Inspection on 30/10/06 for Oaken Holt House Nursing & Residential Home

This inspection was carried out on 30th October 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

Oaken Holt House Nursing &... 02/02/06

Oaken Holt House Nursing &... 08/07/05

Oaken Holt House Nursing &... 14/02/05

Oaken Holt House Nursing &... 13/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Oaken Holt House Nursing & Residential Home Eynsham Road Farmoor Oxfordshire OX2 9NL Lead Inspector Annette Miller Unannounced Inspection 30th October 2006 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 Oaken Holt House Nursing & Residential Home DS0000027166.V317702.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. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaken Holt House Nursing & Residential Home Address Eynsham Road Farmoor Oxfordshire OX2 9NL 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) 01865 863710 01865 864831 j.k.h@oakenholt.co.uk Oaken Holt Care Limited Mrs Mandy Vettraino Miss Alison Kay Valentine Care Home 80 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (80), of places Physical disability (1) Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. On admission persons should be aged 60 years and over. Maximum of 30 persons with nursing needs. The total number of persons that may be accommodated at any one time must not exceed 80 2nd February 2006 Date of last inspection Brief Description of the Service: Oaken Holt House is owned and managed by Oaken Holt Care Ltd, and is situated in 23 acres of landscaped grounds in a secluded elevated position 3 miles from the city of Oxford. The home is registered to provide nursing and residential care for up to 80 residents aged over 60. The main building is a substantial Victorian house and provides nursing and residential accommodation over three floors, serviced by lifts. Accommodation in the residential area of the main house is provided in a variety of rooms, from single rooms to large self-contained apartments with en-suite facilities or separate facilities. The Coach House is a separate building and also provides residential accommodation for less dependent residents. The nursing wing is an extension arranged over two floors, with accommodation provided in single en-suite rooms. The communal rooms are spacious and well furnished. The residents can use the terraces and well-tended gardens. The responsible person, Ms Jane Kennedy-Hill, is in day-to-day charge of the home, with a co-director/proprietor, Mr S Murray. There are two registered managers, one for the nursing wing and one for residential, supported by a team of nurses, care assistants, housekeeping, maintenance, gardening and contract catering staff. The fees range from £518.00 to £1,108.00 per week. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the 1st April 2006 the Commission for Social Care Inspection has developed the way it undertakes its inspection of care services. This inspection was an unaccounced ‘key inspection’ to look at those standards the commission considers to be most important and also any others the inspector considers to be necessary. The inspection took place over two days and the inspector was in the home for 13½ hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the management team and any information that the commission has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the commission had sent out. Eleven residents, three relatives and four health care professionals returned comment cards to the commission expressing their views of the home. The majority of comments were extremely good. A number of the residents’ comment cards were completed on their behalf by family members or staff. The inspector looked at how well the home was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector discussed her findings at the end of the inspection with Mr Murray (proprietor), Ms Kennedy-Hill (co-director), Ms Vetrraino (manager residential unit) and Ms Valentine (manager nursing unit). What the service does well: The staff team achieve a high standard of care for residents. Residents’ accommodation is of a very good standard and the home’s setting, in its own well maintained, extensive grounds provide a very attractive environment which residents enjoy. The quality of cleanliness, catering and décor are of an excellent standard. The managers and proprietors are very experienced in their roles and work well together. They are readily available to residents and visitors on a day-today basis, so that there is a sense of staff having a personal interest in maintaining a high standard of care for residents in this home. Extremely good comments were received from residents during the inspection and also on comment cards returned to the commission, for example: “I couldn’t be more pleased”; “I am perfectly happy here”; “Quite satisfied”; “I couldn’t have a happier life”. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.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 Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 8 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 Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 9 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): 1 and 3. (Standard 6 is not applicable.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s Statement of Purpose and brochure provide a good range of information to help residents make an informed decision about whether the home is right for them. EVIDENCE: All the residents who returned comment cards said they had received enough information about the home and one resident commented the home’s brochure was ‘very good’. This clearly reflects well on the home and shows the importance that is being placed on providing good information that is well presented. However, the inspector noted that not all of the information required is included and the documents need to be reviewed and amended accordingly to ensure they comply with the relevant regulations. