CARE HOMES FOR OLDER PEOPLE
Oakdene Rest Home 165 Minster Road Minster on Sea Sheerness Kent ME12 3LH Lead Inspector
Graham Cummings Announced 08/08/05 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 Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Oakdene Rest Home Address 165 Minster Road, Minster on Sea, Sheerness, Kent, ME12 3LH 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) 01795 874985 01795 871704 Mrs Tracey Melanie Gobbi Registered Care Home 26 Category(ies) of Care Home for Older People registration, with number of places Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27/09/04 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 a deputy manager, 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 for the elderly. 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. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Graham Cummings carried out the Announced Inspection on the 8th August 2005. The Inspector spoke with the Provider/Registered Manager, 2 staff, 2 Residents and looked through 3 staff files and 3 Residents files and toured the home. The Provider/Manager owns another home in the vicinity and was aware of the new report format as this home had been inspected 2 months ago. The Inspector had received the completed Pre Inspection Questionnaire, menu, list of employees, 10 Resident Comment cards and 1 Relatives comment card. The home is registered for 26 but has 23 Residents at present, it is unlikely that the home will have full capacity as it would mean making 3 of the rooms doubles and the Manager thinks this would detract from the quality of care given. The home was clean and tidy and had a relaxed atmosphere. The Requirement from the last inspection had been addressed and the 2 recommendations have also been discussed and partially implemented. Comments made to the Inspector by both Residents and staff indicate that the home is run in the best interest of the Residents, these included ‘everything’s perfect’, ‘ it’s my home, it’s a lovely place and the workers work damned hard’ ‘I am kept clean which is most important’, ‘I get good support from my managers’ and ‘ I can access lots of training’. The Inspector noted lots of positive interaction between staff and residents, staff knocked on Residents doors before entering this was confirmed in discussion with one of the Residents. On checking through the 3 staff files, the inspector noted that there were no references for one member of staff, the Manager was sure that they had been received but had not been put on file yet, all of the other files seen were full and complete and met the Requirements. The Inspector left the premises with no concerns for the care or safety of the Residents living at Oakdene Rest Home. What the service does well:
The home has good staff retention and training and offers a continuity of service to the Residents. They are cared for well and the food is healthy and nutritious. The home provides good training opportunities for staff, they exceed the 50 requirement of staff with NVQ level 2 by 2005. Staff spoken to told the Inspector that they were listened to and well supported. The Management and staff work hard at creating and maintaining good relationships with family and care managers, visitors are welcome at all times. The food provided is of a good quality, the main meal is at lunchtime, as there are now 2 cooks, one of them comes in some evenings to provide a greater variety of choice for tea. Residents commented on the care they received, one said ‘we are asked what we want, it’s like a family, I feel satisfied’, ‘Tracey (Manager) is an awfully nice woman’, ‘we get excellent care’, ‘can’t think of anything that’s wrong’, ‘don’t hear anybody grumble’. The Inspector found the
Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 6 home had a relaxed atmosphere and was clean and tidy throughout and there were no offensive odours and good staff interaction with Residents. 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 Rest Home H56-H05 S54752 Oakdene RH V231321 080805 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 Rest Home H56-H05 S54752 Oakdene RH V231321 080805 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) 1,2,3,5,6 Residents and family have access to the homes Statement of Purpose and Service User Guide. Residents have a Statement of Terms and Conditions on file. Residents have a needs assessment prior to placement. Residents and families are encouraged to visit prior to placement. The home does not take intermediate care. EVIDENCE: The home has a Statement of Purpose and Service user Guide that are available to prospective Residents, family and care managers to enable them to make an informed choice about living at the home, this has been updated to include the change of C.S.C.I. office. The Inspector looked at 3 Resident files and found that they all contained a Statement of Terms and Conditions and all had room numbers as requested in the last Inspection report. Pre placements assessments were on file and the Manager informed the Inspector that prior to any placement it is expected the prospective Resident visits the home at least once. The home does not take intermediate or recuperative care. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 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) 7,8,9,10,11 Residents health, personal and social care needs are set out in individual plans. Resident health needs are fully met. Residents are treated with respect and their right to privacy upheld. Residents wishes at the time of death are known. EVIDENCE: The Inspector looked at 3 Resident care plans and found that they set out the individuals needs and preferred routines. Residents are all registered with a doctor and attend the Community Dentist Department at the local hospital, this also includes a yearly visit to the home by a Dentist. Residents also have access to a local optician. None of the Residents self-administer medication, the home has policies and procedures in place to cover this if it is required in the future. The Inspector noted that staff knocked on Residents doors before entering and when speaking to Residents they commented on how good the staff were, one Resident commented that ‘ they keep us clean which is very important’ another said that the ‘staff are very nice girls and very careful’. The Inspector received 10 Service User comment cards prior to the Inspection and all 10 indicated that their privacy was respected. There were comments on the care plan indicating who the Resident wants contacted and their wishes. