Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Oaken Terrace Hollybush Lane Oaken Codsall Wolverhampton West Midlands WV8 2AT one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mandy Beck Date: 2 3 0 2 2 0 0 9 Information about the care home
Name of care home: Address: Oaken Terrace Hollybush Lane Oaken Codsall Wolverhampton West Midlands WV8 2AT 01902847575 01902846974 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Interhaze Limited care home 92 Number of places (if applicable): Under 65 Over 65 17 20 dementia physical disability Conditions of registration: 17 20 17 Dementia (DE) - Minimum age 60 years on admission 20 Physical Disability (PD) - Minimum age 60 years on admission Date of last inspection Brief description of the care home Oaken Terrace is located between the villages of Codsall and Oaken approzimately four miles from Wolverhampton and stands in its own spacious grounds. The home is set in a rural location with good road links and nearby rail and bus services. The home has four units and provides care for people who need both personal and nursing care, this also includes people with dementia. Accommodation is largley single occupancy but there are shared rooms available. All areas of the home are run separately with an overall manager in charge. The home has not included the range of fees people are Care Homes for Older People
Page 2 of 10 Brief description of the care home expected to pay in the service user guide. People are asked to contact the home directly for this information. Care Homes for Older People Page 3 of 10 What we found:
We made a visit to the home to look at safeguarding concerns raised about the care of one person. There were particular issues about the care of pressure sores and pressure areas, diet and nutrition and care of a tracheotomy. We looked at the pre admission assessment completed by the home, we found there was insufficient information contained in this assessment to allow staff to plan effective care. For example pressure sores were mentioned but no further information about their treatment and management was included. Reference was also made to diabetes but there was no mention of the treatment and management of this condition. There was minimal information about the tracheotomy care needed the assessment said clean 3 - 4 hourly. We looked at care plans, we found they lacked the information to guide staff in meeting this persons needs. We found insufficient written evidence to show us how the home had managed the persons pressure area care. We were very worried to find that since the persons admission the pressure sores on their hip had deteriorated from a grade one (slight reddening of the skin) to a grade three (necrotic (blackened) areas). We spoke to staff who confirmed that the person had been nursed on an air mattress and did have a pressure relieving cushion to sit on during the day. However there was no additional recording of any other pressure relieving interventions. The grade one pressure sore on the hip had not been dressed since the day of the persons admission until the day before the person was readmitted back into hospital, a period of 10 days, at this stage the deterioration to a grade 3 pressure sore was noted. We looked at the wound care plan dated 27/10/09 this did not include information about pressure damage to the hip or sacrum only the heels and right foot pressure sores were mentioned. We asked the manager if staff would record any care relating to pressure area care anywhere else, she said, no it should be in the daily reports. There was very little reference to the care of the tracheotomy within the nursing notes and again the daily reports where both the nurse and the manager had told us they would record if care had taken place. We also asked what specialist training staff had had in order to care for a tracheotomy the manager told us there had been none but staff had learnt by example and were also caring for another person in the home with a tracheotomy. There was only one reference to any monitoring of this persons diabetes during their stay, we were concerned by this because the nursing staff had indicated in the daily reports that the person was not eating or drinking adequately. We could not evidence how the home had kept this persons diabetes under review. What the care home does well: What they could do better:
The home must make sure that assessments of peoples needs are comprehensive and include all the care people are in need of. The home must make sure that staff have appropriate training in order to meet the needs of the people living in the there. If the home is unable to do this then the manager must be confident in saying the home cannot meet that persons needs at that time. Care Homes for Older People
Page 4 of 10 Care planning has improved in this home but there is still more improvement needed if people are to receive the care the need. Care plans we saw in relation to pressure area care, diabetes and tracheotomy lacked the detail to guide staff to meet peoples needs. The home must improve the pressure area care it offers to people. Staff must have further training so that they are aware of the risks associated with pressure area care and pressure sores. This will help reduce the risks to people living in the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 9 13 (2) The home must make 11/02/2009 sure that fridge temperatures are kept between 2oC and 8oC. This will mean that medications requiring cold storage are being kept appropriately and not placing people at risk. 2 9 13 (2) The home must make sure that when people are prescribed medication on a PRN or as required basis there is a clear record in the care plan about the circumstances of its administration. This will mean that all staff are clear about the specific circumstances of when this medication should be administered. 11/04/2009 3 9 13 (2) The home must make 11/04/2009 sure that the current storage for controlled drugs is replaced. The home must do this to make sure they are complying with new legislation and peoples medication is being securely stored. Care Homes for Older People Page 6 of 10 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 4 29 19 The home must make sure that every new worker goes through the recruitment process even if they have previously been employed the home. This will reduce the risk of unsuitable people working with vulnerable adults. 09/03/2009 5 38 13 The home must make sure 02/03/2009 that people are not placed at risk of falling from windows by excessive gaps. The windows must be risk assessed and the home must take appropriate action to keep people safe. This must be done to reduce the risk posed to people living in the home. 6 38 17 The home must make sure it 06/02/2009 keeps written records of the safety checks it carries out on peoples bed rails. This will help the home audit the use of bed rails and the continued safe use. 7 38 23 The home must make sure 27/02/2009 that fire drills are undertaken at suitable intervals. This is so staff will be sure of evacuation procedures in case of fire and the do not place people at further risk. 8 38 13 (4) (c). The home must make sure that bed rails are 02/03/2009 Care Homes for Older People Page 7 of 10 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action not used until a risk assessment for their use has been completed. This will reduce the risk of harm being caused to people using the service. Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 8 12 The home must make sure it 26/03/2009 has systems in place to document, promote and monitor peoples health and welfare. The home must make sure that it seeks assistance from other healthcare professionals. This will mean that people have the appropriate treatment and care they need. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 8 Staff should receive further training in pressure area care and the care of pressure sores. This will help reduce the risk to people living in the home. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
