Inspection on 22/08/06 for Oakfield

This inspection was carried out on 22nd August 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

Oakfield 11/03/08

Oakfield 03/05/05

Oakfield 13/04/04

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

CARE HOMES FOR OLDER PEOPLE Oakfield 30 Oakfield Road Ashtead Surrey KT21 2RD Lead Inspector Deavanand Ramdas Unannounced Inspection 22nd August 2006 10:00 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 Oakfield DS0000013342.V308328.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. Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakfield Address 30 Oakfield Road Ashtead Surrey KT21 2RD 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) 01372 272540 020 86427729 Trilodge Limited Mr C Aristidou Care Home 24 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (24), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (24) Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The age range of the service users in the category of Mental Disorder (MD) must be sixty (60) years and over. The service may accommodate five (5) named service users below the age of sixty (60) years within the category Mental Disorder (MD). One named service user may be accommodated under sixty five (65) years of age under section 37/41 of the Mental Health Act of 1983. The named service user referred to in condition 3 - within the category of Mental Disorder (MD) may be accommodated subject to the following arrangements: (I) There are frequent and regular reviews in conjunction with all significant others and professionals involved in the service users plan of care. (ii) All risk assessments relating to the service user must be reviewed regularly as part of the review process. (iii) The home fire safety risk assessment must be reviewed to incorporate the associated risk in respect of the service user. 3rd May 2005 Date of last inspection Brief Description of the Service: Oakfield is a care home that provides nursing care for 24 people with mental disorder. It is located in a residential area close to the village of Ashtead in Surrey. The home can accommodate twenty four service users both male and female. The accommodation is on three floors which can be accessed via a lift and comprises of two communal lounges, bathrooms and shower rooms, a kitchen, a laundry, a designated smoking area, an office and a staff room. There is a well maintained back garden with mature trees and a large raised patio area. Private parking is available. Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes key inspection by the CSCI (commission for social care inspection) and carried out by one inspector over a period of six hours. A tour of the premises took place, staff and service users were spoken to, and documents and care records were examined. The manager had a meeting with the inspector to discuss KLORA (key lines of regulatory activity which is a method of assessing the overall quality of a service) and CSCI leaflets and brochures were left at the home for information. The inspector would like to thank the manager, staff, service users, relatives and other professionals for their contribution to the inspection. What the service does well: What has improved since the last inspection? Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 6 The home has met the requirements identified in the CSCI (commission for social care) inspection report dated May 2006. This has resulted in improvements in the central heating system, bathing facilities and the safety of the homes lift to safeguard the welfare of service users. 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. Oakfield DS0000013342.V308328.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 Oakfield DS0000013342.V308328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes statement of purpose and service guide is good ensuring prospective service users’ and their relatives have up to date information on which to make decisions about admission to the home. The arrangements for the assessment of needs are good ensuring service users’ needs are assessed before admission to the home. EVIDENCE: The home had a statement of purpose and service user guide which is written in plain English, nicely presented and copies are available to service users for information. The manager stated service users are admitted to the home on the basis of an assessment of needs and the home had an assessment and admissions policy. The inspector sampled records and noted the home had an initial assessment form which is used to assess service users’ needs and covered the areas of personal care, social support and healthcare needs. Further evidence indicated staff working at the home had training in psychiatric nursing, dementia awareness, NVQ (national vocational qualification) in care, promotion of continence and collectively have the skills and experience to meet Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 9 the needs of service users. The manager stated the home does not offer intermediate care and this standard was not assessed. Oakfield DS0000013342.V308328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,8&10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning at the home is satisfactory ensuring service users have individual care plans which reflect their individual needs. The systems for accessing healthcare are adequate ensuring service users healthcare needs are assessed and met. The arrangements for privacy and dignity are adequate ensuring service users privacy is upheld. The management of medications at the home promote health. EVIDENCE: The manager stated service users have individual care plans which are drawn up following an assessment of needs and the inspector noted the home had care plans which sets out in details actions to be taken with regards to personal, social and health care needs. The manager stated service users have named key workers and care plans are regularly reviewed and updated to reflect service users changing needs. The inspector sampled care plans which were regularly reviewed, dated and signed by key workers. A care manager commented ‘‘I am very satisfied with the care my clients receive at the home’’. The manager stated service users have access to healthcare professionals to meet their needs and the inspector noted service users are Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 11 registered with a local GP and the home have input from a psychiatrist to meet the mental health needs of service users. The manager remarked the home had a policy on medications and qualified nurses administered medications to service users. The inspector noted the home had a service level agreement with a local chemist and a contract with an approved company for the disposal of medications. Medication record sheets were dated and signed by staff and a list of staff specimen signatures was available for information. The inspector noted the home had controlled drugs which were recorded in a controlled drugs register and up to date and correct. The manager stated the home had a policy on privacy and dignity and the inspector noted the home had information on the GSCC (general social care council) code of conduct for care staff. Observations confirmed staff addressed service users by their preferred names and the manager knocking on doors before entering service users’ bedrooms. During discussions a service user stated ‘‘nursing care is first class’’. Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 12,13,14&15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for activities are satisfactory ensuring service users social and cultural interests are catered for by the home. The systems for family contact are adequate ensuring service users maintain links with family and friends as they would wish. Opportunities for exercising choice are satisfactory ensuring service users are helped to exercise choice over their lives. Meals at the home are adequate and offer variety and choice. EVIDENCE: The manager stated the home had a policy on social contact and activities and the inspector noted service users have the opportunity to exercise choice in relation to leisure, social activities and cultural interests recorded in service users daily notes. The home employed an activities co-ordinator and a service user commented ‘‘I enjoy the activities here and everybody is helpful’’. A review of the activities programme reflected reality orientation, music therapy, dance classes, social gatherings and manicure sessions. The inspector noted staff were aware of the religious needs of service users and had made arrangements for the local vicar to visit the home for communion. During discussions a service user remarked ‘‘I don’t worry about church, the vicar visits the home every so often’’. The home values equality and diversity and encourage service users to participate in community life. The home has Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 13 contact with a local school and children visit the home to sing songs to mark special religious occasions. The headmistress commented ‘‘it is a pleasure and most rewarding for us to be able to come and entertain’’. A review of records indicated service users had contact with family and friends and the home had a flexible visitor’s policy to promote links with relatives. The manager stated service users have opportunities to exercise autonomy and choice and a review of records indicated service users handle their own financial affairs and had accounts at a local post office. The home had information on local advocacy services and one service user had an advocate to safeguard his interests and welfare. The manager remarked the home had written menu plans and staff commented service users participated in planning the menu. Observations confirmed service users had creamy pork with lemon and parsley, boiled potatoes, cauliflower and carrots for lunch and dessert was home made apple pie. Mealtime was relaxed and unhurried and meals were nicely presented. During discussions a service user stated ‘‘the food is very good, we get seasonal produce’’ and another commented ‘‘food is quite good, if you can’t eat something you get something else’’. A review of menu plans indicated meals offered variety and choice and the cook remarked ‘‘service users enjoy the food, it is good old fashioned home cooking’’. Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 16&18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints process is satisfactory with complaints information available to staff, service users and relatives. The arrangements for protection need strengthening to ensure staff have access to the local authority training on safeguarding adults to protect service users from harm and abuse. EVIDENCE: The manager stated the home had a complaints policy which is available in the policies and procedures file and the inspector noted complaints information in the service users guide. The manager stated the home had a complaints folder which was sampled and no complaints were recorded. During discussions a staff stated she was ‘‘aware of the complaints procedure’’ and a service user remarked ‘‘Generally, I am happy with things. I have no reason to complain’’. The home had a policy on safeguarding adults and an up to date copy of the local authority (surrey county council) procedures on the protection of vulnerable adults. The inspector noted no concerns or allegations in respect of safeguarding adults were raised since the last inspection by the CSCI (commission for social care inspection) and confirmed by the manager. A review of records indicated staff are booked to attend training in safeguarding adults and following discussions with the manager a requirement has been for the home to do an action plan to meet the training needs of staff in respect of this matter to protect service users from abuse. During discussions a service user commented ‘‘staff are helpful, very good, nothing is too much for them.’’ Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 15 Oakfield DS0000013342.V308328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19&26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for the premises are adequate ensuring service users live in a safe and comfortable environment. The systems for hygiene are adequate ensuring the home is clean and hygienic for service users. EVIDENCE: The premises is safe and well maintained and the garden is tidy, attractive and accessible to service users. The home has a programme of maintenance and the manager stated there are plans to extend the home and improve the quality of accommodation for service users. The inspector noted the home had taken appropriate action to comply with fire regulations following a report by the fire safety advisor to promote the health and safety of staff and service users. On the day of the inspection the home was clean and free from mal odour and the manager stated the home had policies and procedures for the