staff supervision was assessed, unfortunately some staff did not have an understanding of what supervision meant and when asked if they received supervision were unsure. Records indicated that some have received regular sessions, however these need to be more regular and robust. Staff who give supervision should be fully trained in these skills. Annual appraisals are available but not all staff have benefited from having theirs completed. The manager stated that all necessary health and safety checks and regular maintenance had been undertaken. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 2 3 3 Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 23 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP30 Regulation 12 Requirement Timescale for action 31/10/07 2. OP36 18(2) 3 OP26 12 The registered person ensures that there is a staff training and development programme which meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. The registered provider must provide the Commission with a training matrix detailing completed training courses. The registered person ensures 31/10/07 that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice in that staff supervision is carried out on a regular basis by qualified and competent staff. 31/10/07 The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance in that bedrooms are kept free DS0000054752.V346191.R01.S.doc Version 5.2 Oakdene Rest Home Page 24 from dust. 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 OP10 OP20 Good Practice Recommendations It is recommended that an activity co-ordinator be employed. It is recommended that consideration is given to replacing the dining room chairs with chairs with arms on. Oakdene Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Rest Home DS0000054752.V346191.R01.S.doc Version 5.2 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. 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