Inspection on 15/09/05 for Oakhill House

This inspection was carried out on 15th September 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

Oakhill House 06/11/06

Oakhill House 31/01/05

Oakhill House 05/01/05

Oakhill House 10/09/04

Similar services:

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

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

CARE HOMES FOR OLDER PEOPLE Oakhill House Eady Close, Highlands Road Horsham West Sussex RH13 5NA Lead Inspector Mrs S Rodgers Announced 15 September 2005, 09:30 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. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oakhill House Address Eady Close, Highlands Road, Horsham, West Sussex, RH13 5NA 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) 01403 260801 01403 264972 hughesle@bupa.com BUPA Care Homes (BNH) Post Vacant CRH(N)-Care home with nursing 47 Category(ies) of OP-Old age - 47 places, DE(E) Dementia - over registration, with number 65, 47 places. of places Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Old Age, not falling within any other category (OP) x 47 male and female. 2. Dementia - over 65 years of age DE(E) x 47 male and female. 3. The total number of persons accommodated should not exceed 47 of either sex. 4. No service users under the age of 65 may be admitted. Date of last inspection 31 January 2005 Brief Description of the Service: Oakhill House is a care home registered to provide nursing care for up to 47 residents over the age of sixty five with dementia. The premisis was purpose built and is located in a residential area of Horsham. Accommodation is provided on ground and first floor level. 43 rooms are for single occupancy, 2 rooms are double. 35 of the rooms have en-suite facilities. A verticle lift is in situ. Communal lounges and dininig areas can be found on both floors. There is also a garden lounge and an activities room on the ground floor. The service is owned by BUPA Care Homes Limited, the responsible individual on behalf of the organisation is Mr Stuart Pendlebury. The managers post is vacant. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 9 hours and was carried out as part of the routine programme of inspection. Preparation for this inspection focused on a review of previous inspection reports, general correspondence, pre inspection questionnaire material and comment cards received from thirteen relatives and nine service users. The comment cards from resident clearly indicate that they are generally satisfied with the services provided. Out of the thirteen comment cards received from relatives eleven included positive comments such as “Everything about the home, its staff and the care they provide for my mother is first class”, “since my mother arrived …… She has made a lot of progress. This is down to the quality of the care, the food and friendly caring staff” and “a very active atmosphere, a lot of thought given to activities and individuals and person centred care”. The two comments, which showed dissatisfaction with the service, were “Oakhill House has not got its priorities right over expenditure. For example, they are buying new carpets and curtains and they have changed to different cheaper pads which do not do the job properly”, this issue was raised with the deputy manager who advised the inspector that BUPA do not supply the pads, they come from the NHS so they have no say in which pads are provided. The second comment, “Three staff are usually on duty but when they have a break only one is left which I do not think is enough”. This pertains to the second floor staffing provision this was also addressed with the deputy manger who advised the inspector that staff are only allowed to go on breaks one at a time. During the course of the inspection the inspector toured the home, spoke with residents either privately in their own bedrooms or within the communal areas of the home in order to gain a sense of how the home is being run and how they or their relatives experienced living at the home. Five visitors were also spoken with. Comments will be included in the main body of the report. Three staff were spoken with in order to gain a sense of the support and training they receive in order to carry out their jobs and to gain insight into how their knowledge of the aims and objectives of the homes philosophy of care. From speaking with resident and their relatives the inspector gained the impression that the standard of care provided by the management and the care team is of a good standard. The inspector also took the opportunity to observe the interaction between both residents and staff. It was noted that the atmosphere within the home Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 6 was jovial and relaxed and that the staff carried out their duties in a respectful manner taking into account the dignity and privacy of residents. What the service does well: What has improved since the last inspection? What they could do better: The home would benefit from developing a recording system to provide evidence that all staff have received fire safety instruction at the recommended intervals of six monthly for day staff and three monthly for night staff. Staff should receive regular updates with regards action to take should they suspect Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 7 abuse of a resident. Residents should be provided with lockable storage space, which enables them to store their valuables or money. 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. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 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 Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 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) 2, 3 Residents receive a contract of terms and conditions on admission to the home. Residents or their relatives are enabled to make an informed choice regarding whether the home will meet their or their relatives needs. EVIDENCE: The pre admission assessments seen on all new admission indicate that health, personal and social needs of a prospective residents are reviewed, information gained at this time is used to devise a care plan for the prospective resident prior to them being admitted to the home. The pre admission assessment enables the management to determine that the needs of person admitted to the home can be met. The deputy manager confirmed that each resident now receives a copy of the homes terms and conditions on admission to the home. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,10 The health, personal and social care needs of residents, are being maintained. Resident’s privacy and dignity are maintained. EVIDENCE: Four care plans were seen at this inspection. Residents and relatives spoken with confirmed that they are aware that the information regarding their care needs are kept and that staff refer to them in order to meet their varying needs. One relative spoken with confirmed that she is kept informed of her relatives care needs and is also invited to the care plan reviews. One relative told the inspector that “ excellent care provided, staff are supportive, there is good communication with staff especially key workers and management come across as approachable”. Care plans contained all relevant information, including risk assessments for manual handling, nutritional assessments and use of bedrails. During the course of the inspection the inspector was able to observe staff maintaining resident privacy and dignity by knocking on doors prior to entering their rooms. Residents who were asked confirmed that staff ensure that they are appropriately covered when being taken to and from the bathroom. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.