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Residents lifestyles match their expectations and preferences. Residents maintain contact with family and friends. Residents exercise choice and control over their lives. Residents food consists of a balanced and nutritious diet in pleasing surroundings. EVIDENCE: During the conversations with Residents they indicated that ‘they felt satisfied’ they were ‘unhappy with nothing’ ‘excellent - can’t think of anything that’s wrong, don’t hear anyone grumble’, there were 3 comment cards received back prior to the inspection that indicated the home could provide more activities, the Manager said that new activities had been purchased recently that would improve movement and hand eye co-ordination, the Inspector saw activities taking place in the lounge, the Manager is aware that they do not go out of the building as much as she would like but when the Residents had an offer to attend an activity organised by the Roundtable none of them wished to attend. The home is arranging to have a fete and barbeque in early September at the home to raise funds for the local Age Concern. The Manager said she will continue to encourage Residents to join in and organise outings from the home. Family and friends are able to visit the home at any time, there is a lounge area where they can have some privacy or if they wish they can use the Residents room. Residents are asked what they would like to do, or if they wish any assistance and support, 1 Resident told the Inspector that during the morning they had an ‘acid’ taste in their mouth and didn’t fancy a cup of tea,
Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 11 she said that she had been offered a glass of milk instead and this was something staff always did, ‘we are asked what we want’. The menu was on display by the main door and was 2 weeks in advance, all of the Residents spoken to and the comment cards received back indicated that the food was good and there was plenty of it, the dining room tables were well laid out and in pleasant surroundings. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Residents feel their complaints would be listened to and acted upon. Residents are protected from abuse. EVIDENCE: The Inspector only received one Relative comment card back, this indicated that they were aware about the complaints procedure and staff spoken to also told the Inspector the procedure they would follow if they had a complaint, this fitted in with the written procedures on display. The Inspector saw paperwork relating to an anonymous complaint that had been made to the Commission, this was all in order and the Manager had followed and taken all the appropriate actions and recorded them. Staff spoken to were aware of the Adult Protection procedures and staff had attended Adult Protection training and a further 2 staff were due to attend an Adult Protection course in late August. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Residents Residents Residents Residents Residents live in a safe, well-maintained, clean and hygienic environment. have access to safe indoor and outdoor communal facilities. have access to sufficient and appropriate baths and lavatories. have specialist equipment that will maximise their independence. bedrooms are suitable, safe and furnished with personal belongings. EVIDENCE: Residents live in a safe and well-maintained home, the maintenance person was working on creating a waterproof casing for putting a call point in so that it could be put outside in both the seating areas of the garden. There are no en-suites in the home but there are 6 toilets and 3 baths. The Residents have access to specialist equipment to assist with increase independence such as Zimmer frames, wheelchairs, grab rails, hoists and stair lift. The Inspector saw most of the Residents bedrooms, these were all safe and comfortable and well furnished with personal belongings and suited Residents needs. The home is clean and free from offensive odours, it is safe and Residents live in comfortable surroundings.
Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Residents needs are met by the numbers and skill mix of the staff. Residents are protected by the homes recruitment policy. Trained and competent staff care for residents. EVIDENCE: A team of competent and trained staff meets the needs of the Residents. Training carried out since the last Inspection includes; Adult Protection, Manual Handling, 1st Aid, Infection Control. The home also uses a competency training booklet covering Administration of medicine, Nutrition, Health and Safety, Aggression Management, Basic Care and Dementia, these are certificated courses. The home has excess of the required 50 of staff with NVQ level 2. The Inspector looked at 3 staff files and found that one of them did not contain references, the Manager is confident that the 2 references have been received but not placed on file, they could not be located during the Inspection, the rest of the files met with the required standards. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 Residents live in a home that is managed by a person fit to be in charge. Residents benefit from the leadership and management of the home. The home is run in the best interests of the Residents. Staff are appropriately supervised. The Residents health, welfare and safety are promoted and protected. EVIDENCE: Residents live in a home that is managed by a fit person, it was apparent from the discussion with the Inspector that the Manager was competent and confident in carrying out their responsibilities. The home is run in the best interests of the Residents, this was confirmed by one of the Residents when they spoke to the Inspector when they said ‘we are asked what we want’ ‘this is my home’. The Inspector saw 3 staff files and these included supervision notes, the home also hold staff meetings at regular intervals. The health, safety and welfare of the Residents are promoted and protected the Management and staff team. Staff were complimentary about the running of the home and the Manager, one said that ‘the Manager is good and supportive’
Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 16 ‘the management treat me well’. A Resident told the Inspector that ‘Tracey (Manager) is an awfully nice woman’. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 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 3 3 3 x 3 3 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 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 18 No 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 29 Regulation 19(1)(b) Requirement The Registered person shall not employ a person to work at the care home unless - subject to paragraph (6), he has obtained in respect of that person the information and documents specified in - (i) paragraphs 1 to 7 of Schedule 2 - in that 2 written references relating to the person are available and on file. Timescale for action Immediate 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 12 Good Practice Recommendations That the Registered person encourages and provides Residents with a varied choice of internal and external activities that suit their individual needs. Oakdene Rest Home H56-H05 S54752 Oakdene RH V231321 080805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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