Inspection on 31/10/05 for Oakland

This inspection was carried out on 31st October 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

Oakland 03/03/08

Oakland 19/10/07

Oakland 23/08/07

Oakland 08/12/06

Oakland 05/05/06

Oakland 31/05/05

Oakland 10/01/05

Oakland 27/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Oakland Oakland Oakwood House Bury Road Rochdale Lancs OL11 5EU Lead Inspector Tracey Devine Unannounced Inspection 24th October 2005 10.00 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 Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakland Address Oakland Oakwood House Bury Road Rochdale Lancs OL11 5EU 01706 642448 01706642389 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) Southern Cross Home Properties Limited Care Home 40 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (22) of places Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 40 service users to include: 22 Older People (OP) 18 Adults with Dementia over 65 years (DE(E)). That the service should employ a suitably qualified and experienced Manager who is registered by the Commission of Social Care Inspection. 31st May 2005 Date of last inspection Brief Description of the Service: Oakland is a care home providing personal care for up to 40 older persons aged 65 years plus in two separate units. One unit provides residential care for 22 older persons (over the age of 65 years) and is located on the first floor of the home. The ground floor unit is registered for dementia care for 18 older people over the age of 65 years. The home does not provide nursing care. Accommodation is provided on both levels of the home. All bedrooms are single with a number providing ensuite facilities. A passenger lift services both levels of the home. Oakland is situated approximately 1 mile from the town centre. A regular bus service to the town centre can be accessed within several minutes walking distance of the home. A small car park is available to the front of the home, with the provision of a larger one to the rear of the home. The home is well sign posted and clearly visible from the main road. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 20th October 2005 by one inspector. A total of 6.5 hours were spent at the home. Time was spent time talking with 3 residents to see what they thought of the care they received, the staff group and the parts of the home they use such as their bedroom, toilets and bathrooms. Time was also spent talking with staff and looking at the records they complete for residents. A manager has recently been recruited to the home, and a large part of this inspection included talking with her about what improvements have been made since the last time the Commission For Social Care Inspection (CSCI) visited the home and how she intends to make sure the improvements made are maintained. What the service does well: What has improved since the last inspection? Records written by staff regarding how to look after the residents have improved and now provide a good description of the resident and detail the help they need, and what they can do for themselves. How often a resident likes to have a bath is written down and staff keep to this. Residents needs are now being met by staff reading what each residents needs are and then providing the care in a consistent manner. Residents spoken said they felt their “needs were being met”. Some extra training has been provided for staff, but this is not enough. A manager has been recruited for the home, and hopefully will continue to build relationships with residents, relatives and staff, and keep listening to what they say about the home and the areas which need to be improved. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 6 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. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 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 Oakland DS0000040406.V260104.R01.S.doc Version 5.0 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, – standard 6 is not applicable to this home. The assessment process in place provides staff with sufficient information to ensure that they are able to meet residents needs. EVIDENCE: Residents are admitted to the home following an assessment of their needs. This assessment is undertaken by the care manager of the local authority responsible for funding the place, or if the person is self funding this assessment is undertaken by the home’s manager. Copies of assessment information completed by care managers (single assessment documentation) is held on resident files and 3 files inspected contained this information. The home has in place a (new) separate assessment record which is used for all residents who are admitted onto the dementia care unit, and is completed by the home’s staff usually on admission. As the home has not had any admissions to the dementia care unit for some months, the manager has not had the opportunity to complete one of the new assessment forms for new residents. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 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, 8, 10 There is a clear and detailed care planning system in place that provides the staff with the information needed to meet the needs of the residents. Arrangements are in place for contacting and working with health care practitioners thereby ensuring that residents’ health care needs are met. EVIDENCE: At the last inspection, it was evident through discussions with staff and residents and on looking at documentation that the care plans in place did not fully detail resident’s needs, and that on occasion, the plan detailed was not followed by staff. Since the last inspection, Southern Cross has provided training to staff on the completion of care plans, and also provided better supervision to the senior staff to ensure that residents needs are not only detailed but are also met. Residents spoken with said they felt that they did receive adequate care, and that staff did attend to their needs. Residents confirmed that they were Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 10 bathed in accordance with their wishes, that they received their own clothes back from the laundry (although some issues still remain in respect of laundering of clothes), that staff were attentive, that they had access to other health professionals and saw their GP as they requested. Comments such as “its alright here”, “staff are good to me”, “staff help me” were made by residents. A number of care plans were looked at during this inspection. It was noted that the care plans now in place are very comprehensive, and demonstrate that a person’s personal hygiene needs have been attended to, recordings of visits made by the GP and district nurses are noted along with any treatment, and reviews of the care needs are noted monthly. Staff spoken to were conversant with the care plans in place. The inspector took time during the inspection to observe the interaction of staff with residents, and to look if the residents were appropriately dressed, clean, and in well fitting foot wear. Observations were that staff treated residents with respect and were at ease in conversations with residents and relatives. Residents were seen to be wearing appropriate clothing which was clean and crease free, and all residents were seen to be wearing either slippers or shoes, with staff observed to be vigilant in this area. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 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 the following standard(s): All these standards were inspected at the last inspection. EVIDENCE: Oakland DS0000040406.V260104.R01.S.doc Version 5.0 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 the following standard(s): 16, 18 The complaints procedure in place is well known to residents and relatives, and other systems also in place for seeking residents views on the service provided ensures that residents or their relatives are listened to, and their views taken seriously. EVIDENCE: Standards 16 and 18 were inspected at the last inspection, and whilst the home does have a complaints procedure in place, which is well known to residents and relatives, it was evident from the number of complaints which the home and the CSCI was receiving, that some residents and relatives were not satisfied with the care and facilities provided by the home. Since the last inspection, the CSCI has not received any complaints regarding the home, and of complaints received at the home, documentation shows only 1 to have been received and resolved. Southern Cross has (since the last inspection) made great efforts to stabilise the management of the home, and has improved its communication with residents and relatives through meetings, and sending out questionnaires. This has demonstrated a willingness to listen and to resolve any issues raised, before it becomes necessary for the relative or the resident to formally make a complaint. Residents spoken to said they felt the home was getting “better” and that any issues they raised with staff “got sorted”. The one area which seems to be a continuing concern to relatives (minuted in the relatives meeting of July 05) is laundry (particularly underwear not being washed and returned quickly Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 13 enough), and 1 resident spoken to (and further commented upon in resident questionnaires looked at) said they the washing and ironing of clothing “could be better”. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The home is reasonably well maintained providing a safe and comfortable environment for residents. EVIDENCE: The home is situated close to the centre of Rochdale, and has good transport links to the motorway and with the local bus service to Rochdale/Bury. The home is well signposted from the main road, has a car park to the front and rear of the premises, and has a small enclosed garden (with suitable sitting out furniture) for residents to use. A selection of bedrooms on the ground and 1st floor were inspected and seen to provide a reasonable standard of accommodation and furnishings. Residents spoken with were complementary about their bedrooms saying “they keep it clean, and its comfortable”, “I have all my furniture with me, and the family can sit in the room with me when they visit, its big enough for us all”. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 15 Sufficient toilets and bathrooms are available although it was noted that one bathroom is not used owing to the bath not having the provision of a hoist, which in effect puts increased pressure on the other bathrooms. The bathroom on the ground floor (on the dementia care unit) whilst generally adequate, the tiles to the lower half of the bathroom walls have seen better days and presented this bathroom in a fairly unattractive way, and it was the inspectors view these tiles needs some attention in order for the usage of this room to be more appealing for residents. Bedrooms, bathrooms and toilets inspected were seen to be clean. Lounge areas were comfortable and provided sufficient chairs and coffee tables for residents. The dining room floors (wooden effect) on both units had not been cleaned following breakfast, and had remnants of breakfast cereal and toast on them when the inspector was looking round just before lunch time. During lunch, a spillage occurred in the dining room on the 1st floor which care staff did not attend to, and was not attended to by the domestic until well after lunch – this spillage presented a slipping hazard. Residents spoken with did say they felt the home was cleaned to an acceptable standard. Signage to aid residents’ orientation on the dementia care unit has improved, but still needs to be better. The manager said she was in the process of addressing this, and was having pictures of toilets laminated to place on the toilet doors, which may aid some residents in identifying the location of the toilet. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 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 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 Sufficient staff are employed to meet the needs of the residents. Not all staff are suitably trained, thereby leaving residents at risk of not having their needs fully met. EVIDENCE: At the time of this inspection, the home was accommodating 16 residents on the residential care unit, and 14 residents on the residential unit. This provides the home with 10 vacant beds. Staffing levels provided were sufficient for the dependency and numbers of residents in situ, although the manager does need to remain mindful that as occupancy increases on both units, the current staffing level will not be sufficient. Staff were described by residents as “friendly”, “patient”, “helpful”. Training courses are run by Southern Cross and each home’s manager is required to ensure that staff are nominated and attend courses. This has been occurring at Oakland and the manager has a record of each member of staff and the course they have attended. This training profile is sufficient in establishing each individual’s training, but does not provide the manager with an overview of the staffing group and the training they have undertaken and where gaps in training for the staff group lie. It was established that of a staff group of 22 care staff most staff have undertaken moving and handling training, 8 staff have undertaken Protection of Vulnerable Adults training, 8 Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 17 staff have undertaken food hygiene training, 3 staff have attended a training session on “falls awareness”, 12 staff have attended training on COSHH, none of the staff were said to have had training in 1st aid (no certificates on site) although 3 staff are to attend 1st aid training booked for 30/11/05. Lack of dementia care training for