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 10 The Statement of Purpose must include information about the number and size of rooms. Also, there must be information about those aspects of the environment that do not meet the government’s national minimum standards. For example, the inspector observed that some bedrooms on the nursing wing were small. There is no requirement for the home to increase what was already in place on the 1st April 2002 when the standards came into force as Oaken Holt was an existing care home, but the Statement of Purpose must provide information about where any shortfalls exist. There is reference in the Statement of Purpose to care plans being reviewed quarterly on the nursing wing. This should be amended to monthly to be in line with current good practice. The home does not have a Service Users’ Guide and this is a requirement of Regulation 5 of the Care Homes Regulations 2001. The inspector was informed that the home’s brochure is used for this purpose. The brochure includes most of the information that is needed, but there are some omissions. For example, the brochure does not provide a standard form of contract, does not have the most recent inspection report (or inform readers where this can be obtained) and a summary of the complaints procedure is not given. Standard 1.2 of the National Minimum Standards for Older People gives guidance on what to include and Regulation 5 of the Care Homes Regulations 2001 states clearly what information must be provided. There is no date on the brochure to show when it was last reviewed and some information was out of date. For example, there is reference to Oaken Holt House and the Coach House being registered by the ‘local authorities’. This ceased to be the case from 1st April 2002. The only reference to making a complaint is on page 5 where there is mention of complaints being referred to Mrs Kennedy-Hill (a co-director). The inspector saw on the complaints procedure included in the Statement of Purpose that complaints should, in the first instance, be sent to either the residential manager or the nursing manager. Information about complaints needs to be consistent. If the directors wish to maintain the brochure as the home’s Service Users’ Guide, it needs to be reviewed and updated to include all the information that is required and also to indicate, either in the title or within the document, that it is the home’s Service Users’ Guide. Alternatively, a freestanding Service Users’ Guide could be considered. Prospective residents are assessed in their own home by one of the managers, or in hospital if that is the person’s current situation, to ensure the home has the capacity to provide the care that is needed. The inspector saw a sample of assessments and found they contained comprehensive and relevant information about all aspects of the individual’s care needs. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Although recommendations have been made regarding some aspects of care planning and management of medication, there was evidence of residents receiving consistently good care from kind and skilled staff. EVIDENCE: The inspector spoke individually to two residents in their rooms (one on the nursing wing and one on the residential wing) and they each expressed complete satisfaction with the care they received. They made good comments about the staff, saying they are kind and gentle, and also that managers ‘do a good job’. The inspector also had conversations with a number of residents in the communal rooms, although some residents approached were unable to express a view due to deterioration in their mental health. The inspector saw that residents looked clean and well cared for, and received good comments from the residents able to express a view. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 12 Feedback from the commission’s comment cards showed that 9 out of 11 residents consider they ‘always’ receive the care and support they need; 2 said ‘usually’. Some respondents made individual comments, such as: “I couldn’t be more pleased”; “I am perfectly happy here”; “Quite satisfied”. Five sets of care records were inspected (3 nursing and 2 residential). The Assessment records were very good, providing important and relevant information about each person’s health and social care needs. However, care plans were not written for some important care needs recorded in the nursing assessments, and this is an area that needs to be developed with staff. There should be a care plan to deal with each specific area of care so that staff have precise information about the care they need to give and also to be able to accurately assess the effectiveness of that treatment. It is current good practice to review care plans at least monthly to check that care needs are being met and that the care that is planned continues to be appropriate. This was not being done routinely. Four health care professionals returned comment cards to the commission and they all made positive comments about the home. A doctor wrote: “Staff within the Coach House, residential and nursing wings provide high quality support and care to individuals with complex mental health needs. Staff refer to us appropriately and use advice well. They are thoughtful about the mental health needs of their residents and provide a very good service to many of our patients.” Risk assessments are