Inspection on 10/05/05 for Oakfield House

This inspection was carried out on 10th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oakfield House 04/01/07

Oakfield House 11/11/05

Oakfield House 02/11/04

Similar services:

Thornton Lodge

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Oakfield House 2/4 Edith Street Nelson Lancs BB9 9HU Lead Inspector Marie Dickinson Unannounced 10 May 2005 10.00 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. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakfield House Address 2/4 Edith Street Nelson Lancs BB9 9HU 01282 612788 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) Oakfield Care Ltd Care Home 37 MD(E) OP DE(E) DE 4 14 18 1 Category(ies) of Mental Disorder registration, with number Old Age of places Dementia Dementia Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Company must at all times, employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 2. Within the overall registration of 37, a maximum of one named service user who falls into the category DE may be accommodated. 3. Should the service user referred to in 2 above be no longer resident in the home, registration should revert to fifteen people over the age of sixty five who fall into the category Older People (OP) Date of last inspection 2/11/04 Brief Description of the Service: Oakfield House is a detached residence, situated close to several shops. Most community resources are located within Nelson town centre. There is a bus stop near the home. There are steps leading to the front of the home and a ramp pathway with handrails. The garden areas at the front of the home are also were ramped to allow access for service users. There is an enclosed outdoor garden area for residents use. Accommodation provided is single and double bedrooms. The upper floors are accessible via stair lifts. There were aids and adaptations such as walk in bath provided to assist people, and all rooms in the home had a call system installed for the residents. There were several sitting rooms and a dining room. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. During the inspection the Inspector looked at written information and records relating to residents and staff employed. Time was spent talking to the people who live at the home, visitors and staff on duty. The Inspector also looked at how resident’s views were considered that affected their quality of life. Observations were made of the care provided in line with Minimum Standards and the residents gave some account of their personal experiences of life for them in the home. Areas that needed to improve from the previous inspection were looked at for compliance. What the service does well: Residents living in the home were cared for by staff that had been trained in special care of people with dementia. Activities were varied and suited all the residents. These included going out for meals, shopping and some residents said they were considering a summer holiday. Consideration was given in providing a relaxed homely environment for the residents in the home. Residents were involved in how they lived their lives. This included being consulted in their care planning and having regular meetings. Staff at the home were friendly and professional in their work. In residents opinions the quality of food served was very good. They particularly liked the choice offered and could have a meal when they wanted. The standard of hygiene was good and the laundry was organised for the benefit of the residents. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: To ensure the home is safe and comfortable, the pipe work running the length of one wall in a bedroom on the top floor, must be covered for the safety of the person occupying this room. In addition to this an additional double wall socket should be fitted to avoid the use of a multiple socket extension. The shower room on the top floor and shower room off a ground floor bedroom would benefit from upgrading. To comply with the findings of the Environmental Health Department inspection, a mesh must be fitted in the kitchen window. The manager appointed in the home must be registered with the Commission. Whilst there was evidence of continuing upgrading of the premises, outstanding requirements and recommendations made on previous inspections must be dealt with such as the outdoor cellar grid covering with safety mesh and the paving in parts levelling. The current office location for the manager and staff needs to improve in respect of the arrangement for confidential storage of information. Please contact the provider for advice of actions taken in response to this Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4, 5. Appropriate use of assessment information had identified that the home could offer care services for people making enquiries about the home. The assessments also contained sufficient information to write a plan of care. Staff were trained in dementia care and advice was taken from other professionals which assisted in providing the right approach to care for residents. The practice for dealing with an emergency admission was good. EVIDENCE: There had been several admissions to the home since the last inspection. Residents had been assessed before they were admitted. The assessments showed how the information recorded was used to provide the right care for the level of support for personal care required. Each person had a plan of care for daily living. One resident said she had been admitted ‘suddenly’ and had not had the chance to visit. However it was clear relatives had visited, and the resident received relevant information within a few days of admission. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 10 Records showed that the changing need of residents was responded to and advice taken from other professionals such as social worker, district nurse and psychiatric healthcare workers. The range of needs of residents had been considered, and staff were trained in looking after residents with a variety of needs such as dementia care. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 Care plans were used to help staff to care for residents in a sensitive manner. Regular reviews of care plans allowed for residents changing needs being dealt with promptly. Residents were satisfied that their needs were met and they considered staff respected their privacy. Staff were professional in ensuring people unable to express themselves were treated with respect. EVIDENCE: The staff said they were involved with care planning and work to a key worker system whereby they take on particular responsibilities for a number of individual residents. Some progress had been made in improving the writing of care plans, although they were generally brief. There was evidence that residents were involved in regular reviews. The resident’s healthcare and mental health care needs were identified and staff confirmed how these needs were met. These included visits from a chiropodist and their doctor when necessary. The continence advisor had also visited the home. A member of staff organised this. Residents were of the opinion that care staff respected their right to privacy, especially when they were attending to their personal care. This was also observed during the inspection. One resident said he liked his own company, Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 12 and was pleased staff ‘didn’t bother him unnecessarily’, and that he valued his privacy of space. Residents who had difficulty in saying what they wanted were treated with respect, and care had been given to their appearance. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Resident’s lifestyle experience of living in the home was generally to their liking. Activities were provided for everyone and people with dementia were catered for. Visitors were made welcome. Catering arrangements were to the resident’s satisfaction. EVIDENCE: Activities for residents were organised and offered a variety such as going for meals, entertainment in the town or just taking part in everyday activities such as dominoes or creative artwork. An activities co-ordinator was employed to organise the various pastimes, which the residents said they enjoyed. There were a number of visitors in the home who said staff made them welcome. Residents said the routine in the home suited them. There were no unnecessary rules to follow. They could please themselves when they get up or when they went to bed and staff were available should they need them. Staff were observed as being thoughtful towards residents with dementia, who were seen to move about freely, and were included in conversations and activities. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 14 Comments from residents indicated the food was up to their expectations. The cook said she discussed menus with them at their meetings. The groceries and fresh produce provided was more than sufficient and she could purchase any special food a resident fancied. Residents were given choices at meals and records showed alternatives were also given. Staff were observed offering support to those people who could not manage to eat their meal without assistance. Meal times were flexible. One resident who took part in a survey had written he was happy because he can have his meals when he wanted them. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 The complaints procedure was clear and accessible for residents and visitors to the home such as relatives. Peoples right to full citizenship had been observed. There were policies and procedures in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: There was a complaints procedure for residents to use. This was given to residents when they came to live at the home. A number of residents said they had no complaints, but if they did they would speak to the manager or any member of staff. There were no recorded complaints since the last inspection. Residents had voted in the general election. Staff said that abuse procedures and whistle blowing had been covered during their induction training. They discussed their responsibility to protect residents from abuse and considered it their duty to follow abuse procedures if necessary. A condition of employment for staff in the home prevents them having any financial gain from residents. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 23, 24, 25, 26 There had been a noticeable improvement in the physical environment of the premises, which had resulted in residents living in a safe comfortable home. Residents were able to move about the home freely and they were happy with their accommodation. A good standard of hygiene was achieved. The home was pleasant. EVIDENCE: There was evidence of improvement to the physical environment of the home. The central lounge had been decorated with new chairs provided. Residents could move freely about the home and as a result of this, a separate dining room is now a feature of the home. The residents were pleased with the decoration of the lounge. A contracted gardener was busy planting bedding plants. During the previous warm spell, residents said they had enjoyed sitting out. The outdoor garden area was safe and private. The cellar grid still required mesh fitting as a safety measure. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 17 The en suite (shower and toilet) in the ground floor bedroom and the shower and toilet on the top floor required decorating. The top floor bedrooms had been decorated and furnished to a good standard as part of the upgrading of the home. For these rooms to be fit for residents use an additional double socket was required in one room and pipe work covered in another bedroom for safety purposes. Residents were very happy with their accommodation. Some bedrooms had been recently decorated, and quality bed covers provided. Furniture and fittings were maintained and adequate for the residents needs, and in some rooms residents had their own furniture. The overall standard of hygiene and cleanliness in the home was good and the laundry was organised for efficiency in the care of resident’s clothes. This was a significant improvement since the last inspection. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 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 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, 28, 29, 30 The level of staffing was good and recruitment and selection procedures were satisfactory. Residents had confidence in the staff working at the home. Staff were given training relevant to their work and career development. EVIDENCE: The current level of staffing in the home was higher than that required by the Commission and rotas showed that this level was usual. There were additional people employed for organising activities, and for general maintenance. Staffing hours for domestic work had also been increased. The residents were very happy with the staff in the home. Staff said they had time for the residents and enjoyed their work. There was a good team spirit observed. Staff files showed recruitment checks to be complete and satisfactory. References and Criminal Record Bureau (CRB) and Protection of Vulnerable Adults(POVA) register check had been applied for, prior to employment Induction training had been given to new staff, and all the staff in the home had attended further specialist training such as dementia care. Staff said they enjoyed training and were encouraged to develop their career in care. Some Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 19 staff had been given extra responsibility because of this, such as medication management and health and safety. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 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 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, For residents and staff to benefit from leadership, the role of the manager must be clearly established. To comply with a condition of registration the manager must be registered with the Commission. Guidance and support given to staff in supervision, training and regular meetings had a positive impact for care of the residents. Residents and relatives views on the service provided were sought. The arrangement for confidentiality of information was not completely satisfactory. EVIDENCE: The manager of the home has been in this position for several months. She is currently working towards level 4 in National Vocational Qualification in care and management. There is concern however that an application to register the manager has not yet been received at the Commission. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 21 Mr Catherine the owner of the home said he had not yet finalised the managers’ job description, and he continued to be in control of day-to-day management of the home. The role and expectations of a manager must be clear in the job description given to the manager together with a contract of terms and conditions of her employment. Staff working in the home said they were benefiting from having a manger. There had been an improvement in their work such as having delegated responsibility for continence management and fire safety. Regular meetings were held for the staff and residents. Residents and their relatives had been quality satisfaction questionnaires to complete. The results of these showed confidence in the management and staff. Comments were noted such as ‘I am satisfied with all aspects of the home is run’ and ‘ I find all the staff helpful and friendly’. Staff confirmed they received routine formal supervision. Records in the home were organised, however the privacy of some records relating to residents was not satisfactory as the room used was also a thoroughfare for residents and visitors to the home. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 x 3 2 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 3 3 x x 3 2 x Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 23 yes 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 19 Regulation 13(4)(a) Requirement The registered person must place protective mesh or similar over the cellar grid at the front of the premises. The registered person must decorate the shower room on the top floor and in the en suite bedroom adjacent to the ground floor toilets. The registered person must install an additional double wall sockett in the top floor bedroom to avoid the need to use a multiple socket extension. The registered person should ensure that pipework is guarded to protect residents from accidents. The registered person shall appoint a manager in respect of the care home. Timescale for action 3/06/05 2. 21 23(2)(d) 29/07/05 3. 24 23(2)(n) 3/06/05 4. 25 13(4)(a) 27/05/05 5. 31 8(1)(a) 30/06/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 24 Oakfield House 1. 2. 3. 4. 5. 19 26 31 31 37 It is recommended that as part of the current grounds maintenance programme, the paving and path be leveled. It is recommended that a mesh be fitted to the kitchen window as advised by the Environmental health Department. It is recommended an application to register a manager be submitted to the Commission. it is recommended the managers job description enable her to to take responsibility for fulfilling her duties. It is recommended that alternative storage facilities of confidential records be made available for the manager and staff to use. Oakfield House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington BB5 5JB 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 House F57 F07 S52388 Oakfield Hs V223309 100505 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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