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) 12, 15 Resident’s benefit from a full activities programme. Meals provided appear well balanced. EVIDENCE: The home has two activities co-ordinators, one fulltime and one part time. The activities room is open all day enabling residents to come and go as they wish. The programme of activities is displayed within various areas of the home. Activities include arts and craft, quizzes, entertainments. Residents also go out on trips within the community, i.e. proms in the park, trips to the theatre and during this summer trips to the beach. There is also a forthcoming events programme; events include a Polish themed evening, a Butlins day that was held the weekend prior to the inspection. Residents and relatives told the inspector that they had a great day with staff dressed up as red coats. Games included a knobbly knees and a glamorous granny competition. Grandparent’s day and a think pink lunch in aid of Cancer Research are also planned. The home has its own mini bus in which residents can be transported on outings or trips to hospital, dentist, opticians etc. On the day of the inspection the inspector was invited to dine with residents’ at the “ladies that lunch” luncheon. Every two weeks ladies are invited to a special luncheon. Those who are going to attend devise the menu, the tables Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 12 in the activities room are laid up and the chef waits on residents. Five residents two staff and one visitor were present. The meal provided was well balanced and plentiful, residents are also offered a glass of wine. Male residents also have the opportunity to have their own luncheon; those who wish attend go for lunch at the local pub. Residents and their relatives told the inspector that all food provided by the home is of a good standard. As well as the main menu there is a “grazing” menu, the deputy manager advised the inspector that some residents due to their dementia can wander and that research shows that this can be caused by the resident being hungry, so the menu has food on it that are easy to eat “hand food” which residents can eat whilst walking round or sitting in the lounge. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 13 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) 16,18 Systems are in place to enable residents or their relatives to raise concerns with the management. Systems are in place to protect residents form abuse. EVIDENCE: Records of complaints received by the home indicate that the homes complaints procedure is put into practice should an individual raise any concerns. The Pre inspection questionnaire indicates that the home has had one complaint in the last twelve months, which was partially substantiated, and dealt with within agreed timescales. The home has BUPA’s policies and procedures for staff to follow should they suspect abuse of a service user. Staff spoken with told the inspector that they would report any suspicion of abuse of a resident with the management of the home. There was no record of when staff last received training in Adult Protection procedures. Adult protection training should be provided on a regular basis to ensure that all staff are aware of the procedures to be followed, indicators of abuse and the procedure, which will be followed, should an allegation be made. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 14 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 From touring the home the inspector was able to determine that residents benefit from a well maintained home. Resident bedrooms are appropriately furnished. The home well maintained, homely furnished and clean. EVIDENCE: Residents can furnish their rooms with personal possessions, which gives them a homely atmosphere. It was noted however that the linings of the curtains in room 30 were torn due to the sun perishing them; this was discussed with the deputy manager who gave her assurance that this issues would be addressed promptly. There is no lockable storage space provided in bedrooms in which money and valuables can be stored, residents should be provided with this facility and provided with a key that he/she can retain unless the reason for not doing so is explained in the care plan. The Standard of cleanliness throughout the home is generally of good standard. However, some individual rooms can develop an odour, every effort Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 15 is made to reduce this i.e. regular cleaning of carpets. Policies and procedures are in place with regards infection control and appropriate systems are in place to dispose of clinical waste. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 16 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 The staff mix on duty at the time of inspection were sufficient in number and skill mix to met the needs of the current residents. Residents are protected by the homes recruitment procedure. EVIDENCE: Information submitted with the pre inspection material and duty rotas seen at the inspection indicate that staff are employed in sufficient numbers to meet the needs of the current residents. Residents and relatives told the inspector that staff are “always helpful”, “supportive”, “can’t fault the staff, really friendly” and “staff generally excellent”. From observation through out he inspection the inspector noted that staff afforded residents with respect at all times and were knowledgeable with regards the needs of residents. The records of five recently employed staff were reviewed. The homes recruitment procedure has been followed for each employee and records kept as required by legislation. Staff spoken with during the inspection confirmed that they receive supervision. They confirmed that they feel supported and listened to by senior staff. One staff member said, “it’s not like a job, it’s a pleasure to work here, you get lots of support, it’s like a family”. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 17 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) 35, 36, 38 The financial interest of service users is maintained. The health and safety of residents and staff are generally promoted however; the home needs to demonstrate that all staff have received fire safety instruction. Supervision of staff promotes continuity of service. EVIDENCE: Residents and relatives confirmed that the management do not maintain the general finances of residents. Residents can if they wish ask for some money to be held in safekeeping. Appropriate systems are in place to record transactions. These are audited on a regular basis. Interest is paid directly to individual residents accounts when it falls due and if they have funds in the account. Records of transactions made on behalf of residents were seen an appeared in good order. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 18 Maintenance records were available which, clearly indicated that equipment is serviced regularly. Staff receive general health and safety training along side specific training such as manual handling, first aid and food hygiene. Fire training records seen on the day of inspection did not clearly demonstrate that all staff have received fire safety instruction at appropriate interval of six monthly day staff and three monthly night staff. Risk assessments of the physical environment of the premises were available. Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 19 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 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x x x 2 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x 3 3 x 2 Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 20 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. 2. 3. Standard 18 24 38 Regulation 13 (6) 12 23 (d) Requirement Staff must recievetrainging in Adult Protection procedures Residents must be provided with cockable facililities. Staff must recievefire safety instruction at recommended intervals 6 monthly for day staff and 3 monthly for night staff. Timescale for action 13.10.05 13.10.05 13.10.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Oakhill House H60-H11 S24183 Oakhill House V241912 150905 Stage 4.doc Version 1.40 Page 22 - 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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