CARE HOMES FOR OLDER PEOPLE
Oakhaven - City of York Council 144 Acomb Road York North Yorkshire YO24 4HA Lead Inspector
Ms Anne-Marie Foster Unannounced Inspection 18th January 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 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. Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Oakhaven - City of York Council Address 144 Acomb Road York North Yorkshire YO24 4HA 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) 01904 791599 01904 784 985 City of York Council *** Post Vacant *** Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: Oakhaven is a care home run by City of York Council and is registered to provide a service for 27 older people of either gender aged over 65 years who do not have any specialist requirements. Oakhaven was purpose-built approximately 50 years ago and is located within a short walk of Acomb Village centre. The accommodation is provided in single rooms on two floors. The upper floor is accessible via passenger lift. Structural alterations have been completed to create more open lounge space and additional toilets. Up to 6 day care places per day are available. Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on 18th January 2006.This was an unannounced inspection and a previous inspection had taken place on 5th July 2005.The inspection took 3 and a half hours to complete, plus 4 hours preparation time. A tour of the home was carried out and discussions were held with the service users and staff. There were opportunities to observe how staff interacted with the service users. A sample of both service user, and staff files were inspected, and a check was made that the home had complied with the recommendations and requirements of the last inspection. Feedback was given at the end of the inspection to the manager. What the service does well: What has improved since the last inspection?
Areas identified at the last inspection that required improvement have been addressed. Care plans have been developed and improved and so help to identify care needs, though these should become more individualised. A statement of purpose and service user guide has been developed – they are helpful, clear and concise. The manger of the home is now responsible for keeping staff records. The pharmacist has been in to the home to check the homes administration of medication system, to ensure that medicines are given to residents as safely as possible. A survey of residents, to assess their views on ‘cook chill’ meals that are then reheated in the kitchen, was carried out, and overall the residents said that they enjoyed this food. Regular in-house training to help staff identify and report adult abuse has started and is ongoing. Staff supervision now takes place regularly and is recorded.
Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 6 The equipment that was noted to be stored in communal /public areas has been tidied away preventing any unnecessary hazard. 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. Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 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 Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 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): 3 and 6 Service users and their families can be assured that their needs can be met by the home. EVIDENCE: The manager of the home goes out to assess any prospective service user, either in their own home or in hospital, and includes any other information from e.g. family or GP that is relative to this pre-admission process. The home has detailed information about the service in the service user guide, and there is a concise statement of purpose available. The home is not offering any form of intermediate care at present. Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 9 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, and 10 Service users needs are set out in a plan of care, and service users are treated with respect EVIDENCE: The manager and staff have developed care plans for the service users, and these have been reviewed regularly since the last inspection. This will help staff to understand the care needs of the service user. Further development of more individualised care plans will be beneficial to both staff and the service user. The staff were seen to be calm, and respectful in their manner, maintaining the dignity and privacy of the service user. Service users spoken to, were pleased with the caring attitude of the staff ‘ the staff are kind to us’. Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 10 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 Service users are generally happy that the quality of life at Oakhaven meets with their expectations . EVIDENCE: Service users said that they were happy living at Oakhaven. Two service users spoken to said that there ‘isn’t much to do here’, and the lack of organised activities was noted at the last inspection. The manager has recognised this and 2 care assistants have been appointed as activities organisers, but this is not separate to working as care assistants. Activities are being planned for Wednesday and Friday afternoons. Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 11 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 Service users, their relatives and friends can be confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: The home has a complaints procedure, and there is a clear outline of this in the new service user guide and statement of purpose. Residents knew what to do if they wished to raise any concerns, and staff questioned also knew how to report and deal with complaints. The home has started to provide in-house training using local authority guidelines and procedures, to enable staff to recognise and prevent adult abuse. Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 12 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): 25 and 26 Service users live in a home that, on then whole is well maintained and safe, however there are two exceptions. EVIDENCE: Since the last inspection the area where equipment was stored that was thought to be unsafe and untidy has been cleared away, old wheelchairs and unused Zimmer frames have been disposed of and the corridors and communal areas are clear. The home has a general no smoking policy, though it does have a smoking area in the conservatory for the service users. On the day of inspection, the main corridor around the smoking area smelled of fresh and stale cigarette smoke. The extractor fan was working, however the smell of smoke invaded the non-smoking areas around the conservatory. The alarm call system does work but is obsolete and intrusive, visitors have to wait an above average length of time to be let into the home - this is because the staff have to walk some distance to turn the alarm off before they can answer the call/door.
Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 13 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): None of these standards were inspected on this occasion. EVIDENCE: Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 14 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): 33 and 38 The service users live in a home, run with their best interests as the priority, by a new, but experienced manager. EVIDENCE: The registered manager has introduced some changes in order to improve care, and in-house training and supervision for staff take place regularly. Staff records have now been obtained from the City of York Council; these were inspected and found to be in order, containing all of the documentation required by regulation. These improvements will contribute to the health and welfare of service users and staff. The views of the service users have been sought about the quality of the brought in meals; the overall result was that the service users were happy with these meals. As a quality assurance exercise, further monitoring systems based on seeking the views of the service user, their family, friends, and other contacts, about other areas would be useful.
Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 15 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X x 2 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 2 Oakhaven - City of York Council DS0000034921.V275441.R01.S.doc Version 5.1 Page 16 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. Standard Regulation Requirement Timescale for action 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 3 4 5 Refer to Standard 12 26 19 28 33 Good Practice Recommendations The home needs to further develop organised activities for the service users. The registered manager needs to take a review of the area that is used for cigarette smoking, as the smell of cigarettes is apparent in the non-smoking areas. The registered manager needs to continue to campaign for a replacement alarm call system and a plan should be drawn up. 50 of care staff should be qualified to NVQ2 standard by 1/6/06 The registered manager of the home needs to further develop a quality assurance and quality monitoring system seeking the views of the service user, family, friends and others to measure success and to enable improvements to the service. Regular, recognised training, and consistent supervision should continue, this will enable staff to maintain safe working practices.
DS0000034921.V275441.R01.S.doc Version 5.1 Page 17 6 38 Oakhaven - City of York Council Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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