control of infection and staff had infection control training reflected in training records. Observations confirmed the home had a laundry room with sluicing facility and staff practiced infection control measures by using gloves, aprons Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 17 and washing their hands regularly to prevent the spread of infection in the home. Oakfield DS0000013342.V308328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29&30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing are adequate ensuring there are sufficient number of staff to meet the needs of service users. NVQ (national vocational qualification) training for staff is good ensuring service users are in safe hands at all times. The systems for recruitment of staff are satisfactory protecting service users from harm or abuse. Induction training is adequate ensuring staff are trained and competent to do their jobs. EVIDENCE: On the day of the inspection the home was adequately staffed and the registered manager, five support workers and a cook were on duty which was reflected on the duty roster. During discussions a staff stated ‘‘staffing levels at the home are good’’ and the manager commented the home had no vacancies. A service user remarked ‘‘ I am very well looked after here, thank you’’ and a relative commented ‘‘all staff are caring, kind and cheerful, the catering and OT are excellent, too’’. A review of records indicated twelve care staff have NVQ (national vocational qualification) training equivalent to 85 of the staff team to ensure service users are in safe hands at all times. A relative commented ‘‘I have always been satisfied with the standard of caring in the home, staff always helpful’’. The manager stated the home had a policy on recruitment and the inspector sampled recruitment files which had completed application forms, references, statement of terms and conditions, CRB (criminal records disclosure) information and a recent photograph of the Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 19 employee to protect service users from harm or abuse. The manager stated the home had an induction checklist and staff working at the home have induction training which covered the values and principles of care, policies and procedures, health and safety and was dated and signed by the supervisor and employee. During discussions staff stated the ‘‘manager is very good and committed to staff training and development’’. Oakfield DS0000013342.V308328.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35&38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for the day to day management of the home are adequate ensuring service users live in a home which is run and managed by a person fit to be in charge of the home. The systems for quality assurance are adequate ensuring the home is run in the best interests of service users. Policies and procedures for managing service users’ money are satisfactory ensuring the financial interests of service users are safeguarded. The arrangements for safe working practices need strengthening to safeguard the welfare of staff and service users. EVIDENCE: The home has a registered manager who provides management stability, leadership and direction to the staff team. The manager has a professional nursing qualification and the RMA (registered managers award). The inspector Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 21 noted there are clear lines of accountability in the home and the manager is aware of his role and responsibilities. During discussions staff stated ‘‘the manager is very good, he works alongside staff and provide advice and support’’ and a relative commented ‘‘Oakfield Nursing Home is Superb, it is more like a hotel than a home for residents with mental health problems’’. The manager stated the home had a policy on quality assurance and a review of records indicated the home had discussions with staff, service users and families to obtain feedback about the home. The inspector noted the home met the requirements identified in the CSCI (commission for social care) inspection report to improve quality and the homes policies and procedures have been reviewed in August 2006 and signed by the registered manager. The manager stated the home had a policy on service users money and service users had personal accounts at a local post office to safeguard their financial interests. The inspector sampled finance records and noted it was up to date, correct, signed by two members of staff and available in the office for information. The home had a health and safety policy and staff have training in health and safety, first aid, food hygiene, infection control and moving and handling. A fire risk assessment was carried out on the 07/05/06 by an independent fire safety advisor and appropriate action taken. The home had a policy on COSHH (control of substances hazardous to health) and observations confirmed COSHH products were stored in a locked cupboard and the home had data sheets to promote the health and safety of staff and service users. The kitchen appeared clean, hygienic and food was appropriately stored. Fridge and freezer temperatures were within normal limits to promote good food safety. Following discussions with the manager a requirement has been made for the home to carry out a legionella test to promote the health and safety of service users and a copy sent to the CSCI (commission for social inspection) for information. Oakfield DS0000013342.V308328.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Oakfield DS0000013342.V308328.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 Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP18 Regulation 13(6) Requirement Timescale for action 01/10/06 2. OP38 12(1)(a) 13(3) The registered person must complete a training plan in respect of staff training in safeguarding adults and a copy sent to the CSCI (commission for social care inspection) to safeguard the welfare of service users. The registered person must 01/10/06 ensure a legionella bacteria test is carried out on the premises to promote the health and safety of staff and service users. 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 *RCN Good Practice Recommendations No recommendations were made at this inspection. Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oakfield DS0000013342.V308328.R01.S.doc Version 5.2 Page 25 - 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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