Inspection on 06/11/06 for Oakhill House

This inspection was carried out on 6th November 2006.

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 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

Oakhill House 15/09/05

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 J Hough Key Unannounced Inspection 6th November 2006 11:30 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 Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakhill House Address Eady Close Highlands Road Horsham West Sussex RH13 5NA 01403 260801 01403 264972 Purdycupa.com www.bupa.com BUPA Care Homes (BNH) Limited 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) Filipe de Pina Muller Care Home 47 Category(ies) of Dementia - over 65 years of age (47), Old age, registration, with number not falling within any other category (47) of places Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Old Age, not falling within any other category (OP) x 47 male and female. Dementia - over 65 years of age (DE(E)) x 47 male and female. The total number of persons accommodated should not exceed 47 of either sex. No service users under the age of 65 may be admitted. Date of last inspection 15th September 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 premises were purpose built and are 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 vertical lift is in situ. Communal lounges and dining 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 Registered Manager for the home is Mr Filipe de Pina Muller who is responsible for the day- to- day running of the home. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken by one inspector on 6th November 2006 starting at 11.30am and ending at 4.30pm. Information, and planning for the inspection process was taken from the registered provider’s monthly monitoring reports, evidence from previous inspections, along with the evidence gained during the inspection visit for this inspection report. A tour of the premises was made and records were examined with regard to resident’s care plans and assessments, staff files, complaints and accident logs, medication, and maintenance of the premises, equipment and systems within in the home. Four members of staff and two visitors were spoken with. Due to the residents mental frailty it was difficult to obtain their views about the home and the care that is provided. However observations were made throughout the day of the interactions between staff and residents. There were no outstanding requirements from the last inspection and one requirement was made as a result of this inspection in relation to the recording of complaints. The range of fees are from £519.00 to £1287.05 per week. What the service does well: The home is comfortable and well maintained and on the day of inspection was clean and fresh. Staff are given regular training so that they are competent to carry out their work and observations made of the interactions between residents and staff showed staff had patience and understanding of resident’s individual needs. A good variety of nourishing food is on offer and special diets are well catered for. Residents are given every opportunity for stimulation with the varied programme of activities and two activity organisers in post. The home has a large activity centre and employs two activity organisers. The choice of activities and events give residents opportunities for stimulation, taking into account their individual capabilities. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 6 The visiting arrangements for the home are open and visitors said they are always made welcome. 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. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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 Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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): 3,6 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. Prospective residents have a needs assessment carried out prior to admission to the home. The home does not provide intermediate care. EVIDENCE: The BUPA Care Homes policy states that residents admitted to the home have a pre-admission assessment completed involving the resident and relatives where appropriate, to ensure that the home is able to meet their individual needs. The home manager or designated person will carry out the assessment in the prospective resident’s home or current residence. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 9 Four care notes were seen and evidence was available that a detailed preadmission assessment was carried out prior to any agreement for admission to the home. The home does not provide intermediate care. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10. Quality in this outcome was good. This judgement has been made using available evidence including a site visit to this service. The care planning system ensures that the needs of residents are fully met. The medication procedures carried out in the home ensure safe practice. Residents are treated with respect and their privacy upheld. EVIDENCE: Three care notes including care plans and assessments were examined as part of the case tracking of residents. Care plans and assessments were detailed in giving all the information and needs of each resident including the level of assistance required by staff. Risk assessments were routinely in place for moving and handling and nutrition as well behavioural assessments for those residents presenting with challenging behaviour. Residents were routinely weighed each month or more frequently if needed. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 11 It was noted that where care plans identified such needs as regular toileting, actions were not specific in giving the time frequency of toileting needs for individual residents. However, toileting charts were completed as evidence of when residents were prompted or taken to the toilet. The residents sitting in the lounge were neatly dressed and all appeared content and relaxed. Care notes gave evidence of GP and other health professional visits, and care staff completed daily records showing the care given. Care plans were signed and agreed by relatives wherever possible. Consent was given for any restraint used such as bed- sides. The incidences of pressure sores were recorded and the appropriate equipment was seen in place for those assessed as high risk of developing pressure sores. The medication records seen were accurately completed and maintained. All medicines were stored and disposed of safely. None of the residents were able to administer or handle their own medicines so the trained nurses took on this responsibility. Staff were aware of the importance of respecting the privacy and dignity of residents and observations of staff assisting residents to the bathroom showed that this was done in a sensitive manner, and any care was given individually and behind closed doors. All new staff as part of the induction training have a session on the privacy and dignity of residents. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 12 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. Quality in this outcome is excellent. This judgement has been made using available evidence including a site visit to this service. Residents can participate in a variety of activities of their choice. Residents are offered a varied choice of meals that are nutritious and wholesome. Residents are able to have visitors at any reasonable times. EVIDENCE: The home employs two activity organisers who work in the activities centre situated in the home. A varied programme of activities, outings and entertainment is provided for residents. Within the centre photographs of past events were displayed on walls that showed residents participating in varied events. On the day of inspection a singing and dancing session took place in the downstairs lounge where residents enjoyed songs from the past. Activities were arranged taking into account the capabilities, interests and wishes of residents. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 13 One to one’s were also carried out for those residents who chose to remain in their rooms. One visitor told the inspector that a party was being arranged to celebrate their 64th wedding anniversary and friends and family were invited. Photographs showed that special occasions were celebrated with residents, relatives and staff. A visitor confirmed that the visiting arrangements in the home were flexible and visitors could stay all day if wished. Visitors were made welcome and could have a meal on request. Due to the resident’s mental frailty none of the residents were able to handle their own financial affairs and money so relatives or an advocate take on this responsibility. Some resident’s rooms were seen furnished and decorated with their own personal possessions from home. Samples of the four- week autumn menus were seen and showed that a wellbalanced and varied diet was offered. A cooked breakfast was available on request. The menus gave no alternative choice for the main meal, but it was confirmed that alternatives were offered when needed. Menus were developed taking into account residents likes and dislikes in food. Special diets were catered for, and it was noted during lunchtime that many of the residents required a pureed diet that was well presented in dishes with separate sections for meat and vegetables. Lunchtime was observed in both dining rooms. It was noticed in the upstairs dining room that many of the residents required assistance with eating and drinking and due to the high dependency levels of residents staff were responsible for feeding more than one resident at a time. Although this is not ideal, staff carried out this task in a dignified and sensitive manner. Fresh fruit, yoghurts, biscuits and bread were available at all times for residents. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome is adequate. This judgement has been made using available evidence including a site visit to this service. A complaints procedure is in place although written evidence was not available to show that complaints were acted upon effectively. Residents are protected from abuse. EVIDENCE: The complaints procedure is displayed around the home and is also contained in the Service User Guide situated in resident’s rooms. The complaints log was read to determine whether complaints were dealt with following the home’s complaints procedure. The complaints procedure states that a formal written record is made of all complaints including even those resolved immediately. There had been 20recorded complaints since February 2006. Complaints were recorded on summary sheets giving a brief outline of the complaint, but gave no information on the investigations, actions and outcomes. Four comment cards completed by relatives showed that they knew who to speak to in the home if they were unhappy with the care provided. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 15 Visitors spoken with said they would not hesitate to discuss any matters of concern with the manager or deputy manager. Staff spoken with confirmed they had regular training on abuse and demonstrated they understood their individual responsibilities in reporting any incidents or allegations of abuse in the home. The induction training for new staff also includes Adult Abuse. Staff training records were not available to check dates for training. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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): 19,26 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. Residents live in a safe, clean and well -maintained home. EVIDENCE: A tour of the premises was made and all areas of the home were generally clean and fresh. The home has to cope with numerous problems of spillages of food and drink by residents and due to this some areas of carpets were stained. There is an on-going programme of maintenance and areas of the home were decorated when needed. The grounds were kept neat and tidy and accessible to residents. Infection control procedures were understood and upheld by staff as staff wore disposable aprons and gloves where appropriate. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 17 Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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. Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. Residents are cared for by experienced and competent staff. Recruitment procedures ensure residents are protected from harm. EVIDENCE: Staff rosters showed that staffing numbers were maintained during the night and day although on some days the numbers of trained nurses varied. Staff spoken with felt the staffing numbers were sufficient for them to care for the residents, although there were times during the morning period when it was very busy. A comment card received stated that the general level of care was excellent in the home but there were pressures on staff from time to time, due to the high dependency of residents. It was observed at lunchtime in the upstairs dining room that many of the residents required assistance with eating and drinking. Therefore the staff had to assist more than one resident at a time. However this was done in a sensitive and dignified manner and residents were not rushed and given time to digest their food. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 19 The home had recruited some new members of staff from overseas and had recently advertised some staff vacancies locally, with a good response. It was confirmed that agency staff were rarely used. Four staff files were seen of new staff. All staff had a Protection of Vulnerable Adults (POVA) and a Criminal Records Bureau (CRB) checks carried out, but not in all instances prior to starting work. It was highlighted that Criminal Records Bureau checks are taking long periods of time to be returned. However, a new member of staff confirmed that during this interim period of waiting for checks, induction training was given and all work was carried under constant supervision. Evidence was on staff files that all new members of staff complete induction training on commencement of employment. The statement of purpose for the home states that six care staff are qualified to NVQ level 3 and ten care staff are qualified to level 2. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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): 31,33,35,38. Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The home is run by an experienced manager. The residents are protected from harm as far as practicable. EVIDENCE: The registered manager is a qualified registered mental nurse with a management qualification with 24 years experience in nursing people with mental health problems. Since 1988 his career has been dedicated to nursing older people with all forms of dementia. From discussions with staff it was clear that the manager is approachable and staff feel able to discuss any matters with him. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 21 The organisational structure for the care home as stated in the Statement of Purpose, shows there are clear lines of accountability within the home. The manager is supported by regional and deputy regional directors and an operations manager from BUPA. BUPA Care Homes have a quality and development self-audit process for the purpose of monitoring the services provided in the home to ensure they are functioning to the best of their ability. This process is on going throughout the year and includes all departments within the home. Surveys from part of the quality assurance system and these are sent out by head office each year to gain the views of residents and relatives of the services provided. It was confirmed that surveys were in the process of being sent out by head office so the results and feedback from those survey were not yet available. Monthly visits under Regulation 26 are carried out, that monitor the premises, records maintained in the home, as well as discussions with staff, residents and visitors. Copies of the written reports from these visits were made available to the Commission. The home handles small amounts of money for residents that were held in named accounts for each resident. Records were maintained of all transactions and withdrawals documented both on computer and on file. The bursar in the home is the only person with access to resident’s accounts and money. Maintenance records seen showed all systems and equipment in the home were serviced and maintained at appropriate intervals. The accident records were checked and there were a high number of incidents, although mainly minor. Total being 245 accidents recorded from June 2006 to October 2006. Evidence was available that frequently occurring accidents and incidents were monitored and appropriate actions were put in place to protect residents as far as practicable. Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 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 4 X 3 X 3 X X 3 Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP16 Regulation 22(8) Requirement The recording of complaints must include the investigations, and actions taken in response to complaints Timescale for action 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakhill House DS0000024183.V312687.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000024183.V312687.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!