Inspection on 11/11/05 for Oakfield House

This inspection was carried out on 11th November 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 10/05/05

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 Mrs Marie Dickinson Unannounced Inspection 11th November 2005 10:30 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 Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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 House DS0000052388.V265649.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakfield House Address 2/4 Edith Street Nelson Lancs BB9 9HU 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) 01282-612788 Oakfield Care Ltd Care Home 37 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (18), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (4), Old age, not falling within any other category (14) Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Company must at all times, employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection Within the overall registration of 37, a maximum of one named service user who falls into the category DE may be accommodated. 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) 10th May 2005 Date of last inspection 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 ramped to allow access for residents. 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 DS0000052388.V265649.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the second inspection this year at Oakfield House. It was unannounced. The process involved checking if the right action to improve in areas that were seen as falling short of meeting standards during the previous inspection had been taken. Written information and records relating to residents and staff employed was looked at. Time was spent talking to the people who live at the home, visitors and staff on duty. Observations were made of the care provided in line with National Minimum Standards and the residents gave some account of their personal experiences of life for them in the home. What the service does well: Admissions were dealt with properly. Since the last inspection this included an emergency admission, and a planned admission. Sufficient information was recorded to write a plan of care for each resident. Advice was taken from other professionals. Residents were given contracts. Staff that had been trained in special care for people with dementia cared for residents living in the home. Staff knew residents needs and worked as key workers to a number of residents. This helped to personalise care. Residents were happy with the carers Activities were varied and suited all the residents. Staff had enough time to spend with residents to make sure they enjoyed these. One resident had brought his cat to stay in the home. This was very important to him. Meals served were homemade and offered choice. Mr Catherine and the staff are commended for the excellent support and care given to a resident who was currently dealing with the death of his spouse. Staff had instruction on handling the care of sick and dying, with good practice information on dealing with this available The environment continues to be improved with ongoing decoration. Credit is given to the staff in making sure the home is kept to a good standard of hygiene that is noticeable. Residents were involved in how they lived their lives. This included being consulted in their care planning and having regular meetings. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 6 Proper recruitment meant residents were protected and sufficient staff were employed to see to their needs. Staff working in the home were friendly and professional in their work. They were properly trained and the number of staff trained in a National Vocational Qualification in care exceeded fifty percent. Staff were supervised. Senior staff had special responsibilities to make sure residents were cared for properly and the accommodation was kept nice. General maintenance of the home was managed well and the health and safety of residents and staff considered. What has improved since the last inspection? What they could do better: Reviews of care plans should be regular for all residents benefit. In the event of a resident having to change their doctor, arrangements must be made for sufficient medication to be made available to cover this period. 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. Maintenance of the outdoor grounds must continue. As discussed during inspection, to meet with the requirement of registration a manager must be appointed and registered with the Commission. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 7 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 House DS0000052388.V265649.R01.S.doc Version 5.0 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 Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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 the following standard(s): 2,3,4,5 Assessments of residents admitted to the home, 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. Residents were given contracts. EVIDENCE: Residents had been assessed before they were admitted. The assessment of one resident admitted in an emergency, was detailed properly. The assessment showed how information recorded was used to provide staff with sufficient information about the resident’s circumstances and level of support required to give the right care. Another resident had first stayed at the home for short periods. This had helped when settling in on a permanent basis. Each person had a plan of care for daily living. 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. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 10 The range of needs of residents had been considered. Staff were trained in looking after residents with a variety of needs including dementia. Residents were given contracts. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10,11 Care plans were used to help staff to care for residents in a sensitive manner. Reviews of care plans were carried out and allowed for residents changing needs being dealt with promptly. However these must be kept up to date for everyone. Residents and relatives visiting were satisfied that care needs were met and they considered staff respected their privacy. Staff were professional in making sure people unable to express themselves properly were treated with respect. Good practice was observed in dealing with bereavement EVIDENCE: Staff continued to be involved with care planning and work to a key worker system. They had particular responsibilities for a number of individual residents. The progress made at the last inspection on improving care plans continued although reviews of need for all residents must be kept up. There was evidence that residents were involved in 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 was responsible to organise this. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 12 Those residents who could express an opinion said care staff respected their right to privacy. Two residents in the top floor bedrooms particularly liked the level of privacy they had. Personal care was given in privacy. Residents who had difficulty in saying what they wanted during the inspection were treated with respect, and staff had taken care in making sure their appearance was good. Records of medication were up to date. However care must be taken to make sure new residents who change their doctor do not run out of prescribed medication. Staff had been trained in safe administration of medication. Mr Catherine and the staff are commended for the level of support offered to a resident dealing with issues around loss of a spouse. The resident openly praised them for relieving the pressure of having to organise a funeral from the home. He said ‘everyone has been marvellous. My wife used to deal with things.’ Policies and procedures for dealing with care of the dying, and dealing with death and bereavement were good. sensitivity to the residents needs had been given. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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 the following 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. Staff had enough working time to accomplish this. Visitors were made welcome. Catering arrangements were to the resident’s satisfaction. EVIDENCE: One resident had brought his cat with him to live at the home. Staff helped him to care for it. He said ‘this meant everything to him’. Activities for residents were organised and continued to offer a good variety. An activities co-ordinator was currently being recruited to maintain this. Staff however said they were given time to organise various pastimes, which the residents said they enjoyed. Visitors in the home said staff made them welcome. One relative visiting said she ‘enjoyed the festive activities. She would definitely be having her Christmas dinner at the home.’ Observing staff at work showed how residents’ routine was suited to them. Good practice by staff meant residents pleased themselves when they get up or when they went to bed. Staff never rushed them and were available should Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 14 they need them. Equally residents with dementia were given the same control over their lives. Comments from residents indicated the food provided was very good. They were given proper choices and alternatives were also available. Menus were changed regularly and residents had a say in these. There were ample supplies of groceries and fresh produce provided and any special food a resident fancied would be bought. Staff were observed offering sensitive support to those people who could not manage to eat their meal without assistance. The meal time was relaxed and was flexible. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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 the following standard(s): 16,18 The complaints procedure was clear and managed properly. There were policies and procedures in place to ensure a proper response to any suspicion or allegation of abuse. Staff were trained to use these procedures 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. There were no recorded complaints since the last inspection. Abuse procedures and whistle blowing had been covered during staff induction training, and continues to be considered a high priority with staff. Staff knew 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 DS0000052388.V265649.R01.S.doc Version 5.0 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): There continues to be noticeable improvements in the environment of the premises. Residents were happy with their accommodation. The home was maintained to a good standard, and residents lived in a comfortable and homely place. Resident’s bedrooms were furnished and decorated to their liking. A good standard of hygiene continues to be achieved. Bathing facilities included assisted baths. All rooms had radiator protection and emergency call points. One bedroom required a length of piping covering. EVIDENCE: There was evidence of continuing improvement in the environment noted in the last inspection report. Care had been taken to create a homely atmosphere in the central lounge, and residents had the advantage of having three comfortable lounges to sit in. Most residents used the separate dining room. Residents and visitors to the home were pleased with the improvements. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 17 The en suite (shower and toilet) in the ground floor bedroom and the shower and toilet on the top floor had been decorated. This had improved the appearance of these areas. There is also a walk in bath on the ground floor for residents use. There was a call system in every room that people could reach. The top floor bedrooms that had been decorated and furnished as part of the upgrading of the premises had extra electric sockets fitted. However one bedroom still requires a long length off piping covered for safety. Resident’s bedrooms were kept to a good standard in terms of provision of furniture, bed linen and decoration. Residents own furniture was accommodated. Residents who were able managed their own bedroom door keys and staff had the responsibility to keep other residents rooms private for them. The overall standard of hygiene and cleanliness in the home was very good and the laundry was organised for efficiency in the care of resident’s clothes. The improvement seen in the last inspection has continued and credit is given to the staff for a difficult job. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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 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 satisfactory. Sufficient staff were employed to make sure all residents needs were attended to. Staff had delegated responsibilities. The position for activities co-ordinator was currently vacant. Staff however said they had sufficient time to spend with residents. One to one care and social activities was part of their role. Staffing hours for domestic work had been kept to a proper level and for general maintenance. The residents spoke highly of the staff. Visitors to the home during inspection were very happy with how staff cared for the residents in general and had no complaints. A good team spirit was noted as staff organised themselves during the day and helped each other where needed. The extra responsibility given to staff, such as medication management and health and safety was proving valuable to an efficient service. 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 Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 19 All the staff in the home continued to attend training following induction training given to new staff. Records were kept. Staff confirmed they were properly supported with training. The percentage of staff having completed a national vocational qualification in care level 2 was over 50 . Staff discussed how the home was run in the interest of the residents. They showed a genuine commitment to give residents a high standard of care, and were sensitive to individual needs of all residents. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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): To comply with a condition of registration a manager must be registered with the Commission. Guidance and support was given to staff. Mr Catherine monitored staff performance and had the support of senior staff in making sure these standards were kept. This was with delegated responsibilities, staff supervision, training and regular meetings. The arrangement for confidentiality of information was satisfactory. The management considered the health and safety of the staff and residents. EVIDENCE: A job description outlining the role and expectations of a manager has been finalised by Mr Catherine the owner of the home. At present Mr Catherine remains in control of day-to-day management of the home, with the support of senior staff. The position of appointing a manager was discussed in relation to expected qualifications for the post. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 21 Senior carers and staff working in the home said they were continuing to benefit from clear leadership. Mr Catherine had set high standards all staff were expected to achieve, and systems for monitoring these standards helped staff to take responsibility for their work. Staff also liked having particular responsibilities they managed. Regular meetings continue to be held for the staff and residents. Staff confirmed they received routine formal supervision. Records in the home were organised. Lockable filing cabinets were in use for the proper storage of records relating to residents such as care plans and assessments. Staff training in safe working practices including First Aid, Basic Food Hygiene and Moving and Handling was ongoing. Health and safety policies were available for reference. Maintenance was managed very well, and residents and staff safety considered. Proper records were kept of safety checks. Full compliance with the fire departments inspection had been recorded as completed satisfactorily dated the 8th November 2005. Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 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 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 4 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 3 3 2 3 X 3 2 3 3 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 2 3 3 X X 3 3 3 Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13(2) Requirement The registered person must make sure when a resident changes their doctor arrangements are made for sufficient medication to be available to cover this period. The registered person should ensure that pipe work is guarded in the top floor bedroom to protect an accident to the resident using this room. The registered person shall appoint a manager in respect of the care home. Timescale for action 12/11/05 2 OP25 13(4)(a) 27/05/05 3. OP31 8(1)(a) 31/01/06 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. 2. Refer to Standard OP7 OP19 Good Practice Recommendations It is recommended reviews of care plans are kept up to date. It is recommended that as part of the current grounds maintenance programme, the paving and path be levelled DS0000052388.V265649.R01.S.doc Version 5.0 Page 24 Oakfield House Oakfield House DS0000052388.V265649.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park 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 DS0000052388.V265649.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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