staff who particularly work on the dementia care unit is an issue which has been raised in the past, and whilst training has been provided the turnover of staff is such that at any one time there are usually staff working on the dementia care unit who have not received training in dementia care. The formulation of a rolling programme which would encompass new staff (shortly after they commence employment) was discussed with the manager. It was established that dementia care training tends to be provided in-house either via the company’s dementia care specialist running a specific session at another home to which staff from other homes are invited, or through staff watching a video and having a group discussion at the home with their manager. Of the staff group of 22, only 6 staff have received any form of dementia care training. The manager of the home has also not received any form of in-depth dementia care training during her time with Southern Cross or with her previous employers. Only 4 of the care staff have undertaken NVQ2 training. The manager said she was aware of the shortfall in this training, and 2 staff were enrolling on the day of the inspection, with a further 4 identified to start in November. 2 personnel files were looked at and both seen to contain references and either a POVA 1st check request, or a CRB disclosure. It was noted that one application form did not fully detail the employee’s full employment history, and the manager had not sought further information on employment nor queried reasons for leaving previous employer. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 18 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, 32, 33, 34, 35, 36,38 The management of the home has been poor, and lacked consistency and leadership resulting in residents receiving a poor service with some of their needs not being met. The recruitment of a manager to this position has now been completed and should provide a stabilising effect for the residents and staff. EVIDENCE: Oakland has been without a registered manager in post since May 2004. Southern Cross have during this period of time put relief managers into the home whilst they recruited someone suitably experienced and qualified. During this time, the lack of a consistent experienced manager impacted directly on residents and staff resulting in some residents not having their needs met, and staff turnover increased. Complaints about the home also increased during this period. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 19 As of 1st August 2005, Southern Cross appointed a experienced manager to the home. This manager has stabilised the home, improved the quality of the care planning, and has worked hard to bring other documentation up to date. The manager has undertaken many short courses in respect of moving and handling, supervision of staff etc which demonstrates her commitment to learning. She has previously managed a home which contained residential and dementia care beds, and whilst she has undertaken a short day course in dementia care, she has not undertaken anything more in-depth or formal in respect of training in dementia care. The manager has completed her Registered Manager’s Award (RMA). The inspector recognises that the manger has not been managing the home for a significant period, therefore, greater comment on the management of the home will be made at the next inspection. The manager receives support from the Regional Manager on a weekly basis, although no record of the Regulation 26 visit (visit by the provider) could be located. The manager has recently circulated to residents a questionnaire on their level of satisfaction with the home. To date only 5 responses had been received which indicated general satisfaction with the exception of the laundry of clothing (underwear not being returned quickly enough) and food was “alright” for 1, “insufficient quantity” and “not enjoyed”, “vegetables too hard”. Discussion took place with the manager as to how these issues could be addressed. The manager has re-introduced relative meetings and staff meetings to which a representative of the resident group attends. The meeting with relatives showed a full and frank discussion from relatives regarding the areas in the home which need improving – laundry being an issue raised. Minutes of both meetings are available. All transactions undertaken by the administrator in respect of monies held on behalf of residents are computerised and subject to a regular audit by the Regional Administrator of Southern Cross. Appropriate insurance in respect of building, fixtures, fittings, public liability etc is in place. Arrangements in respect of health and safety were in place and satisfactory – records showed regular servicing to equipment. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 20 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 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 2 3 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 x 3 Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP18 Regulation 13(6) Requirement All staff must receive training in the Protection of Vulnerable Adults (previous timescales of 30th May 2005, and 30th June 2005 not met). All staff must receive training in respect of food hygiene, health and safety, and first aid. (previous timescale of 30th May 2005 and 30th June 2005 not met) The manager must ensure that residents clothing is laundered and returned in a timely manner, with particular attention paid to the quick return of underwear. Dining room floors must be cleaned after each meal time in readiness for the following meal, and any spillages which occur must be promptly and safely cleaned. All staff who work on the dementia care unit must receive adequate training in caring for people with dementia. A copy of the Regulation 26 visit undertaken by the provider’s representative is held on site at DS0000040406.V260104.R01.S.doc Timescale for action 31/12/05 2 OP30 18 31/12/05 3 OP26 16 30/11/05 4 OP26 23 10/11/05 5 OP30 18 31/12/05 6 OP36 26 10/11/05 Oakland Version 5.0 Page 22 7 OP29 17 the home. Employment histories submitted 10/11/05 as part of the recruitment process must be scrutinised, and any gaps in employment must be accounted for. 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 Refer to Standard OP19 OP31 OP19 OP30 Good Practice Recommendations The tiling in the ground floor bathroom should be attended to for this bathroom to be more inviting for residents. The manager should undertake some formal training in dementia care. Signage appropriate to the needs of people with dementia should be displayed to allow those who retain some capacity to remain orientated to the home. 50 of the care staff group should be trained to NVQ 2 by 2005. Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Oakland DS0000040406.V260104.R01.S.doc Version 5.0 Page 24 - 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!