carried out to discover how any risks to residents’ health and safety can be minimised, such as identifying residents at risk of developing pressure sores. The inspector observed that pressure relieving mattresses and cushions were being used where needed. A resident who had experienced falls had been assessed for mobility, but had not had a full falls assessment, including assessment of the environment relevant to the person’s specific needs. The manager pointed out that a risk assessment on all bedrooms had been done, but this was a general assessment and had not taken into account the particular needs of residents at risk of falling. A copy of the CSCI guidance on the prevention and management of falls in older people was given to the nursing manager during the inspection. Medication on both units was generally well managed. Areas for improvement include returning controlled drugs promptly for disposal through the home’s licensed waste disposal company. There were two controlled drugs on the Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 13 nursing unit that had not been given for some time. Also, a number of residents on the nursing unit were prescribed a liquid medicine supplied in bottles named for each individual resident. There is not enough space on the medicine trolley to hold all the bottles supplied, and therefore one bottle belonging to an individual resident is used for all residents prescribed the medication. The nursing manager should discuss with GPs whether a bulk prescription can be supplied for medication frequently prescribed in large containers. The alternative is to administer the medicine from each person’s own supply. The residential manager should review the storage facilities for Schedule 3 controlled drugs and consideration should be given to storing these in a controlled drug cupboard. The home’s commitment to treating all people equally is referred to in its Statement of Purpose, which states: “The resident’s needs and values are respected in matters of religion, culture, race or ethnic origin, sexuality and sexual orientation, political affiliation, parenthood and disabilities of impairments. From the evidence seen by the inspector and comments received the inspector considers this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. All staff were seen and heard to treat residents with care and respect, and residents told the inspector that they were treated with dignity. One resident said on a comment card, “I couldn’t have a happier life”. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The range of activities provided mean the residents have opportunities to participate in stimulating and motivating activities. Meals are an enjoyable social occasion for the residents. EVIDENCE: There is a very good range of activities available on the nursing and residential units, with each unit having its own activity organiser. Feedback from the commission’s comment cards showed that 8 out of 11 residents thought there were ‘always’ activities to take part in; 2 said ‘usually’; one said ‘not applicable’. Some respondents also made individual comments, such as: “Various places of interest visited in the mini-bus. There are group activities within the home, eg cookery, pottery and scrabble.” Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 15 “There is now a very good activity programme for many nursing wing residents, who can see and talk. More interaction with those who are aware but disabled would be beneficial”. The activity organiser on the nursing wing said that one-to-one activities are provided for residents unable to take part in group activities. Also, that hand and foot massage is provided, which residents who are unable to communicate particularly enjoy. There was information about residents’ hobbies and interests in their care files and the activity organisers also keeps a record of the activities that each resident takes part in. One of the nursing residents said he was looking forward to attending the discussion group, which involves looking at a newspaper article and discussing it with other residents. This is an excellent activity to provide and encourages residents to maintain an interest in everyday news and events. The activity organiser on the nursing unit said that residents and their families/representatives are encouraged to provide a ‘life history’ to help staff understand each resident better so that they can meet the residents’ needs and preferences. There are no restrictions placed on visiting. Three relatives returned comment cards to the commission and they all said they could visit their relatives in private and were always made to feel welcome. The choice of menus from the set menu at mealtimes is impressive. There is also an ‘a la carte’ menu, although this incurs an extra charge. The dining room accommodation on the residential wing is particularly good providing residents with elegant and congenial surroundings to have their meals. The nursing wing has a dining room on the lower ground floor and although not as spacious as on the residential unit, provides cosy and homely surroundings. Many of the nursing residents needed help to heat and staff gave one-to-one help in an unhurried way. Residents can choose to eat in their rooms if they prefer. The chef meets and discusses the menus with all residents to ensure that personal tastes and preferences in food are met. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 16 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. EVIDENCE: Feedback from the commission’s comment cards showed that 9 out of 11 residents ‘always’ knew who to speak to if they were not happy; 2 said ‘usually’. The home has a complaints policy that sets out the stages and timescales for investigating any complaints made. Since the last inspection the home has investigated three complaints. Two were substantiated and 1 partly substantiated. The managers confirmed that a record of complaints is kept. No complainant has contacted the commission with information concerning a complaint about this home since the last inspection. Training on the protection of vulnerable adults (POVA) was last provided in 2003 and an update in this training is scheduled for 30th November 2006. All new staff attend POVA training on induction, when the home’s protection of vulnerable adults policy and procedures are discussed. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 17 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): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The standard of the environment within and outside this home is exceptionally good providing residents with a very attractive and homely place to live. EVIDENCE: Regular maintenance and an on-going programme of improvements and refurbishment ensure the safety and wellbeing of residents, whilst keeping the character and individuality of the buildings and residents’ own rooms. At the time of inspection the upper ground floor lounge on the nursing unit was being decorated and the communal rooms in the residential unit had recently been redecorated. The home has lovely grounds that are well maintained. A resident on the residential unit said she liked walking in the grounds and had a favourite seat, where she could look across to Farmoor reservoir. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 18 Residents in the nursing wing have a small courtyard garden with a fishpond, seating and flowerbeds. Access to this is from the lower ground floor lounge/diner on the nursing unit. Residents in the Coach House apartments each have a small patio area with seating and planting areas, facing over the valley and driveway to the grounds. Residents are encouraged to maintain and choose the planting for the gardens. The standard of cleanliness throughout the home was found to be excellent. The home’s laundry is well equipped and is able to cope with the amount of laundry generated each day, including residents’ clothing. Staff hand-wash facilities are provided throughout the home. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 19 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): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The number and deployment of staff available to meet the needs of residents is good. However, some important recruitment information and checks had not been completed prior to members of staff starting work at the home and this potentially put residents at risk. EVIDENCE: At the time of inspection the home was well staffed. The inspector spoke to one nurse and two carers and they each considered that staffing levels were good, enabling them to have sufficient time to spend with residents. The two residents the inspector spoke to individually said they had access to staff when they needed them. Feedback from the commission’s comment cards showed that 8 out of 11 residents considered there were ‘always’ enough staff; 3 said ‘usually’. Two out of the three relatives who responded to the commission’s survey thought staffing levels were sufficient; one relative thought there needed to be more staff attendance in the nursing lounge and the management team were informed of this comment. The staff spoken to confirmed that training was regularly arranged, and training records provided evidence of this. A nurse said she had recently Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 20 attended training on accountability and record keeping, and was aware of the training opportunities that were planned. The home has not yet managed to achieve 50 of care staff with the NVQ level 2 in care. The nursing and residential managers are both NVQ assessors and external assessors are also used. There are three carers with the NVQ (care) certificate, one who has just completed the training and two on the training. There are 27 carers working in the home and the percentage of carers with an NVQ is therefore 15 (this includes the carer who was waiting her results). The residential manager said she has three staff who trained as nurses abroad and they are employed as senior carers in the home. An NVQ provider needs to assess the training they have done to determine if it is equivalent to the NVQ training in care carried out in this country, and at what level. Personnel files for five members of staff were looked at to check if all the recruitment information and checks that are needed had been obtained. It was found that three members of staff had started before a criminal record bureau (CRB) disclosure was obtained. A manager is permitted to start a member of staff before the outcome of this check is received, but only if an interim check (called POVA First) is obtained. The inspector saw that the POVA First checks and CRB disclosures were all obtained after these three staff had commenced employment at the home. The managers must ensure that the required information and checks are obtained for all staff employed to safeguard residents. It is a requirement that a full employment history is obtained for all new workers in order that gaps in employment can be checked. This information was not provided in two of the files looked at. It is recommended that recent staff photographs are obtained for purposes of identification for all members of staff and that these should be originals, rather than photocopies of passport photographs. New employees are provided with a period of induction and are not included in the staff numbers for the first two weeks’ of employment. The residential manager said the home was developing its induction programme to meet the requirements of the Skills for Council approved induction standards. Workbooks are issued to new workers to complete and when each element of learning has been completed it is signed off by a manager, and then externally verified. This is good practice. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 21 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residential and nursing managers are experienced in their roles and, together with the proprietors, provide clear leadership throughout the home and maintain a high standard of care. There are good health and safety systems in place that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: Both managers have obtained the Registered Manager’s Award, which is a management qualification at NVQ level 4. The nursing manager is a registered nurse and the residential manager has obtained NVQ level 4 in care. They are experienced and have the support of their staff team. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 22 The inspector received good feedback about their performance from residents and staff and the inspector informed them of these comments during the inspection, and also during verbal feedback at the end. The residents and staff spoken to said they found it easy to see the managers when they needed to. The Quality Assurance Manager is responsible for auditing the home’s policies and procedures, and to check that staff are complying with them. She has recently audited the policy regarding residents’ spiritual needs and found that religious and cultural festivals were observed and celebrated, but that records were not kept. Action has been taken to implement changes. The quality assurance manager was in the process of setting up excellent systems in her area of work. The residential and nursing managers are responsible for sending out questionnaires to residents to obtain feedback about the service provided. A resident’s completed questionnaire is put in his/her care file. The inspector questioned the appropriateness of this, pointing out that if a resident wished to make a criticism about a particular area of care or person, they might feel reluctant to do so knowing the questionnaire was available to the care team. It is recommended that survey forms are collected and analysed and not placed in the care records. Also, that the outcome of surveys are summarised in a report for circulation within the home. The managers confirmed that all residents have a family member or appointee to assist them with their personal finances if they are no longer able to manage their financial affairs. The home does not deal with residents’ personal monies. Any small purchases made for residents by staff at residents’ request are receipted and ‘double-signed’ by staff and the resident. Health and safety is well managed throughout the home. Maintenance records were looked at and the checks that are needed had been done and were up to date. Training in health and safety matters is well organised and attendance by all grades of staff is good. During 2005 the home had a full health and safety audit by an external company. The residential manager confirmed that all recommendations resulting from the audit had been completed. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 23 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 4 Requirement Timescale for action 31/12/06 2 OP1 5 3 OP29 19 Schedule 2 (amended) The directors must ensure that the Statement of purpose contains the information required by this regulation. A copy of the document must be submitted to the commission. The directors must ensure that 31/12/06 the Service Users’ Guide (or equivalent) contains the information required by this regulation. A copy of the document must be submitted to the commission. The managers must ensure that 31/10/06 all recruitment information and checks are obtained for all grades of staff before they start working at the home. Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations ●A care plan should be written for each specific area of care so that staff have precise information about the care they need to give and also to be able to accurately assess the effectiveness of that treatment. ●Care plans should be reviewed at least monthly to check that care needs are being met and that the care that is planned continues to be appropriate. Residents should have a falls assessment that includes assessing their environment so that measures can be put into place to reduce any identified risk. ●The nursing manager should ensure that controlled drugs are returned to the home’s licensed waste disposal company so that drugs no longer in use are disposed of promptly. ●The nursing manager should ensure that medication named for one resident is not given to another resident. ●The residential manager should give consideration to storing Schedule 3 controlled drugs in a controlled drug cupboard. The management team should consider how to increase the number of carers trained to at least level 2 NVQ in care, to ensure the home has at least 50 of its care team trained to this level. Feedback that is provided by a resident on the home’s survey questionnaires should be kept confidential and not put in the person’s care records for the care team to see. 2 3 OP8 OP9 4 OP28 5 OP33 Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Oaken Holt House Nursing & Residential Home DS0000027166.V317702.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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