Inspection on 08/09/05 for Oakhaven Residential Care Home

This inspection was carried out on 8th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Oakhaven Residential Care Home 27/03/07

Oakhaven Residential Care Home 31/01/06

Oakhaven Residential Care Home 25/01/05

Oakhaven Residential Care Home 15/09/04

Oakhaven Residential Care Home 12/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Oakhaven Residential Care Home 136-140 Hales Road Cheltenham Gloucestershire GL52 6TB Lead Inspector Sharon Hayward-Wright Unannounced 8 September 2005 @ 10:30 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. Oakhaven Residential Care Home Version 1.40 D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Page 3 SERVICE INFORMATION Name of service Oakhaven Residental Care Home Address 136-140 Hales Road Cheltenham Gloucestershire GL52 6TB 01242 528377 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) Oakhaven Residential Care Home Limited Mrs Myra Arnot & Mr Ralph Holland Care Home 27 Category(ies) of OP OLd Age (27) registration, with number of places Oakhaven Residential Care Home Version 1.40 D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 25/1/05 Brief Description of the Service: Oakhaven is an adapted and extended three-storey Edwardian style house, situated on the main bus routes and within walking distance of local shops, near the centre of Cheltenham. The home provides accommodation for twenty-seven older people. There is a lounge and dining room on the ground floor with the service areas and staff office. Staff sleep-in facilities are located on the top floor of the home, which is not accessible to service users. All service users bedrooms are situated on the ground and first floor and all have hand washbasins and are single occupancy. Sixteen of the rooms have en-suite toilets. A shaft lift and stairs provide access to the first floor, although in some areas of the home service users are required to negotiate stairs to their rooms; these tend to be rooms for more able service users. There is access to a level well-maintained garden to the front and side of the home, which can be used by service users and their visitors. Oakhaven Residential Care Home Version 1.40 D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours on one day in September 2005. Six service users were spoken with to gain their views on the home; the care of three service users was examined in detail and the Registered Manager/Provider and two staff members were also spoken to. Staff were observed going about their duties and interacting with each other and service users. The recommendation made at the last inspection was followed up and records relating to service users care, medication, duty rotas, staff training, staff personnel files and servicing of equipment were inspected and a partial tour of the home took place with a number of service users rooms inspected. No requirements were issued at the last inspection. What the service does well: The home has a clear and consistent care planning system in place that provides staff with the information they need to satisfactorily meet service users needs. The standard of the environment within this home is good providing service users with an attractive and homely place to live. Service users feel the staff have a good understanding of their needs and they have developed positive relationships that help to improve the quality of their lives. The Registered Managers are supported well by their senior staff in providing clear leadership throughout the home, with all staff observed demonstrating an awareness of their roles and responsibilities. Service users complimented the food provided by the home. Oakhaven Residential Care Home Version 1.40 D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Page 6 What has improved since the last inspection? 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 Residential Care Home Version 1.40 D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc 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 Standards Statutory Requirements Identified During the Inspection Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 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 standard(s) 3 & 5 Service users needs are assessed prior to their admission to ensure the home can meet their needs. Prospective service users their friends/relatives can visit the home prior to admission to allow them to make an informed choice about admission to the home. EVIDENCE: Three recently admitted service users care plans were examined and all but one had a comprehensive pre admission assessment as one service user was from out of the area; however the home had obtained information about the service user before making the decision as to whether the home could meet their needs. Either the service user and/or their friends/relatives had visited the home prior to the service user moving in. All three-service users said they are very happy living in the home. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 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 standard(s) 7, 8, 9 & 10 The home has a clear and consistent care planning system in place to provide staff with the information needed to satisfactorily meet service users needs. Service users are able to access health professionals when needed. The medications systems on the whole are well managed but the home must ensure that medication is stored securely during the administration process. Service users feel their privacy and dignity are respected. EVIDENCE: Three service users had their care examined in detail; all had admission details to include next of kin and medical information. An assessment of their needs was also completed and from this their care plans are devised. Reviews were seen on a monthly basis and in the majority of cases the service user or their representative had signed these. One service user needs encouragement to maintain their fluid levels each day, but the home had not devised a care plan for this as the Deputy Manager said the staff in the home encourage and monitor all service users fluid intake. It is recommended that because this was documented on this service user’s hospital discharge information that a care plans is devised. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 10 Evidence was seen of health professionals input and one service user said they are due to visit the GP for a minor operation. Moving and handling assessments were completed on the service users whose care was examined in detail and the Deputy Manager said all service users have a moving and handling assessment. The homes medication systems were examined. Records were seen of medications received into the home, administered to service users and returned to the local pharmacy. It is recommeded that the home stores Temazepam as a controlled medication in a locked controlled medication cupboard as required under The Misuse of Drugs (Safe Custody) Regulations 1973. The Deputy Manager said this was addressed during the inspection and the local chemist contacted for assistance. The systems for administration of medication were examined and it was found that the medication is not always stored securely during administration in certain parts of the home. This was discussed with the Deputy Manager and the Registered Provider/Manager. The Deputy Manager was going to address this as a matter of urgency. Evidence was seen of an up to date medication reference book, specimen staff signatures list and a controlled drugs record book. It was felt that the best option for the home was for the Commission for Social Care Inspection Pharmacy Inspector to visit the home to provide advice and support in relation to the homes medication systems. This standard will be scored at a 2 until reviewed by the Pharmacy Inspector. Service users all said that the staff respects their privacy and dignity and examples given were staff knocking on their doors prior to entering, addressing them with their preferred form of address and receiving their post unopened. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 11 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) EVIDENCE: No standards were assessed in full at this inspection, however service users’ said activities are provided and they can choose whether they wish to participate. Service users’ said that visiting is flexible and their relatives/friends can take them out if able. All service users’ said how much they enjoy the food provided by the home. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 12 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) EVIDENCE: No standards were assessed in this section. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 13 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, 24 & 26 The standard of the environment within the home is good providing service users with an attractive and homely place to live. EVIDENCE: A partial tour of the home took place with a number of service user’s rooms seen with their permission. The home is decorated to good standards and from the partial tour no issues were identified apart from the carpet on the rear staircase as it is starting to look worn in places and must be monitored. One service user said he is very happy with his room, as it overlooks the garden. Service users personal possessions were seen in the rooms examined. The home was very clean with no odours on the day of the inspection and service users said the home is always maintained to these high standards. Staff were seen wearing protective clothing when required. The laundry is sited away from food preparation area. The home does not have a sluicing facility. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 14 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, 29 & 30 Staff morale appeared good, which results in an enthusiastic workforce that works positively with service users to improve their whole quality of life. Since the last inspection the standard of vetting and recruitment practices has declined with a small number of the appropriate checks not being carried out and this could potentially put service users at risk. A training programme is provided by the home to ensure staff are provided with the skills required to meet service users’ needs. EVIDENCE: Duty rotas were seen as evidence of staffing levels. On an early shift the home has four care staff and a senior carer. On an afternoon shift there are three care staff plus a senior carer. On the night shift the home has two care staff, one waking and one sleeping in. The Registered Manager and Registered Provider/Manager are extra to these numbers working office hours in the week. The care staff undertake additional duties to include, cleaning, laundry and working in the kitchen. Additional staff are employed to undertake the preparation and cooking of meals and maintenance issues. All service users spoken with praised the staff saying they are very good and always willing to help them. All said they had good relations with the staff. The personnel files of recently appointed staff were examined. It was found that only one had one written reference and not two as required. One did not have a full employment history as required and one member of staff had Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 15 started working at the home without a POVA check being completed and returned to the home. The home has applied for Criminal Records Bureau check (CRB). The home must ensure that all the required checks as directed under the Care Homes Regulations are carried prior to the member of staff starting at the home. The home met this standard at the last inspection. Evidence was seen of new staff being appointed a supervisor. An induction booklet, that the Deputy Manager said is devised along the guidelines of the National Training Organisation and meets the needs of the home, was seen. The home is looking to review their foundation programme. A number of staff training files was seen and these included evidence of training in moving and handling, first aid, basic food hygiene and fire. There was no evidence that infection control training had been provided. As no issues were identified with infection control at this inspection, it is recommended that this training be provided. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 16 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, 37 & 38 Service users’ feel the homes management team are of good character, friendly and approachable. Ensuring that the health, welfare and safety of service users are promoted and protected. EVIDENCE: A recommendation made at the last inspection, for the Registered Managers to undertake the NVQ 4, has not been addressed and has been made again at this inspection. All service users spoken with said the Management team of the home were approachable and friendly and they could approach them if they had any concerns. It is recommended following the amendments to the Data Protection Act last year that CRB disclosures are stored securely but separately from the staff personnel files. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 17 Evidence was seen of servicing of equipment to include fire, however no evidence was seen of water temperatures being checked. This will be followed at the next inspection. At previous inspection the Registered Managers have shown evidence that they are aware of other relevant legislation. Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 18 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 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 3 x x x x 2 2 Oakhaven Residential Care Home D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 19 no 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 29 Regulation 7, 9, 19 & Schedule 2 Requirement Since the introduction of the POVA scheme, and the amendments to the Care Home Regulations on the 26/7/04 for pre-employment checks on staff, the Home must obtain the following for all staff recruited since this date: 1) A POVA check. 2)Two written references, including, where applicable a reference relating to the person’s last period of employment, which involved work with vulnerable adults, of not less than 3 months duration.· 3)Full employment history with satisfactory written explanation of reasons for gaps in employment. Timescale for action 14/11/05 and ongoing 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 7 Good Practice Recommendations The home should devise a care plan for the service user D51_D03_16518_Oakhaven_v239402_UI_170805_stage4.doc Version 1.40 Page 20 Oakhaven Residential Care Home 2. 3. 4. 9 30 37 that needs encouragment and monitoring with their fluid intake. The home should find out if their Controlled Drugs cupboard complies with The Misuse of Drugs (Safe Custody) Regulations 1973 The home should provide infection control training for staff. The home should store staff CRB disclosures securely but separately from their personnel files. 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